Ready, STEADI, go

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Three weeks ago a patient walked into the Dakshas clinic at the Vivekananda Health Centre. She had been referred to us by a partner NGO She was 80 years old and had a fracture. She had fallen in the bathroom and fractured her hip. She was in tremendous pain and anxious  It would have been so much better if she had never fallen and fractured her hip. 

With 8.6% of India’s population being categorised as geriatric, prevention of falls can save considerable health expenditure. Around 20−30% of the injuries among the elderly can be attributed to falls and, in fact, they are one of the leading causes of death among them. And the truth is that no fall is harmless. Every time, it leads to a loss of confidence in carrying out one’s daily activities and could result in breakage of bones, head injury and hospital stay. Hip fractures are the most common in falls and can make a senior/elder patient bed-ridden for the rest of her/his life. 

Since May 2019, Dakshas has been working with old age homes to implement a fall prevention programme called STEADI (Stopping Elderly Accidents, Deaths and Injuries). STEADI, which is the Centre for Disease Control and Prevention’s (CDC) programme to prevent the elderly from falling. STEADI offers us just the programme we need  to prevent falls among the elderly. We identify elders who could fall and mark them as either ‘high’, or ‘moderate’ or ‘low risk’ through various checklists. We then conduct interventions like providing inmates at old age homes (how many) with regular strengthening, balance, and gait training programmes. All elders with high and moderate risk are referred to the physician and provided with walking aids. All osteoporotic patients are given vitamin D supplements. 

Over the last five months, Dakshas has screened approximately 691 seniors, 508 of whom where in various old age homes. Among them, 119 reported a fall in the last one year, and over 300 used furniture to support themselves. Various medical, orthopaedic, neurological and ophthalmological measures have been introduced to prevent falls. Ambient risk factors have been also discussed with the old age homes. 

Risk of fall pie chart

Post our intervention, no further falls have been  reported in the old age homes, which Dakshas now visits regularly. 

A survey six months later reveals that the absence of the following precautions contribute to   a high risk of falling:

  • grab bars in toilets; 
  • non-slip rubber mats in washrooms; and
  • mats in corridors leading to bathrooms

Dakshas hopes to rectify the situation over the coming weeks.