• Fall-related injury is one of the leading causes of morbidity and mortality in older Australians.¹
• Falls are the single biggest reason for presentations to the emergency department in people over 65 years of age.²
• The effects of falls are costly to the individual in terms of function and quality of life as falls may increase the likelihood of developing a fear of falling or loss of confidence in ADL.³
• Recent research identifies that in the face of an ageing population, if nothing more is done to prevent falls by 2051 the total estimated health cost attributable to fall-related injury will increase almost three fold to A$1375 million per year in 2051.4
• While the body of knowledge regarding the risks of falls and how to reduce these risks is continually growing, one key message prevails: multifaceted, multi professional approaches are best.^{5, 6}
• Falls after hospital discharge have been reported as occurring in 15% of older people within a month of discharge.⁷
• In 2007 data collected by the Occupational Therapy service at Post Acute Care Service indicated that 31.9% of all patients seen by the Occupational Therapists were the result of a fall-related injury.

In response to this startling data, a multidisciplinary, home based, falls prevention program has been developed by the Post Acute Care Service and offered to patients being admitted to our service as a result of a fall.

It consists of functional, QOL, and falls assessments; an 8 week exercise and education program; referral process to ongoing community services and ongoing follow-up.

In this presentation an overview of the program and preliminary outcomes are discussed.

Download this presentation ( pdf - 452 KB) from the 1st Hospital in the Home Conference, 2008.

1. Pointer S., Harrison J., Bradley C. National injury prevention plan priorities for 2004 and beyond: discussion paper. Injury research and statistic series number 18, Australian Bureau of Statistics. Canberra: Australian Institute of Health and Welfare, 2003.
2. Davies A., Kenny R. Falls presenting to accident and emergency. Age and Ageing 2000; 25: 362-6.
3. National Ageing and Research Institute. An analysis of research on preventing falls and falls injury in older people: community, residential care and hospital settings (2004 update). Report to the Australian Government, Department of Health and Ageing, Injury Prevention Section. Canberra: Australian Government Department of Health and Ageing, 2004.
4. Australian Government Department of Health and Ageing. Projected costs of fall related injury to older persons due to demographic change in Australia. Canberra: Commonwealth of Australia, 2003.
5. Haines T., Bennell K., Osborne R., Hill K. Effectiveness of targeted falls prevention programme in subacute hospital setting: randomised controlled trial. British Medical Journal 2004; 328(7441): 676.
6. Feder G., Cryer C., Donovan S., Carter Y. Guidelines for the prevention of falls in people over 65. British Medical Journal 2000; 321: 1007–11.
7. Mahony J., Palta M., Johnson J., Jalaluddin M., Gray S., Park S., et al. Temporal association between hospitalisation and rate of falls after discharge. Archives of Internal Medicine 2000; 160: 2788-95.

Amanda Trist is the Senior Occupational Therapist working with the Post Acute Care Service at Prince of Wales Hospital. Amanda graduated from Sydney University, Health Sciences Campus in 1995 and has experience working in a variety of different fields, specialising in Aged Care and Rehabilitation. She has been working as the Senior Occupational Therapist with the Post Acute Care Service for 9 years, involved in the care provision of orthopaedic, respiratory and HITH patients.

Senior Occupational Therapist, Post Acute Care Service
Prince of Wales Hospital
South Eastern Sydney Illawara Area Health Service
Phone: 02 9382 2470