Master Presentation PART 1 NCOA TBI CG edits (1)...(TBI) Non-Traumatic Brain Injury (ABI) Definition of Acquired Brain Injury No external force to the head An external force to the

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National Association of State Head Injury Administrators | NASHIA.org

FallsandBrainInjuriesAmongOlderAdults

Part1:Connection,Prevention,andResources

October 19, 2018


KeriBennett(NE),ChairNASHIATrainingandEducationCommittee

WebinarModerator

HaleighCushen,NASHIAMembershipServicesandTraining&Education

[email protected]


u  NoCosttoAttendu  CertificatesofParticipationavailablethroughNASHIA.org

ª  $10forMembersª  $15forPotentialMembers

u  RecordingAvailableª  Linkincludedinafollow-upemailª  ArchivedatNASHIA.organdNCOA.orgforlaterviewingª  CertificateofParticipationwillbeavailableafterviewing

archiveu  Q & A at the end of webinar if time allows

u  Handouts


Objectives: u  Impactandprevalenceoffallsandtraumaticbrain

injuries(TBI)amongolderadults

u  RiskfactorsforfallsandTBI

u  Fallriskandbraininjurydetectionassessments

u  ResourcesandprofessionalsavailabletoassistindividualswithpreventingfallsandTBI

u  StrategiesforserviceprovidersworkingwitholderadultsandwithindividualswithTBI


Presenter from National Association of State Head Injury

RebeccahWolfkiel,M.P.PExecutiveDirector

NASHIA

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Presenter from National Association of State Head Injury

GabrielaLawrence-SotoGrantProjectManager

MassachusettsRehabilitationCommission

StatewideHeadInjuryProgram(SHIP)


Presenter from National Council on Aging

KathleenCameron,M.P.H.

SeniorDirectorCenterforHealthyAging

NCOA


Presenter from National Council on Aging

ChelseaGilchrist,M.G.S.SeniorProgramManagerCenterforHealthyAging

NCOA


NASHIAisanonprofitorganizationcreatedtoassistStategovernmentinpromotingpartnershipsandbuilding

systemstomeettheneedsofindividualswithbraininjuryandtheirfamilies.


TheRoleoftheNationalAssociationofStateHeadInjuryAdministrators(NASHIA)

u  Only organization to represent State employees working to support individuals with brain injury and their families.

u  Founded in 1989

u  Membership:

ª  State Employees in Various Agencies

u  Public Health, Vocational Rehabilitation, Medicaid, Mental Health, Education, Developmental Disabilities, Aging

ª  Advocacy Organizations

ª  Health Care and Service Providers

ª  Individuals and Families with Lived Experience


WhatWeDou  Advocacy

ª  Funding:TBIActprograms(ACL/CDC);NIDILRRResearch;DODResearch;andVArehabilitationprograms

ª  Legislation:TBIAct;JuvenileJusticeandDelinquencyPreventionAct;OlderAmericansAct;ViolenceAgainstWomenAct;andmore

ª  CongressionalTBITaskforceandMarchTBIAwarenessDay

u  Trainingª  Webinars:ProfessionalEthics;PersonCenteredPlanning;PartnershipswithProtection&

Advocacy;andOlderAdultFalls/BrainInjurySeries

ª  AnnualSOSConference

u  TechnicalAssistanceª  StateTA:StatePlansandStateSystemDevelopment;DedicatedFundingSources/TrustFunds;

Registries;MedicaidWaivers;BrainInjuryCouncilDevelopment;Advocacy;andmore

ª  FederalTA:HRSATBIProgramTAC;ACLNationalCenterforAdvancingPersonCenteredPlanningSystems(NCAPPS)

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StateTBIPrograms+

NCOAFallsPreventionResourcesTheChallenge:

Addressingthelinkbetweenfallsandbraininjuries.TheObjective:

1)  Educatestakeholdersonresourcesavailabletopreventfalls.

2)  InspireStatesystemsofcarethatidentifyandserveindividualsthathavesustainedafalls-relatedbraininjury.

Improving the lives of 10 million older adults by 2020 | © 2018 National Council on Aging 14


About NCOA

Who We Are: NCOA is the national voice for every American’s right to age well

Our Vision: A just and caring society in which each of us, as we age, lives with dignity, purpose, and security


How We Accomplish Our Mission

•  Innovative Programs: NCOA’s online and in-community programs empower individuals to take small steps that can significantly improve their daily lives.

•  Advocacy: NCOA works in a bipartisan manner to protect and improve federal programs that Americans depend on, like Medicare, Medicaid, and the Older Americans Act.

•  Partnerships: NCOA supports a national network of local partners that provide personalized services to help individuals stay healthy and economically secure as they age.


NCOA’s Center for Healthy Aging

§  Goal: Increase the quality and years of healthy life for older adults and adults with disabilities

§  Two national resource centers funded by the Administration for Community Living q  Chronic Disease Self-

Management Education (CDSME) q  Falls Prevention

§  Other key areas: Behavioral health, physical activity, immunizations, oral health


National Falls Prevention Resource Center

Increase public awareness about falls prevention Serve as the national clearinghouse for tools and resources Support and stimulate evidence-based programs and strategies www.ncoa.org/healthy-aging/falls-prevention/

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National Resource Center Technical Assistance Activities

One-on-one support

Annual meeting

National Falls Prevention Database

Learning collaboratives Webinars Online tools

and resources

Best practices Networking Work groups


National Falls Free ® Initiative

•  A thousands-strong and growing network •  National Action Plan developed in 2005; updated in 2015 •  Strong partnerships

–  ACL and the Aging Network –  CDC’s National Center for Injury Prevention and Control –  National professional and consumer organizations –  State and local public health entities

•  Falls Free® is a critical effort to meet Healthy People 2020 goals of reducing older adult fall-related ED visits by 10%

•  43 State Falls Prevention Coalitions


Older Adult Falls in the U.S. Falls are common •  Falls are the leading cause of fatal injury and the most common cause of nonfatal

trauma-related hospital admissions among older adults. •  One in four Americans aged 65+ falls each year. •  Every 11 seconds, an older adult is treated in the emergency room for a fall; every

19 minutes, an older adult dies from a fall.

Falls are costly •  In 2015, the total cost of fall injuries was $50 billion. Medicare and Medicaid

shouldered 75% of these costs. •  The financial toll for older adult falls is expected to increase as the population ages

and may reach $101 billion by 2030. Source: CDC https://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html


Older Adult Falls in the U.S.

Predictable •  Physical, behavioral, and

environmental risk factors

Largely Preventable •  Everyone has a role to play

and can make a difference within their own sphere of influence.

Source: CDC https://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html

Traumatic Brain Injury (TBI) Basics

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ContinuedTBIEducation

BrainInjuryAssociationofAmerica-www.biausa.orgUnitedStatesBrainInjuryAlliance– www.usbia.orgNationalAssociationofStateHeadInjuryAdministrators-ArchivedWebinarsonTBI–nashia.org

•  Fall-RelatedTBIsAmongOlderAdults.-Wednesday,September30th,2015https://register.gotowebinar.com/recording/5029880138063866113

•  IntroductiontoTraumaticBrainInjury-Tuesday,September8,2015https://register.gotowebinar.com/recording/1897490257299531778

AcquiredBrainInjury(ABI)

TraumaticBrainInjury(TBI)

Non-TraumaticBrainInjury(ABI)

DefinitionofAcquiredBrainInjury

Anexternalforcetothehead

Noexternalforcetothehead

AnABIisaninsulttothebrainthat•  Hasoccurredafterbirth•  Isnothereditary•  Isnotcongenital

•  Traumaticbraininjuryistheleadingtypeofbraininjury.•  Frontallobeinjuriesarecommon–Impairingexecutivefunction•  75%ofTBlsareconcussions•  Concussionsarealsoknownasformofmild-TBI

• 

HowPeopleAcquireBrainInjuriesNon-Traumatic

•  Infection(Meningitis,HIV)•  Neoplastic(tumor,cancer)•  Vascular(stroke,aneurysm)•  Metabolic(anoxia,hypoxia)•  Neurotoxic(leadpoisoning)•  Demyelinating/Dementing–(MS,Parkinson)

TraumaticUnintentionalCauses

•  Falls•  Motorvehicle•  Sports/Recreationactivities•  Work/Industrialrelated

IntentionalCauses•  Assaultsorattacks•  Militarycombat–blastInjury•  Violentcriminalbehavior•  Homicide/Suicideattempts•  Domestic/Datingviolence•  Elder/Childabuse/Shaken

baby

BrainFunctionMOTORAREA•voluntarymovementFRONTAL

•attention•motivation•emotions•judgment•problemsolving•decisionmaking•speech

PARIETAL•senseoftouch•sensations•visualperception•spatialperception

OCCIPITAL•sight

CEREBELLUM•balance•coordination•skilledmotoractivity

BRAINSTEM•sleep•heartrate•breathing

TEMPORAL•memory•understandinglanguage•smell•taste•sound

NationalEpidemicApproximately5.3millionpeoplearecurrentlylivingwithaTBIrelateddisability.2.8millionpeoplewerediagnosedwithaTBI(CDC).Ofthisgrouptherewere:

•  2.5millionEmergencyDepartmentvisits•  282,000TBIrelatedHospitalizations•  50,000TBIrelatedDeaths

0

500,000

35-44 45-54 55-64 65-74 ≥75

EstimatednumberofTBI-relatedEDvisitsattributedtounintentionalfalls,2007and2013

2007 2013National Association of State Head Injury

Administrators | NASHIA.org

Leading Causes of TBI General Population u  Falls – 40.5%

u  Unknown – 19%

u  Struck by/against – 15.5%

u  Motor vehicle – 14.3%

u  Assaults – 10.7%

Adults 65+ years u  51 % - Falls

u  22 % - Unknown (may include cases where senior abuse is suspected)

u  18 % - Other (e.g. assaults, struck by object)

u  9 % - Motor Vehicle Accidents

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Demographics u  Overall population u  The two age groups at highest risk for TBI are

•  0 to 4 year olds •  15 to 19 year olds

u  Adults over the Age 65+ •  The fastest growing TBI population

u  Males •  Males 1.5 to 2 times more likely than Females to sustain TBI

u  Females over the Age 80+ •  Females more than Males likely to sustain TBI •  Female longevity

AdditionalRiskFactorsforFallsandTBI•  Structuralchangesinthebrain(e.g.,Atrophy)•  Complexmedicaldiagnosis

•  Visionchanges•  issuewithlightsensitivity.•  Blurredvision,especiallywithseeingupclose•  Doublevision,Decreasedperipheralvision

•  Dizziness,Vertigo•  30-65%ofpeoplewithTBIsufferfrombalanceproblems

•  Seizuresdisorder-developsin1in10peopleafterinjury•  ChronicpainmayoccurafterTBI•  SubstanceUseDisorders

•  10-20%ofTBIsurvivorsdevelopSUDwithinthefirstyearofinjury.•  Mentalhealthdisorders

•  50%ofTBIsurvivorsexperiencedepressionwithinthefirstyearofinjury.•  NearlyTwo-thirdsareaffectedwith7yearsafterinjury•  71%ofpeoplewithTBIarefrequentlyirritable•  Increaseriskforsuicidesthangeneralpopulation


Risk Factors continued… u  Med Management challenges

ª  Issues with follow through or refusal ª  Side effects

•  Sedation (e.g., increases fatigue and/or balance impairments)

•  Blood thinners (e.g., Coumadin) increased bleeding w/ falls

u  Environmental hazards (Hoarding) u  Vulnerability for abuse and exploitation u  History of previous brain injuries (ABI/TBI)


TBI Interventions ACUTE INTERVENTIONS

•  ED Services •  Specialized Inpatient Care •  Evaluation and Treatment by Medical

Specialists

POST-ACUTE INTERVENTIONS •  Inpatient / Outpatient Rehabilitation •  SNF / Long-Term Care Facility •  Community-Based Supports

Cognitive•  CommunicationIssues•  PoorConcentration•  Disorientation•  MemoryProblems•  PoorOrganization•  SlowProcessingSpeeds•  PoorInitiative•  LackFollowThrough•  PoorJudgement

Emotional•  Anger•  Anxiety•  Depression•  Irritability•  PersonalityChanges•  InabilitytoControlEmotions

Physical•  Dizziness•  Fatigue•  Headache•  Motorimpairment•  Changesinsensoryfunctionssuchashyposensitivitytolightorsoundsorsensoryloss

ConsequencesofBrainInjuries

Families&Caregiver•  Canfeeltrapped,isolated,abandoned•  Canbecomebetargetsofabusebysurvivor•  CanbeannoyedandimpatientwithsurvivorServiceProviders•  Mayendservicespre-maturelywhenlabelingsurvivorsasresistant,aggressive,disinterested,

notmotivated,lazy,ornoncompliant.•  Survivorscanovertimeburnbridgeswithserviceproviders•  Patience,accommodatingsymptomsofTBIandconnectingtobraininjuryservicescanhelp.

Brain Injury Detection Assessments

& Resources

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ImportanceOfScreening•  BrainInjuriesareasilentepidemic.•  Peoplemay“appear”normal.•  TheeffectsofaTraumaticBrainInjury(TBI)varyforeachperson.•  SymptomsofTBIsoftengoundiagnosed,misdiagnosedormistreated.•  Anundiagnosedbraininjurycanmaskotherillnessorconditions.•  Individualsmaynotknowtheyhavebeenexposedtoabraininjuryor

understandtheirlimitationsasaresultsofthebraininjury.•  Individualsarenotalwaysconnectedtobraininjuryservices.

Considerscreeningforabraininjurywhenyouhaveasuspicion!

•  TheHELPSBrainInjuryScreeningTool•  TheOSUTBI–IDMethod


TBI or Something Else?

u  Poor Nutrition u  UTI u  Bipolar Disorders u  Depression u  Substance Use

Disorders

u  Sleep Disturbances u  Headaches /

Migraines u  Learning Disabilities u  ADHD/ADD

Conditions that may mimic symptoms of TBI include:

DetectionTool#1:TheHELPSBrainInjuryScreeningToolDevelopedbydevelopedbyM.Picard,D.Scarisbrick,R.Paluck,9/91ItisanationallyrecognizedeasyScreeningToolwhichcan

•  DetectsANYBrainInjury(ABIsandTBIs)•  CanbeappliedtoANYAgeorsubpopulation•  CanbeimplementbyANYperson–regardlessofeducationlevel•  InANYSetting

H-HityourHeadE-Emergencyroom,HospitalorDoctorL-Loseconsciousness,DazedorConfusedP-ProblemsexperiencedsinceHittingHeadS-Sicknesses

ToaccessthistoolvisittheNASHIAsiteatwww.nashia.org/pdf/hotopics/pa-helps-screening-tool.pdf

DetectionTool#2:OSUTBI-IDMethodOhioStateUniversityTraumaticBrainInjuryIdentificationMethod-  DevelopedbyDr.JohnCorriganandteamattheOhioValleyCenterfor

BrainInjuryPreventionandRehabilitation-  GearedforHealthcareandsocialserviceprofessionals-  Standardizedprocedureforelicitingaperson’slifetimehistoryofTBIviaa

3-5minutestructuredinterview.-  DetectshistoryoflifetimeexposureofTraumaticBraininjuries(Only)-  Assessapersonscognitiveandemotionalstate-  Canusedtoinformapproachoftreatmentandservicesbeingprovided-  Toaccessthetoolandeducationalvideovisitwww.

ohiovalley.org/tbi-id-method/

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Interdisciplinary Approach u  Primary Care Physician u  Neurology u  Neuropsychologists u  Behavioral Health Services

ª  Psychologist ª  Social Workers ª  Substance Use Treatment

u  Rehabilitative Therapies ª  Physiatrist ª  Physical Therapy ª  Occupational Therapy ª  Speech and Language

Therapy ª  Recreational Therapy

u  Brain Injury Support Groups u  Case Management

u  Vocational u  Socialization Opportunities

ª  Day programs

ª  Senior Centers ª  Recreational groups

u  Transportation

u  Community Living Supports ª  Home Making Services

ª  Personal Care Aide

ª  Money Management

ConnectingToBrainInjuryServicesBrainInjuryAssociationofAmerica-https://www.biausa.org/UnitedStatesBrainInjuryAlliance-http://usbia.org/

•  Independent,non-profitnationalorganization

•  Servesforallages,alltypesofbraininjuriessurvivors,families,caregivers,professionalsandnon-professionals.

Theycanconnectyouto:•  SupportGroupsforsurvivorsandcaregivers•  InformationandReferraltosurvivors,caregiversandprofessionals•  BrainInjuryPreventionPrograms•  EducationandAdvocacy

Strategies for Service Providers

PhysicalEffectsofTBI

DizzinessFatigue

HeadacheMotorImpairmentChangesinsensoryfunction

ü Hypersensitivitytolightandorsound

Strategiesmayinclude:•  Frequentshortbreaksorrestperiods.•  Helpindividualdeterminebesttimeofdayforwork,

someindividualstireinearlyafternoon,othershavemoredifficultiesinthemorning.

•  Presentinformationinsmallsegments,watchforsignsofoverload.

•  Startwithshortershifts,enduranceoftenbuildsintime.

•  Reviewsleeproutine•  Useofearplugsorglassestofilterlightorsound•  Adjustlightingwhenpossible•  Facilitateaccesstoquiet/lessstimulatingspaces•  Assistwithreinforcingrecommendationsmadeby

PT/OT/SPtherapistsandothermedicalproviders•  Cuingtomoveslowlyandusemobilityassistive/

adaptivedevicesasprescribed.

Notethatfatigueandsleepdisturbancecanaffectattentionandconcentration.

CognitiveEffectsofTBIStrategiesmayinclude:•  Presentinfoslower,sayonethingatatime•  Bemindfulofpacing.Watchforsignsof"overload"or

fatigue.Askindividualtorepeatbackorsummarizetheinfoprovided.

•  Bepatientforresponse–Allowforprocessing•  Watchforfrustration,personfeelingoverwhelmed•  Adjustenvironment/decreasedistractions•  Developamemorysystem,routine/organization•  Memorybooks,calendars/smartphones•  Discussions-repeat,review,paraphrase•  Wellorganizedschedulesandroutines•  Clear,repetitivetasksanddirections•  Uselabels,highlightersand“ToDo”lists•  Haveappropriatebreaksandchoices•  Cleartransitionroutines•  Scriptsaboutsituations•  Monitorprogressandadjustasneeded

CommunicationConcentrationDisorientation

MemoryOrganizationProcessingInitiativeJudgement

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EmotionalEffectsofTBIAngerAnxiety

Depression

IrritabilityPersonalitychangesInabilitytocontrol

emotions

Strategiesmayinclude:•  Remaincalmandmodelappropriatereactions•  Givesuggestionsformaintainingandregainingcontrol

•  Avoidsituationsthattriggeruncontrollableemotionalreactions,redirectwhenpossible

•  Encouragerestbreaks,reviewconsequencesofbehaviorwithsuggestionsonhowtoremedytheproblem/issue/situation.Praiseonceincontrol.

•  Redirectandmodelofsubstituteappropriatebehaviors•  Recommendgroup/peeractivitiestofacilitateappropriatebehaviors.Praisepositive

behaviors.•  Avoidsituationsthattriggeruncontrollableemotionalreactions,redirectwhen

possible.•  Establishboundariesandfocusonprogress.

•  Encouragecooperativebehavior•  Redirectinappropriatebehavior.Verbalizeimpactonothers.Holdindividual

accountablefortheirownactions,naturalconsequencesareavaluableteachingtool.•  Userole-playingtopracticeinterpersonalskills.

•  Avoidcomparisonstohowtheywerepriortoinjury.•  Considerpeerorgroupactivitiestofacilitateappropriatebehavior

Fall and Brain Injury Prevention Strategies


Individual Prevention Strategies u  Education

ª  Dissemination of resources and information about their risk for falls.

u  Home and Safety evaluations ª  Declutter/organize for free unobstructed movement

ª  Improve lighting and visibility

ª  Replace or repair damaged flooring, rugs, stairs, railings, etc.

u  Medication Monitoring ª  Make sure that side-effects are understood by the individual and

monitored by the prescribing doctor(s)

u  Home Modifications ª  Installation of ramps, bathroom remodels, lifts, electric door opener, etc.


Individual Prevention Strategies

u  Aiding them to make better-choices

Adjust their day to day habits in a variety of areas, including ª  Regular vision checks

ª  Acquire appropriate adaptive devices and medical equipment (from eye wear, mobility devices, transfer equipment, etc.).

ª  Wearing proper footwear when ambulating

u  Rehabilitative Therapies ª  Initiate or facilitate touch up of occupational therapy and/or physical

therapy

u  Balance Training Programs ª  with medical approval connect individuals to balance training programs

(e.g., Tai-Chi).

u  ...and more which will covered by our NCOA partners!

REFEFERENCES•  CenterforDiseaseControlandPrevention(CDC)-https://www.cdc.gov/traumaticbraininjury/severe.html•  CDC-https://www.cdc.gov/traumaticbraininjury/get_the_facts.html•  CDC-https://www.cdc.gov/traumaticbraininjury/outcomes.html•  BrainInjuryAssociationofAmerica-https://www.biausa.org/•  UnitedStatesBrainInjuryAlliance-http://usbia.org/•  Taylor,C.A.,Bell,J.M.,Breiding,M.J.,&Xu,L.(2017).TraumaticBrainInjury-RelatedEmergencyDepartment

Visits,Hospitalizations,andDeaths-UnitedStates,2007and2013.Morbidityandmortalityweeklyreport.Surveillancesummaries(Washington,DC:2002),66(9),1-16.

•  OSU-TBI-IDMethod-OhioValleyCenterforBrainInjuryPreventionandRehabilitation-http://ohiovalley.org/tbi-id-method/

•  HELPSBrainInjuryTool–NASHIAhandout-https://www.nashia.org/pdf/hotopics/pa-helps-screening-tool.pdf.TheOriginalHELPSTBIscreeningtoolwasdevelopedbyM.Picard,D.Scarisbrick,R.Paluck,9/91,InternationalCenterfortheDisabledTBI-NET,U.S.DepartmentofEducation,RehabilitationServicesAdministration,Grant#H12800022.TheHELPStoolwasupdatedbyprojectpersonneltoreflectrecentrecommendationsbytheCDConthediagnosisofTBI.

•  ModelSystemsKnowledgeTranslationCenter–TraumaticbrainInjury-https://msktc.org/tbi/factsheets•  MassachusettsTraumaticBrainInjuryinElderswebcourse-https://elderswebcourse.org/

Gabriela Lawrence-Soto, Grant Project Manager Massachusetts Rehabilitation Commission (MRC)

Community Based Services Department Statewide Head Injury Program (SHIP)

Email: [email protected]

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You CAN change You CAN’T change

•  Physical inactivity •  Muscle weakness •  Home environment •  Vision •  Medication Use •  Fear of falling •  Social isolation •  Improper use of

assistive devices

•  Age •  Gender •  Ethnic background

Fall Risk Factors


Risk Factors for Fall-Related TBI

•  Gender – men more likely to suffer moderate/severe TBI than women

•  Medication – older adults taking antiarrhythmic medication more likely to suffer a fall-related TBI

•  Activity during a fall – older adults who fall climbing stairs or transferring from a chair or bed are more likely to suffer a moderate/severe TBI compared to those who fall while walking

•  Direction of fall – older adults who fall backwards or sideways are more likely to suffer a moderate/severe TBI compared to those who fall forward.


Fall-related TBI prevention

•  Fall prevention can help reduce incident of TBI

•  Example: Connecticut Collaboration for Fall Prevention –  Compared the rate of hospitalization for fall-related TBI in older adults (≥ 70

years old) between a treatment region or a usual care region.

–  Clinicians in the treatment region translated fall prevention protocols and procedures into clinical practice.

–  Rate of hospitalization for the treatment region was significantly lower compared to usual care.

–  Results suggest that engagement of practicing clinicians in the use of evidence-based fall prevention practices may reduce hospitalizations for fall-related TBI.


Adverse Consequences of Falls for Older Adults

•  Serious injuries – traumatic brain injuries, hip and spinal fractures, brain injuries, broken bones, e.g., wrist, femur

•  Increased fear of falling and restriction of activities, social isolation, depression, helplessness

•  Decreased ability to function •  Loss of independence and reduced quality of life •  Increased risk of premature death


Fall Risk Assessment: CDC STEADI Toolkit Stopping Elderly Accidents, Deaths and Injuries (STEADI) Toolkit

§  Based on the AGS/BGS Falls Prevention Guidelines (evidence-based)

§  Materials for providers and patients

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CDC STEADI Tool Kit

Comprehensive Approach •  Screening •  Assessment of risk factors •  Intervention to address risk factors

–  Exercise – strength & balance –  Clinical – Geriatric care to address chronic conditions,

medication, vision, nutrition –  Home assessment and modification for fall hazards

•  Full tool kit available at https://www.cdc.gov/steadi/materials.html


Fall Risk Assessment: Checklist

•  Available at https://www.cdc.gov/steadi/pdf/STEADI-Brochure-StayIndependent-508.pdf


Fall Risk Assessment

•  Algorithm for fall risk screening, assessment, and intervention

•  Available at https://www.cdc.gov/steadi/pdf/STEADI-Algorithm-508.pdf


Fall Risk Functional Assessments

•  30-Second Chair Stand Test •  4-Stage Balance Test •  Timed Up and Go (TUG) Test •  Measuring Orthostatic Blood

Pressure


Postural Hypotension

•  Checking PH routinely in all elders is critical and often overlooked.

•  PH is defined as > 20 mmHG drop in systolic Bp or > 10 mmHG drop in diastolic

•  Does the elder report falling back into chair during sit to stand?


STEADI Resources for Clients and Patients www.cdc.gov/steadi/index.html

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Falls Prevention Professionals


Falls Prevention Professionals

•  Occupational Therapists

•  Physical Therapists

•  Home Safety and Modification Experts


Falls Prevention Professionals •  Pharmacists

•  Community-Based Exercise and Fall Prevention Program Leaders (i.e., senior centers, YMCA)

•  Professionals in aging and health care (i.e., Area Agencies on Aging)


State Falls Prevention Coalitions

https://www.ncoa.org/resources/list-of-state-falls-prevention-coalitions/


Falls Prevention Coalitions

Home Health Fire Department

EMS/1st Responders Professional Associations

(OT, PT, RN) Senior Housing

Many Others

Public Health

Aging Services Network

Health Care Providers


National Fall Prevention Awareness Day (FPAD)

§  FPAD is held each year on the first day of fall: September 23, 2019

§  Raise awareness about how to prevent fall-related injuries among older adults.

§  View the FPAD Impact Reports for event, activity, and partnership ideas

–  Public awareness activities –  Professional education –  Physical activity events –  Falls risk screening fairs –  Medication review –  Enrolling older adults in evidence-based falls

prevention programs

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FPAD Resources

•  General Resources •  Marketing & Media •  Past Activities •  Advocacy •  How to Get Involved •  Visit www.ncoa.org/FPAD


Falls Prevention Resources


NCOA Falls Prevention Resource Clearinghouse

•  Filter by Audience o  Older Adults & Caregivers o  Professionals o  Advocates

•  Filter by Type o  Document o  Video o  Template o  Webinar o  Image

•  Visit https://www.ncoa.org/resourcetype/falls-prevention/


Infographics and Handouts •  Falls Prevention Fact Sheet •  6 Steps to Prevent a Fall Infographic •  6 Steps to Protect Your Loved One from a

Fall •  Winterize to Prevent Falls •  Osteoarthritis and Falls •  Osteoporosis and Falls •  Falls Prevention Programs: Saving Lives,

Saving Money Infographic


Videos •  6 Steps to Prevent a Fall •  You Have the Power to

Prevent a Fall •  Medication Management Tips

and Strategies •  Navigating Outdoor Fall

Hazards •  18 Steps to Modify Your Home •  Falls Free ® Video Contest

Winners


Caregiver Education

•  Why falls prevention is important. •  Caregivers can participate, too! •  Falls prevention basics. •  Step 1: Is it time to talk? •  Step 2: Who and how to talk to others who

may be involved. •  Step 3: Develop a falls prevention action

plan. •  Perspectives: You are not alone. •  Additional Resources.

Falls Prevention Conversation Guide for Caregivers

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Home Safety

Home Safety and Home Modification Resource Inventories •  Evidence-Based Programs, Best Practices in Home Modification

•  Home Assessment Tools

•  Home Modification Funding Resources

•  Visit: http://stopfalls.org/resources/home-modification-tools-programs-and-funding-landingpage/


Medication Management

ASCP/NCOA Falls Risk Reduction Toolkit •  Falls Risk Checklist •  Falls Application Cases •  Communications Documents •  Build Your Referral Network •  Bibliography

Visit: www.ascp.com/page/fallstoolkit


Medication Management

•  Bemedwise.org o  Medication Use Safety Training for Seniors (MUST for Seniors): Toolkit provides educational

materials on avoiding medicine mishaps, managing side effects, and improving medicine use knowledge.

•  Beers Criteria for Potentially Inappropriate Medication Use in Older Adults

•  Medication-related interventions o  HomeMeds Medication Safety Program o  Screening, Brief Intervention and Referral to Treatment o  Medication reviews and brown bags


Join Us!

•  Visit ncoa.org and sign up for enews

•  Follow @NCOAging on social media

•  Donate to support NCOA’s work: ncoa.org/Donate

•  Share NCOA’s free, trusted tools with older adults o  BenefitsCheckUp.org o  EconomicCheckUp.org o  MyMedicareMatters.org


Thank You!

KathleenCameron,MPHSeniorDirector

[email protected]

ChelseaGilchrist,MGSSeniorProgramManagerCenterforHealthyAgingchelsea.gilchrist@ncoa.org


Questions? Please send your questions to the

moderator on the chat board.

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Part Two Coming Soon Falls and Brain Injuries Among Older Adults, Part 2:

Partnerships, Programs, and Public Policies

November (Date TBD) @ 12:00 pm - 1:30 pm Eastern

Part two will highlight community-based programs and prevention initiatives, state and community partnerships between professionals in the falls and brain injury prevention networks, and public policy connected to systems and partnerships.


Not a Member? Join NASHIA Today! Rebeccah Wolfkiel

Executive Director PO Box 1878

Alabaster, AL 35007 202-681-7840

[email protected]

Haleigh Cushen Member Services and Training & Education Coordinator

205-296-8783 [email protected]