Atikokan — Two years in, the Atikokan Falls Prevention Team has proven its value – so much so, the team plans to stay together, and continue helping seniors maintain the quality of their lives.
“There isn’t another program in the region like this,” said occupational therapist Amanda Dickson, the team leader. “It would be pretty rare to get the professionals we have to be able to work so closely together on a team. In a small town, we are able to do that.”
Originally, the group was one of 33 community-based fall prevention teams funded for two years by the Northwest LHIN and St. Joseph’s Care Group. They were formed to address falls in long term care homes. But here, that model quickly expanded to include community members through in-home assessments, with the goal of helping seniors stay in their own homes as long as possible. That mobile team component, combined with the seamless approach of sharing information and resources made Atikokan unique in the NW LHIN region.
When the team’s two-year funding wrapped up last month, members decided to keep it going. The team includes Cathe Hoszowski, counsellor Bob Botham, RN Keira Lacosse, dietician Kira Schan, (all from the Family Health Team), seniors’ counsellor Patricia Dunnett, Home Support coordinator Brenda Wood, pharmacist Earle Arnold, ComCare’s Phyllis Mosley, and Extended Care Wing (ECW) program coordinator Tanis Hampshire.
The team looks at a broad range of health and environmental issues which can contribute to frailty and falls, with the goal of supporting independent living. That can mean relatively simple measures such as providing special footwear, eye wear, or double-sided tape to secure rugs and carpets, to improving lighting and installing hand rails. The group also addresses more complex matters: identifying balance issues caused by improper medication use, lack of balance or muscle tone, poor nutrition, or even depression.
Doing all of that is fairly easy in an extended care facility, where many health professionals work in close proximity. But it has been reaching out to the community – seeing seniors in their homes, where half of all serious falls occur – that has proven valuable here. Reaching out makes sense: 50% of falls occur in the home, and seniors now make up almost a third of Atikokan’s population.
Family Health Team RN Keira Lacosse said without the home visits, critical health issues may otherwise go undetected until a fall actually occurs. The visits have also been eye-opening for physicians, who may not be aware of contributing factors that can affect the overall health picture of their patient.
“A lot of older people in town don’t have supports and they may have some depression or are just very isolated [and not taking proper care of their health], so it’s good for them to have someone checking in.”
Adds counsellor Bob Botham: “You’re there to identify fall risks but because of your profession, you’re also noticing [other health risks], and that’s where referrals come from.” (Clients sign a form that allows the team to share information and referrals among health professionals).
Lacosse will provide some preventative materials on the first visit (such as double-sided tape and nightlights) and provides information on other in-town services (such as Home Support for meals or grocery shopping services, emergency response bracelets, and blister packs to keep medications organized and easy to open). Typically, she then refers clients to Dickson, who conducts a home assessment and recommends equipment or exercises to improve safety. If necessary, the client may also be referred to a dietitian, counsellor and physician, or encouraged to sign up for home care services.
Botham conducts follow-up visits to see how effectively those measures are being implemented, and if the situation is improving. These visits suggest risk factors have been reduced by 41%.
Many seniors living in their homes have some fear that admitting a fall to a health professional or family member can mean ending up being put in long-term care; in fact, that is the opposite of the team’s goal, said Botham. “The goal is to keep them in their homes, and as healthy as possible,” he said.
And there are many inspiring examples of seniors living in their homes in their later years, with a little help, noted Hoszowski, who cited the example of a 92-year-old friend who has used the recommendations of the team to reduce risks of falls in her home.
Brenda Wood (Home Support) estimates the number of seniors using the emergency response bracelets has doubled since the team began doing assessments. Patricia Dunnett (Community Counselling) said that while some may initially feel embarrassed to need certain devices as they age, “if they see their friend [has an emergency response bracelet] then it becomes okay to do this.”
The team has compiled a wealth of information on accessing services and assistive devices including coupons and reduced payment plans available for low-income seniors. Botham added that they are also working on a list of contractors who are available for home upgrades and equipment installations.
Dunnett said that while seniors on fixed incomes may be reluctant to pay for certain items, it helps to realize that with an initial, and usually affordable, cost, they might be able to keep their independence much longer. With some funds from Northwest LHIN, and a donation from the seniors’ forum, the team has been able to make night lights, mats, special tape and other devices available free to clients.
The team anticipates keeping their services going indefinitely; basically, communication is free, and just practical. Botham credits the “openness of our employers and the community, who realized that this would a benefit to everybody because we’re doing [these functions] anyways, so sharing our expertise and sharing the workload between us all just really made sense.”
An example of pooling resources was the recent eight-week SAGES (Safe and Gentle Exercises for Seniors) program the team hosted in February which brought both ECW and community residents together four weekly sessions held each at the ECW or the Pioneer Centre. Up to a dozen seniors learned strengthening and balancing exercises from ANFC fitness instructor Shanna Brewster. (“They were doing sitting Tai Chi at the start and by the end of four weeks they were doing modified aerobics,” said Dunnett.), and heard special presentations on a range of health topics such as nutrition (by Schan) and safe medication use by Arnold.
The program reunited some old friends from both ECW and the community, “and had a secondary benefit of getting them out and socializing with members of their community, especially for the higher functioning seniors,” noted Dickson. The team plans to run the SAGES program again, soon.
By Jessica Smith, Atikokan Progress, May 3, 2011