European Innovation Partnership on Active Healthy Ageing A Compilation of Good Practices – Integrated Care for Chronic Diseases (2nd edition) This compilation is the product of the collaborative work of the members of the B3 Integrated Care Action Group. In this collective effort, the experts of the Action Group have been pooling their knowledge and […]
The challenges included shifting from institutional based care to care at home or a homely setting, the need for quicker assessment and care plan coordination and formulation in a more homely setting taking into account the person’s conditions and home situation instead of needs and support being assessed in a ward setting.
Previous mapping of the falls pathway had demonstrated that there was no clear systematic approach to the identification and onward referral of those presenting to the A&E department at the local hospital with a fall.
Fall related injuries in older people are a major public health challenge and an unnecessary cause of ill health and mortality. It is estimated that one in every three people over the age of 65 years and one in two people over the age of 80 years fall every year. Staff had identified that there was a lack of awareness that falls could be prevented and action wasn’t taken until after a fall had occurred. The role of exercise was often overlooked and although staff could identify who was unsteady on their feet they were not aware that this could be improved through specific exercises to improve strength and balance.
This initiative tackles social isolation and support to maintain independence through a blend of timebank support, befriending and a focus on person centred outcomes.
Person of 90, isolated within her community since the death of husband, struggling with long term and deteriorating condition; feeling lonely and unable to cope with her garden yet resistant to ‘giving up’ and moving into care.