What is a Falls Clinic? The story behind the valued grant from Marlborough's Friends of Savernake Hospital
Patients attending the Integrated Team Falls Clinic (ITFC) at Savernake Hospital will now benefit from a vast array of new equipment, thanks to a generous grant of £1,211 from the Friends of Savernake Hospital and the Community.
This NHS Falls Clinic is part of Great Western Hospital's community health services. It assists both patients who have had a fall and those balance-impaired patients who are at risk of falling.
“After a fall, patients will often feel less confident about walking. This leads to reduced mobility and activity and, in turn, to reduced muscle strength, reduced stamina, reduced flexibility and poor balance, which can lead to another fall,” explains physiotherapist, Karen Roberts.
“One of our roles at the Falls Clinic is to reverse that cycle by increasing muscle strength, stamina and flexibility through a series of short term goals so as to increase the patient’s mobility and ensure that the patient reaches that long term goal of walking again safely and confidently, and therefore be able to return to a more independent life.”
Through an eight week program, patients meet as a group led by Karen, Pete Sears (Occupational Therapist) & Hayley Wylie (Health Care Support Worker) and will use the new equipment to steadily improve their mobility and balance.
“It is lovely seeing the patients, many of whom are anxious about walking, develop friendships and grow in confidence with peer support,” says Karen.
Whilst meeting as a group, each patient has an individually tailored physiotherapy circuit for each session and is assessed both at the beginning and at the end of the eight week program.
“Variety is so important when doing these exercises,” explains Hayley, “which is why the new equipment is so welcome.”
The new equipment includes a balance beam which replicates for patients in a safe environment the sensation of walking on an uneven surface outside; a rocker board to encourage patients to transfer their weight evenly, which is particularly important where there is a weakness on one side of the body after a fracture or stroke; and a multitude of apparatus to assist patients in learning to walk up and down stairs, to encourage patients away from taking short shuffling steps, and to teach patients how to get up safely from another fall should it happen.
The ITFC also provides a triage service. Through a comprehensive assessment the team will assess a patient who has fallen to determine the cause of the fall and which course of action is best to improve the patient’s balance and mobility.
The Support Nurse will look at the patient’s history of falls and undertake various tests, including a urine analysis, ECG, standard blood pressure test and postural hypotension test to determine dizziness after standing, check on current medications to see if any may be making the patient more susceptible to imbalance, vision tests and skin tests to check sensation. Where appropriate the team will make a referral to the doctor.
Karen, from a physiotherapy perspective, will look at the person’s balance and range of movement, weaknesses and coordination, using the new equipment funded by the Friends. Some of these patients will be given exercises to do at home and may be invited to join one of the eight week circuit classes.
Pete as an occupational therapist conducts a cognitive assessment involving long-term and short-term memory tests. He also looks at the home environment to determine what simple changes can be made to avoid falls in the future, including bedside lighting, moving electricity cables out of the way, identifying loose rugs and having extra stair rails and handles in the bathroom.
Understandably, the Falls Clinic has strong links with many other medical departments, including podiatry, nutrition and dietetics, audiology, orthotics, memory clinics, all of which have their role to play in assisting patients avoiding further falls.
“Our aim is to promote independence for our patients in a safe environment for as long as possible,” explains Pete.
The latest statistics from Age UK shows the importance of the work of the Falls Clinic:
One in five men over the age of 65 fall. One in three women over the age of 65 have a fall. By the age of 85, half of people - men and women - have a fall. These falls are estimated to cost the NHS in the region of £2.3 billion each year, and fractures in people over 65 accounts for over four million hospital bed days each years.
This is aside from the human cost of falling, which includes distress, pain, further injury, immobility, loss of independence, depression and even early mortality.
Clearly the work of the Falls Clinic and Karen’s team cannot be underestimated. After following the eight week physiotherapy program, many of the patients move on to exercise programs at Marlborough Leisure Centre, supplemented with home exercises. After three months the patients are invited back to the Falls Clinic for a review.
Many will have maintained or improved their balance and flexibility since finishing the eight week program, and if not may be offered further one on one sessions and further direction and encouragement with their home exercises.
Anyone who feels they would benefit from an appointment with the Integrated Team Falls Clinic or joining one of the eight week Balance & Awareness Classes can do so on a referral from their GP.
Trudi Granger, who works with the Friends of Savernake Hospital and the Community, wishes to thank the ITFC team for the help with this article.