Falls Prevention, Oban, Argyll

Overview
On the island of Islay, Southern Hebrides, an action research approach was adopted to translate the research evidence for preventing falls into practice. Falls are the biggest cause of accidental death for older people nationally with one third of people aged 65 and over having a serious fall each year, and this figure increases as people age. A community team of older people and interested health and social work staff was established. Team members were keen also to raise awareness of this issue with younger people. They approached Islay High School and it was agreed a group of students would work alongside the team to address problems related to certain pavements and roads. These had been identified in a previous action research study for National Falls Awareness Day. (Credit for illustration above from website GP Learning - An overview of the problem of falls in primary care, risk factors, assessment, and risk reduction in elderly patients presenting after or fall, or concerned about the risk of falling.)

Citizenship
The falls prevention project became the ‘citizenship module' for the second year students. The researcher met with the students to describe the work and explained that, while it is important to address problem areas of roads and pavements, many other things can contribute to falling, such deteriorating vision, loss of hearing, poor balance and slower reaction times, the inability to pick up speed and the loss of muscle strength. She also pointed out that falls are not an inevitable result of ageing and that strength and balance exercises can significantly reduce the risk.The students interviewed older people who were identified by the community team.

The students gave a presentation to the community falls prevention team, outlining the incidence and causes of falls. They made general suggestions relating to maintaining health and preventing falls and outlined the specific work they had undertaken in three areas (Bowmore, Port Ellen and Port Charlotte) where they felt that there were particular environmental problems of sufficient severity to require action. (Photo credits: Activate Health website - Exercise, Health & Wellbeing Specialists.

What did the young people learn?
The messages became very real for the students when they learned of an incident in which an older lady had fallen and fractured her hip. Potholes in the car park area where the library van parked for the residents of a sheltered housing complex were highly suspect. The action research offered opportunities for younger people and older people to work together to serve their communities and to increase their personal responsibility.

The community team and the students presented their work and findings to the Argyll and Bute Area Committee and to the Roads Department of Argyll and Bute Council. As a result, repairs were carried out. They also gave a joint presentation to a Joint Future rehabilitation conference in Oban. It was evaluated very highly by the audience comprising health and social work staff and managers, care home managers, carers and planners.

A very different audience at a Home Carers Study Day was equally impressed by the way the students presented the evidence in a clear, concise and meaningful way. In all, the action research showed that ‘Where there are open lines of communication, caring and support between the generations, we are better off as individuals, and better off in our families, communities, and as an overall society' (Hatton Yeo & Telfer, 2008).

Update as of July 2011 - Christine McArthur (NHSH Project Lead Prevention and Management of Falls) is currently writing her PhD thesis on the study which contains the themes of public involvement in healthcare, social capital, action research as a methodology to translate healthcare research into practice and intergenerational working.

Christine also believes that this model of involving students in intergenerational working with community members through action research could be used in many areas of healthcare, for example, to investigate the effect of smoking on COPD and peripheral vascular disease, the incidence of Coronary and Cerebral Vascular Disease in areas of social deprivation. The effect of diet and diabetes and teenage obesity may also be of interest.  

Email: Christine McArthur

NHS Choices website: Falls

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