It takes a village to prevent falls: reconceptualizing fall prevention and management for older adults

Abstract

Systematic evidence reviews support the efficacy of physical activity programs and multifactorial strategies for fall prevention. However, community settings where fall prevention programs occur often differ substantially from the research settings in which efficacy was first demonstrated. Because of these differences, alternative approaches are needed to judge the adequacy of fall prevention activities occurring as part of standard medical care or community efforts. This paper uses the World Health Organization Innovative Care for Chronic Conditions (ICCC) framework to rethink how fall prevention programs might be implemented routinely in both medical and community settings. We highlight examples of innovative programs and policies that provide fall prevention strategies consistent with the ICCC framework, and provide evidence where available on the effects of these strategies on processes and outcomes of care. We close by proposing a “no wrong door” approach to fall prevention and management, in which older adults who are found to be at risk for falls in either a medical or community setting are linked to a standard fall risk evaluation across three domains (physical activity, medical risks and home safety).

Lesões graves em vítimas de queda da própria altura

“…In spite of some debate, prevention programs seem to have positive effect, but their application is difficult. 19,21,[26][27][28][29][30] However, we have observed, in our date, that only 32.1% of FSL victims are aged over 60. In spite of its severity among the elderly, this trauma mechanism involves a greater number of patients with their own characteristics.…”

Integrated care for chronic conditions: The contribution of the ICCC Framework

“…Examples of its use as a reference framework for analysis include evaluations by the Centre for Health Policy, Planning and Research at the University of New England in Maine, USA [65,66], an evaluation of podoconiosis treatment and prevention in Ethiopia [67], an assessment of fall prevention interventions [68], and a review of patientreported outcome metrics in chronic conditions [69].…”

Validity and reliability of the Chinese translation of the Physical Activity Scale for the Elderly (PASE)

“…Conversely, increased physical activity is associated with, among others; a healthy body mass index (BMI), [11] better mental health [12,13] dynamic balance [14] and a decreased risk of falls [15]. Despite the obvious health benefits of physical activity, 63% of all Canadians are not sufficiently active to benefit their health [16] with 17% of those under the age of 64 being completely inactive compared to 29% of adults 65 and older [17].…”