Helping seniors reduce the risk of falling

December 16, 2014

PT-Valerie-Johnson-INSIDER

From the moment he got out of bed in the morning, Wayne Yancy feared he would lose his balance and hit the floor.

“There were times when I would just be walking along and fall down,” said the 67-year-old retiree, who had suffered several injuries from falls.

Only when he was hospitalized for complications from Chronic Obstructive Pulmonary Disease, did Yancy learn ways to reduce his risk of falling.

Before being discharged, he was introduced to Safe Transitions for the Elderly Patient, or STEP, a hybrid transitional care model developed by UNT Health Science Center. The program is designed to reduce 30-day hospital readmissions, decrease falls and improve the quality of life for Medicaid-enrolled adults.

The STEP program takes a holistic approach to managing a patient, said Program Manager John Allen. An interprofessional team that includes a nurse practitioner, social worker, pharmacist, physical therapist and physician addresses health concerns from different angles. While a physical therapist might work on balance training and education, other team members address medical or psychosocial factors that may contribute to falls.

Yancy’s high risk of falling made him an ideal candidate for STEP.

To help him regain his confidence walking, Physical Therapist Valerie Johnson taught Yancy exercises to strengthen his legs and improve his balance.

Balancing on a foam block with his eyes closed was especially challenging for Yancy because he wasn’t able to rely on his vision or joint position sense, Johnson said. The exercise forced him to rely on his inner ear for balance, which significantly reduced his fall risk, she said.

“At first he lost his balance in five seconds,” Johnson said. “But now he can hold his balance for a good 30 seconds, really until I tell him to stop.”

The STEP program started in June and is getting positive results. The hospital readmission rate is 10 percent, half of the state average, Allen said.

Often, people are readmitted to the hospital because they have substandard care once they get home, he said.

“We’re working to better serve this population and return them to health,” Allen said.

Dr. Nolan Kline, School of Public Health
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