April Fools Day is a long-time and much-loved fixture of this month, but in the realm of geriatric health, it has a lesser known counterpart that’s certainly no joke.
April Falls Month, championed by the NSW State Government, and April No Falls month by the Queensland State Government, are annual initiatives that hope to raise awareness about the importance of mobility and falls prevention in older age.
One in three people over the age of 65 experience a fall each year, with these events often having devastating consequences for the elder’s health and quality of life.
Latest data from the Australian Institute of Health and Welfare (AIHW) shows that from 2019-2020, 5000 Australians aged over 65 died from a fall.
The report also showed that, compared to the general population, elders are eight times as likely to be hospitalised and 68 times as likely to die from a fall.
Furthermore, the impact of the COVID pandemic is feared to have put elders at even greater risk of injury or mortality.
Lockdown conditions, especially in residential aged care facilities, saw residents confined to their rooms and largely immobile for days, sometimes weeks on end — contributing to significant functional loss.
The AIHW also points out that slips, trips and stumbles are responsible for a greater proportion of cases as people age, emphasising the importance of targeted interventions for increasing elders’ balance and mobility.
Simon Kerrigan, a physiotherapist and the managing director of Guide Healthcare, tells Aged Care News that this year’s April Falls initiative was developed in direct response to these statistics.
“We know that falls are Australia’s largest contributor to hospitalised injuries and a leading cause of injury deaths,” he says.
“Our aged care residents are one of, if not the highest risk population.
“The good news is, we know many falls are preventable, we just need to implement the right strategies.”
Kerrigan, in fact, has developed a spin off initiative, called the Real World Games, to satisfy the goals of April Fools in the most fun way possible.
Launched on April 18, and taking place across the next four weeks, the games encourage elders to participate in a series of events that mimic typical obstacles they may face in the community, to be completed under the supervision of an allied health professional.
Each event incorporates a different environment, skill and challenge, and elders and their carers can plug their progress into an online, interface so they can compete with friends across the country.
“Motivation to exercise requires purpose,” Kerrigan says.
“After two years of lockdowns, we think there’s no greater purpose than gaining the confidence to get back out into the real world.”
The events, Kerrigan notes, have been designed to be fun and familiar, bearing in mind the intimidating nature of heavy gym-equipment for many seniors.
“We’ve ditched our usual kettlebells for grocery bags, so that even the most hesitant residents won’t be intimidated by traditional exercise/gym programs,” he says.
“We have a live leader board on our website, so residents can monitor their competition, and we’ll finish the event with five days of live streamed action as our elite competitors face off in our virtual stadium.”
Points will be awarded for both resident and staff participation, and at the conclusion of the event, all participants will receive a certificate of participation, with the top three competitors in each category awarded gold, silver and bronze medals.
“We’ll also be donating $1800 worth of exercise equipment to the top three teams,” Kerrigan adds.
“Engaging, creative and innovative events like these games are really effective at driving participation and enjoyment.”
The University of Oxford’s Centre for Evidence-Based Medicine notes that a mix of resistance, strength and balancing exercises are best for restoring lost function.
And these factors were front of mind for Kerrigan when developing the Real World Games.
“We know that a combination of resistance training, dynamic balance exercises and multi-tasking is necessary to reduce falls risk.
“As such, we’ve created a series of events which incorporate these elements in a way that is relatable and enjoyable.
“Residents will be tackling sidewalk curbs, transporting shopping bags, transferring objects of varying weights and sizes to different heights, speed walking and concentrating intently as they transport a full wine glass through a series of obstacles.
“We’ve also designed challenges for people with lower mobility levels and even staff members, so the whole community can get involved.”
The initiative hopes to instil an ongoing confidence in elders to keep active, with evidence from a Queensland research project in 2018 showing that aged care residents who consistently exercised could reduce falls risk by 55 per cent.
For optimal physical and mental health, it is recommended that all adults (regardless of age, health, or ability) do 30-60 minutes of physical activity most days.
To prevent falls and maintain independence this should include exercise or activities that improve strength and balance- with safe, senior-specific examples available via this link.
An information booklet detailing the games/challenges that will form the Real World Games is available via this link.
For more handy tips on how to prevent falls in residential aged care facilities, Kerrigan provides further advice in this video.