Falls pathway Pallini

Recruitment for the Falls pathway

by Stavridi Eva, Scientific Researcher, MSc

In Pallini case, during the first assessment of the individuals and by completing the questionnaire (T0) , we used the algorithm score in order to access if seniors needed to be integrated in the falls pathway or not. In few cases, there were indications for falls prevention from the clinical examination with MD, despite the case there was no indication from the questionnaire.

Below, is the score algorithm that we used for the recruitment of the elderly in the pathway:

Implementation of the “Falls pathway” @ Pallini

From the 194 people in the UHCE intervention Group, 103 individuals found to complete the criteria for the Falls Pathway intervention. Apart from the indications from questionnaire, there were 10 individuals that admitted to participate, either because they self-estimated that they needed it, or as a result from clinical examination. Finally, 88 individuals agreed to participate in this pathway. In the municipality of Pallini, various choices were planned for activities, in order for the elderly to be able to participate in the pathway in a convenient way:

Brisk walking around municipal stadium in two Groups (1 h duration)
- Pallini (Twice per week)
- Gerakas (Twice per week)
Swimming in the municipal pool: One Group (1 h duration)
- Once per week
- Approximately for groups of 3-5 participants
Muscle training in the municipal gym: One Group (1 h duration)
- This type of exercise started from October 2015
- Twice per week
- Up to15 elderly
- Available only for women
Brief Leaflet with advice to avoid falls
- Given by the Engineers, the Trainers (for Falls) or the Physician
Engineer assess safety at home

The duration of the Intervention lasted from May 2015 until May 2016.

Feedback after the Intervention

From the 88 individuals who agreed to participate, 50 of them did it. That equals to the 67% of the initial people that gave consent to take part. If we examine the activities separately, we have some important findings:

the most successful activity was the Brisk Walking activity. Most of the elderly continuously participated in the sessions during the whole Intervention and seemed to be very happy. They were giving a very good feedback to their trainer, with whom they already had some previous collaboration. Participants were divided into two groups according to their familiarity in physical activity. Also, it is an important issue that good feedback was received about social interaction among the individuals in this activity.

Swimming activity seem to be interesting for the elderly at the beginning, but finally was not convenient enough for the majority of them . For this reason, it had not a big success and 4 elderly participated in total Swimming, as well as Brisk Walking were newborn activities, operating exclusively for UHCE program.

Muscle training activity started from October 2015. This was an already existing activity that was included as one more option for those who had problems with movements. Finally, 11 individuals participated in this activity. One of the disadvantages of this choice was that it was addressed only to women.

Finally, the Engineer Assessment at home was completely unsuccessful, because only 2 elderly agreed to implement it.

During the intervention period, there were some difficulties that Pallini pilot faced. The first difficulty was that exercising and training are not in the mentality of the elderly people in Pallini. It was difficult to be persuaded and be integrated in this pathway. Furthermore, for some of them there was a difficulty to move from their home to other places because they live in remote areas, where the use of public transport is not very convenient. Moreover, some of them had lack of time because of taking care of their grandchildren. Pallini team tried to overcome these difficulties by making a schedule of the falls pathways and this is the reason why various groups were created both in Pallini and Gerakas sites, in order for them to have the possibility to choose the most convenient day and location. Finally, the majority of them denied the visit of the Engineer at home, because they considered it as an interference.

To conclude, interventions for Falls Pathway were something completely innovative for elderly people in the Municipality of Pallini and this is the reason why some of the activities were very successful while others less. However, from the experience and feedback from Pallini pilot, the municipality will be able to build interventions with effective and efficient programs to reduce risk of falls among the elderly.