Falls, Tech

Spotlight on Falls

 

Falls are one of the most feared health emergencies for older people and their families. In our three-part series, we will be shining a spotlight on falls, the changes we aspire to make and the impact these will have in reducing falls. We begin by looking at how falls impact older people and the implications for a person when they fall.

The potential to have a fall is something many older people and their families dread. Whether the person lives at home, is in hospital or in a care home, having a fall can have significant and far-reaching consequences. It’s something many health and social care staff also fear and often find difficult to mitigate against and manage. 

 

What do we know about falls?

The 2018 ‘NICE impact report on falls and fragility fractures’ said:

Older people are more likely to fall. They are also more likely to suffer significant consequences, such as a loss of independence and confidence, leading to physical and mental deterioration and frailty. This increases the risk of a person experiencing multimorbidity, which is when a person has 2 or more long-term health conditions. It can also increase their risk of further falls and fractures.

In 2015/16, NHS Improvement reported that 204,269 inpatient falls were voluntarily reported by acute trusts, with a fall rate of 2.8 falls per 100 patients. However, many falls occur at home and go unreported, so the true incidence of all falls is unknown. It is estimated that approximately 30% of people older than 65 fall at least once a year; this is around 3 million people in England.

The 2022 Age and Ageing Journal published the first ‘World guidelines for falls prevention and management for older adults’ that said: 

Falls occur at all ages and are an inevitable part of a bipedal gait and physical activity. They occur in 30% of adults aged over 65 years annually, for whom the consequences are more serious, despite concerted efforts of researchers and clinicians to understand, assess and manage their risks and causes. In addition to personal distress, falls and fall-related injuries are a serious health care problem because of their association with subsequent morbidity, disability, hospitalisation, institutionalisation and mortality.

In Europe, total deaths and disability-adjusted life years due to falls have increased steadily since 1990. The Global Burden of Disease study reported nearly 17 million years of life lost from falls in 2017. Related societal and economic consequences are substantial. In high-income countries, approximately 1% of health care costs are fall-related expenditures.

Note: NICE (National Institute for Health and Care Excellence) are currently updating their guidance on Falls and their new recommendations will be published in August 2024.

 

Falls and care homes

With these statistics in mind our Associate Director, Preet Shergill, has made falls the subject of his NHS Digital Academy TOPOL Fellowship (TOPOL Fellowships were borne out of the 2019 Review conducted by Eric Topol MD entitled ‘Preparing the healthcare workforce to deliver the digital future’). In his first blog for the NHS Digital Academy about his fellowship entitled ‘Empowering social care through digital innovation: My Topol Digital Fellowship journey’ Preet said:

The public health data highlights the urgent need for falls prevention strategies, given the impending exponential growth in the 85+ age group. In my local county of Buckinghamshire, the number of people over 85 is projected to rise by 78% over the next 12 years. The total annual cost of fragility fractures to the UK, including social care, is estimated at £4.4 billion.

 

What are the current challenges around falls?

As we go into the autumn and winter seasons, falls join flu, Covid and many other seasonal challenges making NHS-related headlines every year. Falls outside are more likely in cold and icy conditions, and falls inside become more common when people are unwell with infections and more confused, tired or struggling with their balance.

Once a person has a fall, shock and distress are highly likely, making the psychological impact immediate. The physical consequences can, at worst, mean broken bones – hip fractures are especially common and often life-changing or life-shortening – and, if the person has hit their head, potentially the consequences can be fatal. 

Even if these worst-case scenarios are avoided, a fall often means going to hospital for a precautionary scan and tests, an in-patient stay may be needed, pain may be difficult to assess and control, and bruising and any cuts can take a long time to heal. 

With extended waiting times for ambulances, overstretched A and E departments, shortages of beds on wards, and the difficulties for an older person or a person with dementia when they are in an unfamiliar environment (that can often lead to further falls, loss of independence, weight loss and incontinence), going to hospital alone can be a traumatic experience.

Even if a person’s physical injuries heal, the physiological ones often remain. The person may repeatedly think about how they fell and what the cause was. They may become fearful of walking, or lose confidence in maintaining aspects of their independence that they feel may have either led to their fall or could lead to another fall. It then becomes a vicious circle of reduced mobility, with the physical consequences of pressure ulcer risks and greater chances of infections like UTI’s, and greater dependence, which can often erode feelings of self-worth and self-esteem.

 

Falls matter to everyone

Because falls have such a massive impact on the lives of people who fall and their families, we believe they are a vital issue for us to understand more about. We need to find innovative ways to prevent falls and, should a fall still occur, manage a person’s recovery as effectively as possible through modern rehabilitation techniques – like our personalised, at-home physio service – to ensure the best quality of life for our residents.

We will never be able to prevent every fall, or indeed the physical and psychological effects a person may be living with from a fall prior to moving into a Peverel Court Care Home. What we can do, however, is change the narrative and our approaches to find new solutions and ways of thinking.

 

What’s next?

In our second blog of this series, we will hear from some of our residents, families, staff and other healthcare professionals about their personal and professional experiences of falls. We will also discuss how digital transformation can lead to a positive impact in reducing falls.

 

About Peverel Court Care

Peverel Court Care is a group of one residential and two nursing homes, located in Buckinghamshire and Oxfordshire. Bartlett’s Residential Care Home and Stone House Nursing Home in Aylesbury, and Merryfield House Nursing Home in Witney. We are a long-standing family business. Providing exceptional, personalised care, delivered by talented and compassionate people, in exclusive and idyllic settings.

With happiness at the heart of our homes, we recognise and respect the contribution made by our residents to society during their lifetimes. Valued by residents and their families; our reputation, investment in each property, and approach to appointing and developing our staff makes each home unique and the benchmark in premium care.

Best Care Practices

Personalised, at-home physiotherapy for our residents

Enabling our residents to remain as mobile as possible is a key aim to ensure everyone who lives with us can enjoy maximum quality of life. Read on to learn more about our partnership with The Caring Physio and how this service is benefiting the ladies and gentlemen in our care homes.

 

Supporting our residents to move comfortably and keep as active and fit as possible is a key aim for the care we provide. We know that ageing can bring many challenges with joint, muscle and bone health, and this often leads to reduced mobility, which can be detrimental for both physical and mental health.

With this in mind, we’ve partnered with The Caring Physio so that our residents at Stone House, Bartlett’s and Merryfield can enjoy physiotherapy services in the comfort of their home. This has been a revolutionary offering for our residents that means we don’t need to wait for NHS referrals: the treatment our residents need can begin swiftly and in a relaxed and supportive environment with The Caring Physio visits to us. Our staff and families can be on-hand to provide any additional support and encouragement that our residents may need, and the physios are able to provide in-depth mobility knowledge to support our care teams in their roles. 

 

Why keeping our residents moving is important

When a person can’t move as they’d like to because of arthritis, other painful conditions or recovery from an operation, fall, stroke or other illness we know this can have a huge knock-on effect for their overall health and quality of life.

Physical inactivity has also been highlighted this World Alzheimer’s Month by Alzheimer’s Disease International as a factor in reducing the risk of developing dementia and for ongoing risk reduction for people who are already living with dementia.

We know that keeping our residents moving is beneficial in many other ways too, including for helping to lower blood pressure, improving heart health and boosting immunity, and to support good mental health, especially when exercise is taken outside.

 

The benefits of at-home physiotherapy when you’re living in a care home

We’ve found that providing our residents with regular access to a physiotherapy service that is person-centred and responsive to each person’s needs is playing a huge part in keeping our residents as physically active as possible, as we’ve seen recently with our Stone House Sports Day and Bartlett’s Mini Crazy Golf.

Moreover, for our residents who are living with dementia, having at-home physio means they can be surrounded by their own possessions and have their treatment in a relaxed atmosphere, rather than having to go to an unfamiliar clinic with time-pressured appointments. 

The small team of physios who visit us are able to get to know our residents very well, and for our ladies and gentlemen with dementia they often adopt creative approaches to make the exercises and movements they are recommending as easy to understand and participate in as possible. The physios are also able to assist staff and relatives in understanding how they can support exercise and movement regimes in-between visits.

 

What our residents and families have said about our at-home physio service

Tony said:

“I have been seeing Gemma for the last two weeks and my problem has gone. She has not needed to see me again. She has improved my walking by doing basic walking techniques. Gemma is very easy to get on with and has treated me with dignity and respect.”

 

Audrey (Family member) said:

“My husband suffered a serious stroke in July 2020. He was previously very fit. I was present for a short session given by Ms Barnes during a visit to Merryfield in January 2023, and was immediately struck and most impressed by her completely different approach from that of the community physiotherapists. Determined and dedicated, she never gives up hope and has in-turn given my husband hope. She is always cheerful and her pleasant attitude means my husband looks forward to her visits. My husband is now starting to engage core muscles enabling him to reach forward a little. Most importantly, Gemma has enabled my husband to slightly move his left leg which is an incredible achievement as it is now three years since his stroke. This has had an immense psychological effect on him. I would thoroughly recommend Gemma: her dedicated approach and positive demeanour is second to none.”

 

Esther said: 

“Gemma is now a regular visitor to Merryfield and is a great comfort and help to all. Residents have one-to-one sessions with Gemma and they are helped with their individual needs. She converses well, has a wide knowledge and gives great advice on ‘aches and pains’. She explains specific problems and the best way to deal with them. She has helped me a great deal.”

 

About The Caring Physio

The Caring Physio are a team of physiotherapists – all of whom are members of the Health and Care Professions Council and the Chartered Society of Physiotherapy – that specialise in providing person-centred treatment in the comfort of their patient’s own homes. Their physiotherapy is delivered by professionals with outstanding knowledge and experience, and they are able to provide best practice advice for recovery from a multitude of different health conditions and injuries.

Gemma – one of the physios supporting our residents – graduated in 2008 with a first-class honours degree in Physiotherapy. She went on to have a successful career as a Military Physiotherapist before specialising in frailty. Gemma believes – as we do – that no one is too old for rehab, and she enjoys helping people from a variety of different backgrounds to fulfil their potential.

 

 

We caught up with Gemma to ask her some questions about being a physio and what she and her colleagues offer our residents

 

Gemma, you’ve had a really interesting career, including working at the Defence Medical Rehabilitation Centre (Headley Court) in the fields of Complex trauma, Amputee rehab and Neurology before specialising in frailty. What do you love most about working with older people?

Gemma: “Yes, I’ve been very lucky in my career so far and have had the chance to work with some incredible people spanning all age groups and backgrounds. I think what I enjoy most about working with older people is what you can learn from them. They have so much lived experience and will inevitably teach me something new every day. This generation in particular have lived through so much change and tend to have a real ‘can do’ attitude, which translates well into the physio sessions. I find myself laughing most days as they often have a very refreshing outlook on things.”

 

Why do you and your colleagues believe that timely access to physiotherapy is so important for people as they age?

Gemma: “We firmly believe that no one is too old for rehab and that prevention is often better than cure. If we can maintain people’s physical fitness, mobility, confidence and balance then this can reduce their falls risk and also improve their overall quality of life. We also believe that age shouldn’t be a predictor of quality of life and that people shouldn’t be ‘given up’ on because they reach a certain age. Sometimes even a small amount of input can have a hugely positive effect.”

 

Many care providers don’t yet offer at-home physiotherapy for their residents. What do you and your colleagues believe are the key benefits of an at-home physiotherapy service for people living in care homes?

Gemma: “Sadly, some people see going into a care home as ‘giving up’. We believe that a good care home environment should encourage people to live their best lives, but often physical barriers can stand in the way of this. Providing an in-house physio service to residents allows us to problem solve in their own environment, meaning we can give advice and make changes in real time. We can also provide physio for residents who are bed bound and may not be able to go out and access ‘traditional’ physiotherapy in clinics or outpatient departments. It may also be that people don’t know what physio can provide, or how much it can help particularly with conditions such a Parkinson’s Disease, stroke & with general frailty. We also provide advice to the care home and family members on equipment that may help residents, and can signpost to other services that may be required for residents who may have ‘slipped through the net’ within a very stretched NHS.”

 

You and your colleagues have made a huge difference to the lives of many of our residents already. Can you tell us some of the successes in treating our residents that you’re particularly proud of?

Gemma: “Within the care homes that we work in, we have seen some brilliant things, including enabling an 89-year-old gentleman to undertake a skydive for charity. He wasn’t able to adopt the correct flight & landing positions, but following an intensive period of physio, he managed it and was able to complete the skydive, raising over £6K for charity and fulfilling a lifelong dream. This was a very proud moment for all of us. (Note: this wasn’t a gentleman in a Peverel Court Care Home). 

We have managed to get a gentleman who had a stroke and was deemed to have ‘no rehab potential’ to actively move his leg, and he is now able to stand using a piece of equipment we have sourced for him. This has had a profoundly positive impact on both him and his family. 

We have also been working with a lady to help her regain full functional use of her hand after it came out of plaster following a break. She didn’t get any physio through the NHS but we have managed to get her using the hand functionally again, which has enabled her to remain more independent with tasks, including being able to feed herself. 

However, it’s not always about the ‘big wins’. Sometimes it’s just as rewarding to see someone’s confidence grow, or to get them walking independently again, or get someone a piece of equipment that enables them to be more independent or engaged. Often it’s all the ‘little wins’ that really add up to give great job satisfaction.”

 

Many thanks to Gemma and her colleagues for the support they are providing to our residents.

 

About Peverel Court Care

Peverel Court Care is a group of one residential and two nursing homes, located in Buckinghamshire and Oxfordshire. Bartlett’s Residential Care Home and Stone House Nursing Home in Aylesbury, and Merryfield House Nursing Home in Witney. We are a long-standing family business. Providing exceptional, personalised care, delivered by talented and compassionate people, in exclusive and idyllic settings.

With happiness at the heart of our homes, we recognise and respect the contribution made by our residents to society during their lifetimes. Valued by residents and their families; our reputation, investment in each property, and approach to appointing and developing our staff makes each home unique and the benchmark in premium care.

 

Bartletts, Community, Events

Bartlett’s charity walk for Age UK

On 15th September 2023 at 2pm, Bartletts residents and staff are taking part in a charity walk around the home to help fundraise for Age UK.

Peverel Court Care is proud to sponsor Age UK Buckinghamshire and Oxfordshire. Age UK is a well-known charity dedicated to supporting older adults, promoting well-being and tackling loneliness and isolation. They offer a wide range of services including befriending, social activities and practical assistance, which aligns perfectly with our focus on providing holistic care to our residents.

As you know, our mission extends beyond providing exceptional care services to our residents. We believe in supporting and enriching the lives of those in need around us. This partnership allows us to extend our reach and work together with these organisations, combining our efforts for a greater collective impact.

Please join us in supporting Age UK by sponsoring us on our JustGiving page. Together, we can create a positive impact and bring about meaningful change.

Bartletts, Events, Food & Drink, Wellbeing

Enjoying Cheese and Wine Tasting

 

We love sensory experiences for our residents and we’ve taken this to a new level thanks to our partnership with wine professional Kelly Sullivan. Read on to find out more about our inaugural event with Kelly where some of our residents living with dementia enjoyed delicious wines and cheeses from around the world.

 

A few weeks ago our residents at Bartlett’s participated in our first Cheese and Wine Tasting event as part of our new partnership with wine professional Kelly Sullivan.

We’ve partnered with Kelly to build on the work we do around promoting sensory stimulation across Peverel Court Care Homes. We aim to provide sensory stimulation regularly and in a variety of ways, including using everyday sounds, foods, objects and other items to awaken the senses and elicit a positive response or feeling. This contributes to improved quality of life, one of our core commitments to everyone who lives with us.

 

Sensory support for our residents living with dementia

Sensory support is especially beneficial for people who are living with dementia because it can help the person to live in the moment and interact with their current surroundings. Studies have shown that when done on a regular basis, sensory stimulation can be helpful in supporting memory loss. It can also improve daily functioning and other cognitive symptoms when all five senses are engaged and different ways to communicate can be explored.

 

 

Our first Cheese and Wine Tasting

Some of our lovely residents at Bartlett’s – Denis, Paul, Rosemary, John, Barbara, June and Doug – joined Kelly in the upstairs lounge where Kelly provided all of the cheeses and wines to try, sharing insights and knowledge of where they were sourced from as part of an eclectic round-the-world sensory experience. 

John chose to sit close to the window, overlooking views of the Chilterns, as he drank the wine and ate the cheeses independently, while Denis was pleased to learn about the various wines and the different countries they originated from, asking Kelly if she had visited any vineyards in New Zealand before. 

Paul reminisced while drinking wine with his friends. He was very engaged in the activity, keen to share his own knowledge and learn more from Kelly by asking various questions regarding locations and temperatures. Paul told us he enjoys wine and would like to do this activity again.

 

 

Why we will be doing more events with Kelly

We found that all of our ladies and gentlemen who shared the Cheese and Wine event with Kelly were very happy and keen to participate. This was a fabulous experience because our residents could be independent in a relaxed, adult-focused activity that some had enjoyed in their earlier life, exercise choice about what they wanted to taste, and experience both sensory enjoyment and supportive conversation.

Paul said: 

“I have visited many vineyards with friends, so it was nice to share stories with Kelly. It was a lovely experience – we all had a good time and the wines were very nice.” 

John said: 

“It was very nice to sit around with everyone enjoying fine wines – I really enjoyed myself. They went down very easily!” [laughing]

 

About Kelly

Kelly is a trained wine professional who has worked as a wine writer for various leading publications including Good Housekeeping, Decanter and Stylist. Kelly’s years of experience and deep passion for wine helped her to guide our residents through the tasting experience, supporting everyone to appreciate the intricate flavours and stories behind each bottle.

 

 

We caught up with Kelly to ask her some questions about her passion for wine and her work:

 

Kelly, what ignited your passion for wine and led you to becoming a wine professional?

Kelly: “Everyone has that one great bottle of wine that piques their interest and sparks a passion for wine. I was working in publishing at the time and doing weekly blind tastings for a magazine. I decided to take my professional wine exams to sharpen my knowledge and as a result it led me down a path of sharing my passion with other wine lovers and making wine more accessible for everyone.”

 

How did you choose the wines to share at our wine event?

Kelly: “To kickstart our series of wine tastings, I went with a ‘classic styles’ theme. This way we know there are styles in there that everyone will like or at the very least will have tried as it opens up conversation and makes it less daunting.

My selection of wines was based on reliable and popular producers, so I could guarantee quality. I chose approachable wines I felt the residents would enjoy.”

 

How did you choose the cheeses to pair with the wines? 

Kelly: “I chose the cheese based on what would best complement the wines and enhance their flavours. I wanted to find as many local, British cheeses as I could and to share the stories behind them.”

 

What are the benefits for people living in care homes from having Cheese and Wine Tasting events?

Kelly: “Cheese and wine tastings are a great thing to do in groups. It brings people together, opens discussions and gets you thinking, especially when you’re trying to pinpoint different tasting notes.”

 

What do you like most about engaging with our residents during these events?

Kelly: “The residents always have great stories to share about wines they have tried and the styles they love. It’s really interesting hearing their life stories and getting to know them better.”

 

What advice would you give care homes who want to engage their residents in sensory experiences like Cheese and Wine Tasting?

Kelly: “I would really encourage it. It’s a nice thing to do with an afternoon and it really engages the senses. I would advise care homes to make it accessible to residents by ensuring residents have the best set up and help they need.”

 

Many thanks to Kelly for a really positive experience for our residents at Bartlett’s. We look forward to hosting more Cheese and Wine Tasting events with Kelly soon.

 

About Peverel Court Care

Peverel Court Care is a group of one residential and two nursing homes, located in Buckinghamshire and Oxfordshire. Bartlett’s Residential Care Home and Stone House Nursing Home in Aylesbury, and Merryfield House Nursing Home in Witney. We are a long-standing family business. Providing exceptional, personalised care, delivered by talented and compassionate people, in exclusive and idyllic settings.

With happiness at the heart of our homes, we recognise and respect the contribution made by our residents to society during their lifetimes. Valued by residents and their families; our reputation, investment in each property, and approach to appointing and developing our staff makes each home unique and the benchmark in premium care.

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