Right Side Up Falls Prevention

Description

Falls account for the leading cause of injury-related deaths in adults ages 75 and over. Annually, more than 1 in 4 individuals over the age of 65 fall each year, but less than half tell report it to their doctor. The Right Side Up program was developed with the goal of providing a comprehensive and organized continuum of care for the prevention and management of falls and falls risks in rural, elderly individuals.

An interprofessional falls and prevention team is made up of pharmacy, medical, and physical therapy students as well as a public health nurse, physical therapist, occupational therapist, nurses, and clinical pharmacists.

Right Side Up offers services to elderly community members in rural Otter Tail County who have a history of falls or are at risk for falling. Primary risk factors for falls include:

• Medical conditions
• Multiple medications
• Environmental hazards
• Vision and balance age-related changes

This program previously received funding through a Medical Education and Research Costs Grant and a U.S. Department of Agriculture Rural Health and Safety Education Grant.

Partners of the Right Side Up program include:

• Lake Region Healthcare
• Otter Tail County Public Health Department

Services offered

An interdisciplinary healthcare team made up of medical professionals and students assesses the individual's risk for falling and provides falls prevention recommendations based off of the completion of an in-home assessment. Referrals to this program can be made by family members or healthcare providers. At a typical home visit:

• A nursing and environmental assessment is given by a public health or home health nurse (and occasionally a nursing student)
• All prescription and over-the-counter medications are individually reviewed by a pharmacy student
• The community member's clinical record and laboratory tests are reviewed by team members, if available
• A physical therapy student conducts strength and balance assessments
• Occupational therapy, medical, and nurse practitioner students may participate as well

Common falls prevention recommendations include:

• Replacing slippery rugs with non-skid rugs
• Safety bar installation
• Improved nutrition, strength, and increased activity level
• A physical therapy or occupational therapy consult
• Medication adjustments to minimize dizziness, lethargy, or light-headedness

At a meeting where the entire team is gathered, the students propose falls prevention recommendations specifically catered to what they found at each in-home assessment. After a discussion takes place among the interdisciplinary team, written recommendations are sent to the individual who had the assessment, and/or their family member, as well as their primary care provider.

Results

Short-term outcomes:

Telephone interviews were conducted and data was obtained from 11 out of 16 visits that had been performed within a 6 month time span. Data was acquired from 7 patients and 6 caregivers, and the time since the visit averaged 3.5 months. Results showed:

• 100% found the visit and recommendations to be helpful
• 78% made a change to reduce falls
• 57% discussed recommendations with their primary care provider
• 17% had falls after the visit
• 86% thought the visit would be beneficial for others

In 2011, Right Side Up received the Minnesota Rural Health Team of the Year Award for its compassionate efforts to decrease fall risk and increase quality of life among senior citizens within the county.

Challenges

Differing schedules among participating healthcare professionals, students, patients, and their caregivers can pose as a challenge for coordinating home visits as well as follow-up evaluations.

Replication

For more information on Right Side Up, see the Summary, Goals, Methods, and Impacts of the Otter Tail County Health Aging Collaborative.

View this article on Lake Region Healthcare's website for more information on the program's positive community impact and grant success.

Contact Information

Mark Dewey, Pharm. D., Right Side Up Coordinator
Lake Region Healthcare
Right Side Up
218.736.8057
mwdewey@lrhc.org