Community Care and Hospital Based collaborative Falls Prevention Project

INTERVENTION: Community based falls prevention follow up of people discharged from a hospital emergency department following a fall and people discharged from a hospital out patient falls prevention clinic. The intervention group will receive up to 8 hours of support worker contact time over 2 to 4 weeks to review risk factors in the home, strategies to reduce risk factors, assistance to implement a falls action plan. This includes practical assistance e.g. visits to GP, Optometrist, Podiatrist, reinforcing awareness and reduction of risk factors. All patients discharged from either the hospital Emergency Department or Falls Clinic have a standard Falls Action Plan to implement following the standard hospital falls intervention process. This can include a home exercise plan, organising an optometrist or podiatrist review, removing loose rugs or obtaining a non slip mat for the bathroom. A face to face interview 4 weeks post discharge will review actions taken with the original falls action Plan of the intervention group and the control group. At this time both groups will be provided with a falls callender to record informatin on falls. At three months all will have a phone reminder to regarding filling in the falls calendar and at 6 months a questionairre for both groups will measure qualitative and quantitative outcomes for both groups. The number of falls in the six month period from discharge to the initial 4 week post discharge will be ascertained at interview and from the initial interview at the end of a six month period of recording falls on the calendar. Patients attending the hospital's emergency department (100) and Falls Clinic (100) who meet inclusion criteria and who consent to participate will be randomised into control group (no community follow up) and intervention group (post discharge community follow up) CONDITION: Falls in the elderly living in the community PRIMARY OUTCOME: Decreased falls over a six month post intervention period. Increased implementation of actions to reduce risk factors. The number of falls participants in the intervention and control groups will be compared as will implementation of a Falls Action Plan to reduce risk factors. The area a fall occurs such as bathroom or footpath will also be recorded. SECONDARY OUTCOME: Increased awareness of falls prevention and confidence falls are not inevitable and perception they can take action to reduce risks. INCLUSION CRITERIA: Presenting to the Emergency Department or Falls Clinic. live in the Perth north metropolitan hospital catchment area. live in the community.