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The Fall Prevention Center of Excellence (FPCE) is a source of fall prevention information for older adults, families, caregivers, professionals, service providers, researchers, and policymakers. FPCE's aim is to provide leadership, create new knowledge, improve practices, and develop fall prevention programs.
The center's goals are to advance fall prevention as a public health priority and educate and train service providers and professionals in fall prevention. It also aims to development and implement fall prevention programs that address the needs of older adults.
To address the problem of falls, the Archstone Foundation held the first statewide Fall Prevention Summit in 2003 of over 150 stakeholders representing government, professional, and community organizations. A major outcome was the creation of FPCE with support from the Archstone Foundation to implement FP awareness and building a statewide FP infrastructure.
A background White Paper was developed prior to the conference. [1] Afterwards, a Blueprint for Fall Prevention was created. [2] In March 2004, a one-day event on fall prevention was held at the American Society on Aging/National Council on Aging Joint Conference. In January 2005, the Fall Prevention Center of Excellence was established.
FPCE is partnered with the University of Southern California's (USC) Andrus Gerontology Center (Andrus), and the Center for Successful Aging (CSA) at California State University, Fullerton.[ citation needed ]
Andrus serves as the program office, is responsible for administrative responsibilities and serves as the communication/dissemination site. They share their expertise in the environment, particularly home and community safety in relation to fall prevention, and they operate an executive certificate program in home modification. Their director of communications is Maria Henke and the co-director is Jon Pynoos.
CSA offers instructor training for a group physical activity program called FallProof. The instructors conduct group physical activity classes in the community. They specialize in balance and mobility as a strategy for fall risk reduction. The co-director is Debra Rose.
FPCE is affiliated with:
GRECC conducts research in fall prevention. They share their expertise in medical management of risk factors for falls and are skilled in evaluating fall prevention programs.
SACB works with Epidemiology and Prevention for Injury Control (EPIC) to track and identify causes and frequencies of fall-related injuries across the state. They promote fall prevention at the state level and share their expertise in improving programs and services available to reduce fall risk.
USC Pharmacy offers dual degrees in Pharmacy and Gerontology for students interested in pursuing geriatric pharmacy practice. They specialize in the pharmaceutical management of risk factors for falls.
FPCE:
FPCE is supported by the California Wellness Foundation, the Kaiser Foundation, The Eisner Foundation, the SCAN Foundation, and the Centers for Disease Control and Prevention (CDC). This support has augmented the resources provided initially by the Archstone Foundation and allowed FPCE to more widely reach older adults and underserved minorities by building the capacity of professionals and providers to address falls.
At the national level, FPCE's partners include the National Council on Aging (NCOA) and the Falls Free Coalition, the National Safety Council, Rebuilding Together, and the CDC. In California, FPCE works with organizations that represent older persons (e.g., AARP), ¬-government (e.g. Departments of Aging, Public Health, and Housing), health and social service providers, and caregiver organizations. Locally, FPCE partners with Area Agencies on Aging, the County Department of Public Health and the City and County Fire Departments. FPCE has an Advisory Board.
Ranking in the top ten causes of death, disability, and healthcare expenditures (Rubenstein, 2006; Ganz et al., 2007), the rate of falls and their associated costs are staggering (Stevens et al., 2006). In Los Angeles County, home to 1.4 million people aged 60 or older, EPICenter data show that approximately one third fall each year. In 2010, there were more than 20,000 hospitalizations for falls among 65+ year olds with an average of $61,800 in medical cost per visit. In California, over 565,000 older people fell more than once in 2007 (Wallace et al., 2010) and the costs of falls in California could reach $6.6 billion in 2020 (Trent, written communication, 2010). The fear of falling can lead to depression, isolation, and loss of independence for older adults.
To address the problem of falls, the Archstone Foundation held the first statewide Fall Prevention Summit in 2003 of over 150 stakeholders representing government, professional, and community organizations. An outcome was the creation of FPCE with support from the Archstone Foundation.
Funded by The Kaiser Foundation, the vision of FPC-LA is promoting safe fall-free aging. Its mission is to reduce fall risk for older adults through education, planning, and community action across Los Angeles County. Coalition members, including representatives from public, private, and non-profit organizations, have identified “fall hotspots”- zip codes where older people fall at high rates - to help target programs, conducted a Walkability Workshop to highlight hazards to pedestrians such as uneven sidewalks and unsafe street crossings, created a presentation for older adults that is being used by the Department of Public Health Speakers Bureau, and developed The Falling Monologues, a series of performances by an older adult scriptwriter and actors to raise awareness about falls.
This project is funded by the Archstone Foundation. Emergency Medical Services (EMS) personnel are often the first to arrive at the scene of a fall. FP Connect aims to educate Los Angeles County EMS personnel to address fall risks and reduce repeat falls. It enhances the ability of Fire/EMS to respond to falls effectively by providing LACoFD with an information and assessment tool that enables Fire/EMS personnel to conduct a home assessment and connect older adults who have fallen with community services.
Funded by the SCAN Foundation, the purpose of Pills & Spills is to help direct care workers in nursing homes and older adults’ homes reduce falls through medication and environmental interventions. The Fall Prevention Center of Excellence and the USC School of Pharmacy jointly created six 1-hour in-service sessions with corresponding case studies and video segments of teaching material. Topics include:
Funded by the Eisner Foundation, the mission of Home SAFE is to make home safety a component of successful aging and preventive health in LA County by increasing activities and awareness among consumers, professionals, organizations and the wider community. The project's home safety focus areas include:
An outcome is the development of the Home Safety in Your Community: A Toolkit for Change, with home safety information in English, Chinese, Korean, and Spanish.
The project is funded by the Archstone Foundation to develop a program aimed at reducing fall risk for older persons at moderate to high risk of falls, FPCE staff analyzed the effectiveness of three basic InSTEP models, which differ by intensity of professional involvement (high, medium and low). Validated instruments were used to measure fall risk behaviors, concerns about falling, fall history, and current physical activities. Multiple physical performance tests were also conducted pre- and post-intervention.
The project is funded by the Archstone Foundation. From 2006–2009, ten agencies were supported to create/strengthen fall prevention coalitions in two major areas in California. FPCE provided technical assistance and evaluated their progress. Coalitions conducted assessments to identify their community's greatest needs, created three-year strategic plans to address those needs, and employed strategies to build local capacity to reduce fall risk. During the grant period, the coalitions established four assessment and referral systems and eight resource directories for consumers and professionals covering 14 counties. Over 3,800 older adults were assessed for fall risk and more than 2,500 were referred to local services. Coalitions also trained over 2,800 service providers and educated more than 25,000 caregivers and older adults.
Funded by the Archstone Foundation. From 2006–2009, six agencies that were providing direct services to older adults to reduce their risk of falling were supported to integrate additional fall prevention components to their programs, such as balance and mobility training, medical management, and environmental assessment and modification. FPCE provided technical assistance and evaluated their progress. Over the grant period, the Program Expansion Grantees provided fall prevention services for 450 older adults and educated 7,100 seniors and caregivers on fall risks and fall prevention.
Elder abuse is "a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person." This definition has been adopted by of the World Health Organization (WHO) from a definition put forward by Action on Elder Abuse in the UK. Laws protecting the elderly from abuse are similar to and related to laws protecting dependent adults from abuse.
Elderly care, or simply eldercare, serves the needs and requirements of senior citizens. It encompasses assisted living, adult daycare, long-term care, nursing homes, hospice care, and home care. Because of the wide variety of elderly care needs and cultural perspectives on the elderly, it includes a broad range of practices and institutions. For example, government-run elderly care is seldom used in many Asian countries, where younger generations often care for the elderly.
The USC Leonard Davis School of Gerontology is one of the seventeen academic divisions of the University of Southern California in Los Angeles, focusing in undergraduate and graduate programs in gerontology,
Early childhood intervention (ECI) is a support and educational system for very young children who have been victims of, or who are at high risk for child abuse and/or neglect as well as children who have developmental delays or disabilities. Some states and regions have chosen to focus these services on children with developmental disabilities or delays, but Early Childhood Intervention is not limited to children with these disabilities.
Fall prevention includes any action taken to help reduce the number of accidental falls suffered by susceptible individuals, such as the elderly (idiopathic) and people with neurological or orthopedic indications.
A patient safety organization (pso) is a group, institution, or association that improves medical care by reducing medical errors. Common functions of patient safety organizations are data collection and analysis, reporting, education, funding, and advocacy. A pso differs from a Federally designed Patient Safety Organization (PSO), which provides health care providers in the U.S. privilege and confidentiality protections for efforts to improve patient safety and the quality of patient care delivery
Gerontechnology is an inter- and multidisciplinary academic and professional field combining gerontology and technology. Sustainability of an aging society depends upon our effectiveness in creating technological environments, including assistive technology and inclusive design, for innovative and independent living and social participation of older adults in any state of health, comfort and safety. In short, gerontechnology concerns matching technological environments to health, housing, mobility, communication, leisure and work of older people. Gerontechnology is most frequently identified as a subset of HealthTech and is more commonly referred to as AgeTech in Europe and the United States. Research outcomes form the basis for designers, builders, engineers, manufacturers, and those in the health professions, to provide an optimum living environment for the widest range of ages.
Program of All-inclusive Care for the Elderly (PACE) are programs within the United States that provide comprehensive health services for individuals age 55 and over who are sufficiently frail to be categorized as "nursing home eligible" by their state's Medicaid program. The ultimate goal of PACE programs is to keep eligible older adults out of nursing homes and within their communities for as long as possible. Services include primary and specialty medical care, nursing, nutrition, social services, therapies, pharmaceuticals, day health center services, home care, health-related transportation, minor modification to the home to accommodate disabilities, and anything else the program determines is medically necessary to maximize a member's health. If you or a loved one are eligible for nursing home level care but prefer to continue living at home, a PACE program can provide expansive health care and social opportunities during the day while you retain the comfort and familiarity of your home outside of day hours.
The Massachusetts Department of Public Health is a governmental agency of the Commonwealth of Massachusetts with various responsibilities related to public health within that state. It is headquartered in Boston and headed by Commissioner Monica Bharel.
A caregiver or carer is a paid or unpaid member of a person's social network who helps them with activities of daily living. Since they have no specific professional training, they are often described as informal caregivers. Caregivers most commonly assist with impairments related to old age, disability, a disease, or a mental disorder.
The U.S. Centers for Disease Control and Prevention defines aging in place as "the ability to live in one's own home and community safely, independently, and comfortably, regardless of age, income, or ability level".
Falls in older adults are a significant cause of morbidity and mortality and are a major class of preventable injuries. Falling is one of the most common accidents that cause a loss in the quality of life for older adults, and is usually precipitated by a loss of balance and weakness in the legs. The cause of falling in old age is often multifactorial and may require a multidisciplinary approach both to treat any injuries sustained and to prevent future falls. Falls include dropping from a standing position or from exposed positions such as those on ladders or stepladders. The severity of injury is generally related to the height of the fall. The state of the ground surface onto which the victim falls is also important, harder surfaces causing more severe injury. Falls can be prevented by ensuring that carpets are tacked down, that objects like electric cords are not in one's path, that hearing and vision are optimized, dizziness is minimized, alcohol intake is moderated and that shoes have low heels or rubber soles.
The California Department of Alcohol and Drug Programs (ADP) was a California state agency concerned with substance abuse prevention and treatment. Created by the California Legislature in 1978, ADP brought together the Governor's Office of Alcoholism and the California Department of Health's Division of Substance Abuse to form the single state authority for substance abuse prevention and treatment, and is currently within the auspices of the California Health and Human Services Agency. In this capacity, ADP provided leadership and policy coordination for the planning, development, implementation, and evaluation of a comprehensive statewide system of alcohol and other drug (AOD) prevention, treatment and recovery services. As of July 1, 2013, functions of ADP were transferred to the Department of Health Care Services.
The Older Americans Act of 1965 was the first federal level initiative aimed at providing comprehensive services for older adults. It created the National Aging Network comprising the Administration on Aging on the federal level, State Units on Aging at the state level, and Area Agencies on Aging at the local level. The network provides funding – based primarily on the percentage of an area's population 60 and older – for nutrition and supportive home and community-based services, disease prevention/health promotion services, elder rights programs, the National Family Caregiver Support Program, and the Native American Caregiver Support Program.
Guided Care is a model of proactive, comprehensive health care for people with several chronic conditions. A form of medical home, the model has been developed and tested by a multidisciplinary team of experts at the Roger C. Lipitz Center for Integrated Health Care in the Johns Hopkins Bloomberg School of Public Health. Guided Care is provided by physician-nurse teams in primary care practices to the physicians' most complex patients, mainly older adults with chronic conditions and complicated health needs. It is designed to increase patients' quality of care and quality of life, while improving the efficiency of their use of health care resources, thus reducing their overall health care costs.
The Pennsylvania Department of Aging is a cabinet-level agency charged with providing aid to Pennsylvania's approximately three million individuals age 60 and older. Although the bureau operates some services directly, such as the Pharmaceutical Contact for the Elderly (PACE) prescription drug program, it generally serves as a clearinghouse of funding and information for county-level Area Agencies on Aging. The department was formed under the governorship of Milton Shapp.
In the United States there are approximately 50 million people who are caring at home for family members including elderly parents, and spouses and children with disabilities and/or chronic illnesses. Without this home-care, most of these cared for would require permanent placement in institutions or health care facilities.
The LGBT Aging Project is a Boston-based non-profit organization dedicated to ensuring that lesbian, gay, bisexual, and transgender older adults have equal access to life-prolonging benefits, protection, services and institutions as heterosexual and cisgender adults. Founded in 2001, the project provides cultural competence and institutional capacity training to elder service providers on how to create and sustain LGBT welcoming environments, develop community-building programs for LGBT older adults and caregivers, and also works to enact policy and legislative changes to improve access to care and benefits for LGBT elders.. The LGBT Aging Project was featured in the 2010 award-winning documentary Gen Silent.
Barbara Barlow is an American pediatric surgeon who was the first woman to train in pediatric surgery at Babies Hospital, present-day Morgan Stanley Children's Hospital. She has also reduced the amount of injuries for inner-city children through her research and efforts to educate the public on prevention of accidents.
National Safety Month (NSM) is an annual month-long observance in the United States each June.