Accredited in September 2011
Authors:
Dr. Andreas DINSENBACHER
PRM Specialist
Coordinator of the Department of Geriatric Rehabilitation
Service de rééducation gériatrique
ZithaKlinik S.A.
36, rue Sainte Zithe
L-2763 Luxembourg
LUXEMBOURG
andreas.dinsenbacher@zitha.lu
SUMMARY
ZithaKlinik S.A. is regularly confronted with admissions of elderly people due to sudden falls that lead to an important number of detrimental health consequences.
By identifying those individuals demonstrating low gait stability and consequently a higher risk of falling, specific training programmes can be proposed to them and be implemented in everyday care and support activities.
Preventing falls, reducing risk factors and fall-related psychological and physical injuries, by maintaining the patient’s autonomy is our priority in the Geriatric Rehabilitation Unit. We integrate fall risk assessment in a structured pathway.
Our programme addresses fall risk and fall prevention strategies for frail ageing people.
Patients are examined, evaluated and assessed with respect to target risk factors of falls. Based on assessment results, strategies to prevent falling hazard are proposed. They may participate in the programme for fall prevention in an ambulatory or in-patient unit.
Multidisciplinary intervention targeting multiple risk factors is effective in reducing the incidence of falls, whilst strength, balance, vision, body awareness and reaction time is individually assessed and trained in groups of patients by health professionals.
For patients’ assessment, we use a series of tools and tests such as Tinetti, Timed Up and Go, Stratify, GAITRite, the functional independence measure (FIM) and other individually adapted programmes for training safe mobility.
The geriatric assessments are multidisciplinary and rely on a core team consisting of a coordinating PRM physician, a general practitioner, several nurses, a social worker, several physical and occupational therapists and a psychologist. Other professionals are included when needed. For example, a dietician may be needed to assess dietary intake and provide recommendations to optimize nutrition. A neurologist may be questioned on the causes which may affect the neurologic assessment of an old person.
Our geriatric rehabilitation unit provides objective data about the PRM strategy outcomes, on the basis of initial and final assessments, e.g. Functional Independence Measure or balance and gait measures.
Multiple indicators, such as aetiologies, rehabilitation programme types, functional outcomes, mortality rate and home returning rate are analysed on a quarterly basis. When leaving the Geriatric Rehabilitation Department, home visits by the occupational therapist and the social worker are proposed from case to case.