Referrals and conclusion
Referral to falls prevention services
Many areas now have NHS falls prevention services. These can provide a falls risk assessment by an appropriately skilled and experienced clinician to all people aged 65 years and over who have had several falls in the past 12 months, or have presented for medical attention following a fall, or who cannot perform, or perform poorly, on the Walking Speed Test, and/or the Timed Up and Go Test and/or the Turn 180 Degree Test.
Pharmacy teams should make sure patients know how to access these services. Depending on local commissioning arrangements it may be possible to refer patients directly to the service. If not, consider referring patients to the GP surgery for further assessment.
Example of a CPD record on falls prevention and older people
I will review my own practice in providing public health advice about practical ways of preventing falls. This will include knowledge about the contributory factors known to be associated with falls, how frailty develops and its signs, how to recognise older people who are at risk of falling, and practical tips on improving resilience and safety. I will refresh my knowledge about the medicines that are most frequently associated with falls and will update my awareness of local activities for older people that can help to build their confidence, strength and balance.
I am planning to learn this through a combination of:
- A short CPD module in Pharmacy Magazine, which includes a reflective exercise and an online MCQ self-assessment test
- With my team, identifying resources for signposting:
- relevant content on the Age UK website
- local activities to support older people and improve safety.
It will be a challenge to incorporate this learning into my everyday practice and that of my team. I will focus on how to offer brief advice together with signposting. Targeting patients with prescriptions for osteoporosis, or on benzodiazepines, is likely to be part of our plan and we will look to participate in future local campaigns.
- The key things that I have identified from my learning that I intend to put into practice are…
Conclusion
Community pharmacy teams can contribute to reducing falls beyond monitoring medicines that are known to be associated with falls. Simple practical tips can help to build resilience and prevent or ameliorate the effects of frailty through encouraging physical activity, improving diet, enhancing safety in the home and through the use of social networks.
Resources
- NICE. Falls in older people: assessing risk and prevention. Clinical Guideline 161, 2013 (regularly updated)
- Clinical Knowledge Summaries (CKS). Falls: Risk Assessment
- Age UK – A Practical Guide to Healthy Ageing
- The Chartered Society of Physiotherapy booklet: Get up and go – a guide to staying steady
- The Age UK information guide: Staying steady: keep active and reduce your risk of falling
- NHS Health A to Z: Prevention: falls