Authors (including presenting author) :
Cheung KL(1), Cheng MK(2), Cheung YW(2), Cheung L(2), Yuen WY(3),
Yeung CW(4), Cheung HY (5)
Affiliation :
(1) Physiotherapy Department (Integrated Rehabilitation Service), Tseung Kwan O Hospital
(2) Department of Medicine, Tseung Kwan O Hospital (3) Occupational Therapy Department (Integrated Rehabilitation Service), Tseung Kwan O Hospital (4) Department of Prosthetics and Orthotics, Tseung Kwan O Hospital (5) Department of Podiatry, Tseung Kwan O Hospital
Introduction :
Falls in community-living elderly are common in Hong Kong at a rate of 25% each year. Falls can cause serious injuries and fractures. The Fall Assessment & Prevention Program (FAN) was formed at Tseung Kwan O Hospital (TKOH) in 2016 to tackle this problem. This multidisciplinary team, consisting of doctors, nurses and allied health professionals, provides individualized assessment and fall prevention education to elders with history of falls.
Objectives :
To investigate FAN program effectiveness and the functional outcomes of patients
Methodology :
Ten elderly (9 females; 1 male; average age 77.5 years old) with fall risk were recruited by Geriatricians of TKOH from January to September 2016 and participated in multidisciplinary assessment twice in initial and third month at Day Medical Centre: Physiotherapist provided comprehensive musculoskeletal, balance and gait assessment, fall risk factor identification and tailored home exercise program on fall prevention. Occupational Therapist conducted assessments of patient’s Activities of Daily Living level, fall awareness and cognitive status. Home environment and assistive aids advices were given accordingly. Both Prosthetist and Orthoptist (P&O) and podiatrist offered footwear and foot care education. Pressure mapping investigation was also taken by P&O for body balance examination. Geriatrician conducted case conference during FAN program. Nurse delivered group educational talk to patients and also made follow-up phone calls in 6th month to evaluate any fall incident within half year.
Result & Outcome :
Result: Seven patients completed those two sessions of FAN program. Two patients defaulted in subsequent session and one patient failed to attend due to death. Nearly 90% patients reported to have no fall within half year after attending the program. Eight patients attended the pre and post physiotherapy in FAN program with re-assessment. 50% of patients achieved improvements in Timed Up and Go Test. Three patients were noted to have improvement in Functional Reach Test. One patient achieved to be a supervised walker from Modified Functional Ambulation Classification (MFAC) IV to MFAC V Nine patients were recruited for P&O interventions. To reduce risk of fracture due to fall and control pain, hip protectors and orthosis were prescribed to patients according to individual’s need. 90% patients showed satisfaction with the overall FAN program. Conclusion: Results demonstrated functional improvements and prevention of fall incident in elderly patients. FAN program was proven successful to provide comprehensive assessment and intervention to reduce fall risk among this target group. However, the issue of manpower resources should be addressed for the program sustainability.
Co-location with:
