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Falls and mobility

Falls and Mobility

Introduction

After a fall an older person has a 50% probability of having their mobility seriously impaired and a 10% probability of dying within a year (Help the Aged, 2008).  Falls within the older population is a big health risk, not only for those that suffer the fall but also for the healthcare system, falls and fractures within the over 65 years population account for over 4 million hospital bed days each year in England alone (Royal College of Physicians, 2010). 
 

Much of the falls data that is reported comes from the hospital data.  They record falls that result in hospital admissions, and rely on a fall being recorded as the reason for hospital admission in all cases where they were indeed the cause. Although considered robust this is not exhaustive, for example it does not consider falls that don’t lead to hospitalisation.  Oxford Brooks University have produced estimates of the total number of falls occurring in the population using self-reported falls from the Health Survey for England (2005).  The results for England show that females are at a greater risk of falling when compared with men, and that as age increases as does the number of falls.

     

This is a health risk with wide-reaching health implications that cannot be overlooked.

Current best practices and Strategic Drivers / links
National

Locally there are no falls specific strategies aimed at Falls, however it is covered under the Prevention Strategy and documents such as the Health and Wellbeing.

 

Wokingham Borough’s population is changing, with the introduction of multiple housing developments the population is set to grow, and with this the number of older people is predicted to increase. With this increase in population there will be a need to keep older people as active and independent as possible. One in three people aged over 65, and half of those aged over 80, fall at least once a year (Todd and Skelton 2004). Falls are the most common cause of death from injury in the over 65s, and many falls result in fractures and/or head injuries. Falls cost the NHS more than £2 billion per year and also have a knock-on effect on productivity costs in terms of carer time and absence from work (Snooks et al 2011).

 

Within Wokingham Borough there is programme called Steady Steps.  This is a specialist falls prevention exercise programme for people aged 60+ who have fallen or are worried about falling.  The programme is run over 30 weeks in blocks of 10 weeks at a time.  It is a group exercise with no more than 12 people in any one group.  It is a GP referral scheme so anyone participating must see their GP or other health professional first in order for them to generate a referral.

 

The SHINE programme, is aimed at keeping older people active, which in turn helps with health, stability and muscle tone which all contributes to helping to prevent falls.  Activities range from Line Dancing, Tai Chi, Pilates, Yoga and much more.  


Visit the SHINE webpage to find out how to join.

 

In addition to the physical activity based prevention services Wokingham Borough Council’s Occupational Therapist and Assessment teams accept referrals regarding falls. If necessary the teams will provide a home visit and undertake and environmental assessment which can lead to the instalment of grab rails. 
 

As well as the services ran by the Local Authority, Berkshire Healthcare Foundation trust has a falls prevention team that is able to come out and visit people in their own homes to identify and address any falls risks before they become a problem.

    

 Within Wokingham Borough 7380 people aged 65 and over are predicted to have a fall in 2015, with the figure predicted to increase to 11317 by 2030.  In addition to this 5001 people aged 65 and over in Wokingham are predicted to be unable to manage at least one mobility  activity on their own, this is predicted to increase to 8171 by 2030.

 

Source: Projecting Older People Population Information System

Figure 1 shows the number of injuries due to falls in people aged 65 years and over in 2013/14. This shows Wokingham to be lower than the National and South East averages. Figure 2, also shows the trend of falls in Wokingham Borough between 2010/11 and 2013/14, whilst still significantly below the National and South East levels, Wokingham is following the national trend and numbers are increasing.  
 

Figure 1 - injuries due to falls in people aged 65 years and over for the six Berkshire Local Authorities, 2013/14

Injuries due to falls in Berkshire

Source: Public Health Outcomes Framework

 

Figure 2 - Injuries due to falls people aged 65 and over, compared with England and the South East (2010/11 – 2013/14) 

Injuries in the over 65s

 Source: Public Health Outcomes Framework

A number of inequalities have been identified across the Borough. 

  •  People living with Dementia are being referred to the Steady Steps service and due to their Dementia they cannot partake in the current service.
  • there is now a falls prevention class running once a week with dementia focus.    
  • The demographic of individuals accessing the steady steps service have either experienced a fall or are worried about it, which can lead to decreased mobility and ability to get around, for this reason transport is an issue for some people within the Borough.  Therefore, those living within the Borough who cannot afford taxis, without a convenient bus route or a person to drive them have difficultly accessing the service.


Based on the identified inequalities there is a need to for a falls prevention service for people living with Dementia and a requirement for the issue of transport to be addressed.


Recommendations for consideration by other key organisations such as: CCG’s, General Practices, Local Authority department e.g housing and other providers.

  •  A deeper insight of transport issue is required for any solution to be identified
  •  Look into the provision of a falls service for people living with Dementia

Chapter last updated on the 12th of December 2016