Foot Sure Fall Free - Partners-and-Projects - Upstream

Foot Sure Fall Free

With funding from the Department of Health, and the close co-operation of local surgeries and hospitals, Upstream and Well UK pioneered a carefully constructed and monitored ‘falls prevention’ programme with older and more vulnerable adults in three locations in Mid-Devon, Silverton, Tiverton and Crediton. The aim of the ‘Foot Sure, Fall Free’ programme is to help reduce the number of falls, and injuries from falls, experienced by older people. The service is holistic in design and addresses the physical, emotional, mental and environmental aspects of each individual participant. It is based on the principles of early intervention by identifying individual risk and removing the obstacles to participation in falls prevention programmes. It has been designed to be flexible and take into account the differing needs and circumstances of its service beneficiaries; i.e. sheltered housing residents, care home residents, high vulnerability day care users, and individuals living in non-sheltered private or social housing within the community.

For more information and reports, contact;
upstream-uk@hotmail.com or info@welluk.org

The first six-month pilot (2009), in Silverton, was linked to a sheltered housing scheme, with referrals made by the local surgery. 24 people participated in a mixture of activities, including exercise, healthy cooking and eating, and cognitive stimulation through creative activities. There was an increase in awareness about falls and falls prevention and a slight average improvement recorded in the Berg scale tests, an indicator of balance. The surgery considered the pilot to be a success and many of the participants were keen to repeat or extend the programme.

This resulted in a 2nd phase in 2010, which targeted both those living independently and others living in sheltered accommodation, to encompass a wider ranging falls prevention pathway. The objectives were to: improve balance; measure and reduce the incidence of falls; raise awareness of health exercise; deliver nutritional advice; improve confidence and general well-being. Based on Berg scale tests at the beginning and end of the course, 50% of the results showed ‘significant’ improvements, or to put it another way, for 50% of the group it is possible to say with 95% confidence that the improvements were not by chance.

In Tiverton, there was a wider spectrum of people from the community referred by a local surgery. The Falls Prevention classes ran for 12 weeks starting in October 2010. The programme ran during a difficult time of the year in terms of weather, dark evenings and Christmas. The 12- week programme which took a holistic approach offered weekly balance and muscle strengthening exercises followed by either nutrition or cognitive sessions such as arts, craft and music. A core group of between 8-10 people attended regularly, and transport was provided. The group included one lady in a wheel chair who was able to join in with all the co-ordination and upper body stretching exercises. The exercises were chair based at the start, progressed from sitting to standing on the 4th week, and extended from 25 to 45 minutes. Participants were given ‘mild’ exercises to do at home; these ranged from massage first thing in the morning and getting out of a chair correctly. The general improvement by all participants was supported by the results of the Berg scale tests. One lady who had difficulty at the start of the programme getting out of a chair stood up and said, ‘I couldn’t have done that a few weeks ago before I started coming.’ Another said, ‘I can now do my bra strap up at the back.’

Nutrition sessions included a look at present day diets compared to 70 years ago, a focus on ‘5-a-day’, cholesterol, use of spices and reduced salt, and a quiz on portion size and weight conversion. Cognitive and creative sessions included live violin music with jigs and folk songs, making pomanders for Christmas, painting terracotta flower pots, indoor seed planting.

One lady who since went on to join an independent exercise class made considerable progress.  She felt the falls prevention programme had helped with her agility; she found it easier to get in and out of cars; she considered she was generally fitter and found it much easier getting dressed and ready to go out. She found the nutrition and cognitive sessions were lively and fun.  End of programme feedback showed that all had enjoyed coming and appreciated the social element.

A final comment from one lady: ‘I want to thank my doctor for getting me on this course. I’ve really enjoyed it and I’m so much more pliable now.’

In Crediton, the local hospital has worked with Upstream to refer people for a similar falls prevention programme but with the emphasis on dance activities which the participants find especially stimulating.