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Minnesota Falls Prevention Initiative

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Kris Gjerde, PT, Minnesota Chapter. American Physical Therapy Association. Minnesota ... Kris Gjerde, PT. Project Manager. Specific Project Goals: ... – PowerPoint PPT presentation

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Title: Minnesota Falls Prevention Initiative


1

Stand Up Be Strong! MN APTA Evidence-Based
Falls Prevention
MN Chapter American Physical Therapy
Association www.mnapta.org 651-635-0046
Co-sponsored by the MN Department of Human
Services
2
Stand Up Be Strong! MN APTA Evidence-Based
Falls Prevention
  • You will be able to
  • Measure fall risk due to lower body weakness
  • Incorporate screening of older adults into your
    program
  • Understand action steps to reduce this risk
  • Project Manager
  • Kris Gjerde, PT,
  • Minnesota Chapter
  • American Physical Therapy Association

3
Minnesota Falls Prevention Initiative
  • MN Board on Aging RFP Community Service/ System
    Change/ Service Development (CSSD) grants to
    foster decreased nursing home utilization
  • MN Chapter APTA system change proposal
    community based fall
    risk screen and action steps piloted in 10
    Western MN Counties
  • MN APTA Collaborative partners
    PrimeWest Health
    Services Area
    Agencies on Aging
    Local Health Care providers
    County public health
    departments
  • Other CSSD Falls Prevention grantees
  • Mayo Medical School-in home assessment by
    geriatric fellow, Olmstead County MN
  • Fairview Ridges-in home assessment by PT Dakota
    County

4

Stand Up Be Strong!
MN Chapter American Physical Therapy
Association Kris Gjerde, PT Project Manager
651-635-0046 www.mnapta.org
5
Specific Project Goals
  • Create a community-based system that makes
    assessment of fall risk prevention of falls
    routinely available
  • Enable individuals to assess lower body strength
    and related fall risk
  • Enable individuals to take action to decrease
    risk or maintain low risk

6
MN APTA Stand Up Be Strong!
  • Demonstration project designed to prevent falls
    in older adults
  • Community based system change
  • Co-sponsored MN Dept of Human Services

7
Why Is This Unique?
  • MN CSSD grants are highly competitive
  • MN Chapter received the first state grant to a
    professional association
  • Innovative approach to sustainable system change
  • Use of membership network to disseminate public
    health program

8
MN APTA Workgroup
  • Reviewed the evidence
  • Identified Fall Risk Factors
  • Decreased strength and balance
  • Medication use
  • Vision impairment
  • Unsafe home environment
  • Unsafe outside environment
  • Having fallen in past year
  • Fear of falling

9
Stand Up!Guiding Evidence
  • Rand Report on Falls for CMS, 2003
  • Multifactor approaches are most effective
  • Two most effective interventions are lower body
    strengthening medication review
  • Strengthening was mentioned but not provided in
    the nine national programs reviewed by Rand

10
Stand Up! Development
  • Combined the expertise of MN APTA members
  • Assumptions
  • Physical therapists will serve as trainers
    consultants
  • Focus community dwelling older adults
  • Adults currently perform single repetition of sit
    to stand
  • Requirements of screening tool
  • Enables self assessment
  • Applicable to groups or individuals
  • Community based, not medical intervention
  • Includes action steps that allow variable
    technique

11
MN APTA Falls Prevention Initiative
  • Oct. 2005 MN APTA invited members in 10 pilot
    counties to participate
  • Apr 2006 MN APTA trained 30 PTs
  • May-Dec. 2006 PTs trained 587 community partners
  • Jun. 2006 Community partners started screening
    participants
  • Jan. 2007 Statewide dissemination began

12
Primary Fall Risk Screen
  • Have you fallen in the past year?
  • Are you afraid that you might fall?
  • Do you frequently need to use your arms to rise
    from chairs?
  • YES indicates that you may be at risk

13
Physical Prescreen
  • Cross your arms
  • Rise to standing position
  • Successful rise continue with timed sit to
    stand
  • Unable Proceed to high risk category

14
Timed Sit to Stand
15
Risk Score
16
Action Steps
  • High Risk Consult your doctor or Physical
    Therapist for advice instruction to improve
    your strength. Do the exercises only if you feel
    safe doing them on your own.
  • Moderate Risk Do the exercises. Seek assistance
    if you do not feel safe
  • Low Risk Continue your active lifestyle, add
    the exercises to your program
  • Groups Add the two exercises to your program
  • Reassess every 3 months

17
Exercises
  • Sit to Stand
  • Side Hip Raise

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22
Reach
  • 576 Physical Therapist trained
  • 1296 Community Partners trained
  • 1855 Individuals screened

23
June 2006 June 2007
  • Adults aged 65 and older
  • Risk Score 1662 total Percent
  • High 741 45
  • Moderate 518 31
  • Low 359 22
  • Unknown 44 2

24
Uptake
  • Follow up calls at 1, 3, 6 months
  • Retention of information
  • Action taken after screening
  • MD, PT visit
  • Performed exercises
  • Increased activity
  • Falls since screen
  • Overall functional mobility
  • 4 mobility questions from SF 36

25
Whats Next?
  • Screen Older Adults in your community
  • Assisted Living
  • Home Health
  • Senior Centers
  • Area Agency on Aging
  • EMS, Sheriff Dept, Fire Dept
  • Parish Nurse
  • Faith based programs

26
To Learn More
  • www.mnapta.org
  • www.healthyagingprograms.org
  • www.cdc.gov
  • www.aoa.gov
  • www.minnesotasafetycouncil.org/
  • www.stopfalls.org

27
Stand Up Be Strong!
  • Kris Gjerde, PT
  • Minnesota Chapter
  • American Physical Therapy Association
  • www.mnapta.org
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