The national statistics on falls are eye-opening, 1 in 4 Americans over the age of 65 will suffer a fall every year. Twenty to thirty percent of these falls result in injury. Falls are the leading cause of fatal and non-fatal injuries for older Americans leading to associated medical costs exceeding $30 billion. From these figures, suffering a fall is an all too common event that can in an instance cost older adults financially and impact their daily independence.

There are different initiatives one can take in their everyday life to reduce the likelihood of suffering a fall. Some are as simple as completing a routine evaluation of the living space, making sure it is free of clutter and any loose rugs or cords that may cause an accident. There are also some different evidence-based, or scientifically proven to be effective, fall prevention programs offered nationwide. We will be covering these initiatives in the coming weeks to showcase the steps that can lead towards reducing this alarmingly high rate of older adults suffering from falls. 

Stepping on: fall preventionOne of these evidence-based programs that have had an international impact is Stepping On. The program was developed by two Australian occupational therapy researchers at the University of Sydney. Stepping On is a unique program that combines initial group sessions and is followed up with in-home visits. The program covers seven weeks with one three hour group session each week. Each week’s group session covers a different topic. These subjects include falls and risk, strength and balance exercises, home hazards, safe footwear, vision and falls, safety in public places, community mobility, coping after a fall, and understanding how to initiate a medication review. A more thorough break down of the program’s content can be found at the bottom of this page. In 2015, the Journal of Safety Research found in their scientific assessment that a participant’s likelihood of suffering a fall was reduced by 31%.

Stepping On trainers and researchers have found that the group session format has helped those that have already suffered a fall. Typically following a fall, many will find themselves feeling helpless, losing confidence, or reducing their overall activity. This response will often lead to another fall. Bringing the participants together to take control, explore ways of coping, and encouraging one another to stick with the program. Following the 7-week program and in-house assessment Stepping On includes an hour and a half booster session. This booster session makes sure that the participant is staying on track and practicing correctly.

Stepping On is non-compliant for those with memory problems, progressive neurological disorders, and those who are entirely dependent on a walking frame. The program has not been found to work with those with Parkinson's Disease.

Currently, Stepping On is available in the United States through the Wisconsin Institue for Healthy Aging. Their staff offers training for trainers and program support nationwide. Stepping On is currently available in 20 states. Find out if it is available in your state here.

Program Sessions

Week 1: Introduction, Overview and Risk Appraisal

Building trust, overview of program aims, sharing fall experiences, choosing what to cover and balance and strength exercises.

Week 2: Exercises and Moving About Safely

Review and practice exercises, explore the barriers and benefits of exercise, moving about safely – chairs and steps, learning not to panic after a fall.

Week 3: Home Hazards

Identify hazards in and about the home and problem solving solutions

Week 4: Community Safety and Footwear

Generate strategies to get around the local community and reduce the risk of falling. Learn about the features of a safe shoe and identify clothing hazards.

Week 5: Vision and Falls and Vitamin D

Recognize the influence of vision on the risk of falling. Review strategies to reduce risk of falling from dysfunction. Identify the importance of vitamin D, sunlight and calcium to protect from fall injury.

 Week 6: Medication Management and Mobility Mastery Experiences

Identify medication risks and falls. Explore strategies to reduce risk of falls from medication side effects or misuse. Identify behaviour and sleep alternatives to taking sedatives. Review of exercises. Strategies for getting out and about in the local community safely. Practice safe mobility techniques learned during the program in a nearby outdoor location.

Week 7: Review and Plan Ahead

Participants express their personal accomplishments from the past 7 weeks and reflect on scope of things learned. Review anything requested. Identify strategies to assist in safe public transportation. Determine safety strategies. Graduation ceremony.

To find out more about the Stepping On Fall Prevention program visit the Wisconsin Institute for Healthy Aging

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