F-2-12-07
AVOIDING DISABILITY - HIP PROTECTORS & THEIR VALUE
Ellis Margaret, West Square Associates, & King's College SMD, London, UK
Lauritzen Jes B, Bispejerg Hospital, University of Copenhagen, Denmark.
Accidents are a major cause of mortality and disability in the elderly population and a growing socio-economic concern. National and international organizations (WHO, EU, ECOSSA) ate addressing this issue. Targets have been set for reductions in numbers of deaths from accidents. One of the most serious injuries associated with a fall is hip fracture. The incidence of hip fractures in 1990, world wide was 1.66 million with a projected increase to 6.26 million by 2050 with 700,000 hip fractures per year in Europe. As well as the costs to the patient in terms of mortality, disability, functional impairment, and impaired quality of life, this projected increase is a major financial concern with respect to health care utilization and use of support services. Groups identified as being at increased risk of sustaining a hip fracture include living in a nursing home, a previous hip fracture, cognitive impairment and impaired visual acuity.
Methods of injury and damage limitation have been reviewed. External hip protectors apply a technology of diverting impact from the greater trochanter, of falls from a standing height and offer nearly full protection in this region. This paper reviews types of hip protectors available and the technology they involve, research in compliance in nursing home and community dwellers, and socio-economic factors concerned with cost effectiveness and extending active healthy life by avoiding disability.
F-2-12-08
FALLS AVOIDANCE AND PREVENTION STRATERGY FOR THE ELDERLY
Ellis M, Close JCT, Jackson SHD, Swift CG, (Clinical Age Research Unit, King's College School of Medicine and Dentistry, London, UK.)
Falls account for two thirds of home accidents and are the largest cause of death in this age group. The WHO has set targets to reduce these numbers.
A randomized controlled clinical study in community dwellers, aged 65 and over, attending an Accident and Emergency Department, uses an inter-disciplinary approach (Medical and Occupational Therapy), aims to reduce incidence of falls and maintain function and community independence.
Over seven months 397 (76.5%) of the intervention group were assessed at home by the Occupational Therapist using Barthel, Functional Independence Measure (FIM) Falls Handicap Inventory (FHI) and Environmental Hazards Listing (EHL). Provision of disability equipment (54) and more complex equipment and adaptations (37), requests to Health (3) and local Social Services Departments (49) and to Medical Consultants (33), General Practitioners (8) and to Medical departments already dealing with the patients were made to ensure appropriate provision of care (38).
Only 15.6% required no intervention. At the end of an eight month follow up period there was a significant difference in the reduction of falls incidence 123 v 354 (p< 0.01) in this high risk population.
