Stage One: Supporting health improvement and self management to reduce the risk of falls and fragility fractures
Description (adapted from Up and About)
At this stage:
- A person is living in the community (including care homes) with support as required.
- The emphasis is on self care, supported self management, health education and promotion.
- There are opportunities for early intervention if circumstances change, therefore this stage has strong links with anticipatory care planning.
- Support for carers may be essential to achieve positive outcomes.
Many activities and interventions at this stage contribute to active and healthy ageing generally; some are more specific to falls and fracture prevention. Physical activity warrants a special mention. Research has demonstrated that increasing physical activity not only reduces susceptibility to falls, but improves cardiovascular fitness, strength and physical function; reduces aspects of cognitive decline; and can improve aspects of mental wellbeing such as self-esteem and mood. A range of local, accessible physical activity and exercise opportunities designed (or modified) for older people and others at higher risk of falls are needed.
The focus for the minimum standard 2014/16 is providing easy to access information and educational materials and sign posting to relevant services to support falls prevention and management.
Support for self management is what services provide to encourage people to take decisions and make choices that improve their health, wellbeing and health related behaviours. A wide range of activities supported and/or provided by statutory, independent and third sector organisations contribute to supporting health improvement and self management to reduce the risk of falls and fragility fractures. Providing access to information is only one aspect of supporting self management, but is an important first step as part of a minimum standard.
Actions to achieve the minimum standard for 2014/16
Up-to-date information on the prevention of falls and the prevention of harm from falls (including fractures) is made available to older people (and others at risk of falls), their carers and relatives.
- Information is available in local communities, clinics, care homes, day care facilities, waiting areas etc, and is also provided on a one-to-one basis as appropriate.
- The information is in a format and a language which can be understood.
- The information includes:
- key falls prevention messages (and where to get more detailed/further information), e.g. NHS Health Scotland's Tips to prevent trips and falls
- how to access resources, equipment, local services and organisations, which aim to support:
- the maintenance of health and wellbeing, including physical activity opportunities such as exercise classes, walking groups and other community-led activities, support for medicines management and eye health checks
- a safe home environment, including care and repair services, telecare and community alarm services and access to aids and adaptations
- a safer community environment, including Dial-a-bus and equivalent transport services.
- To ensure consistency of message, information provided on falls and fracture prevention and management is based on materials from the following sources:
- NHS Health Scotland
- Age Scotland and Age UK
- The National Osteoporosis Society
- NHS Inform (NHS 24's online information service)
The Framework in action
NHS Ayrshire and Arran, working with the local authority partners and third sector organisations have developed the 'Positive Steps' resource to promote falls prevention awareness. The resource can be used by any service or organisation to deliver information about falls prevention and bone health to the older people they support or work with. Thirty six resource boxes are available and have been used by, amongst others, Voluntary Action South Ayrshire at community based forums and clubs and by exercise instructors at Ayrshire and Arran's Invigor8 exercise classes.
Similar resources are being used in Highland and the Scottish Borders and are reaching diverse groups of older people and their carers.
NHS Grampian has produced a credit card size information resource which directs people to their healthPOINT for further information on a range of services and organisations which can support falls prevention. The card is also handed out by Scottish Ambulance Service and at Emergency Departments.
More information and contact details for the examples provided can be found on the Falls and Bone Health Community at http://www.knowledge.scot.nhs.uk/fallsandbonehealth/the-national-falls-programme.aspx
Encouraging positive attitudes to falls prevention
Don't mention the F word. Advice to practitioners on communicating falls prevention messages to older people. Produced by Help the Aged in 2005. Access at :
Falls and bone health specific resources for the public
NHS Health Scotland resources:
Tips to prevent trips and falls (poster) PDF can be downloaded here:
Up and About. Taking positive steps to avoid trips and falls (booklet) PDF can be downloaded here:
Copies can be ordered from NHS Health Scotland, at:
or by emailing HS publications directly: firstname.lastname@example.org
National Osteoporosis Society
NHS Inform Falls Prevention Zone will be available later in 2014.
Self management information
The Health and Social Care Alliance Scotland (the ALLIANCE) website is a useful source of information on self management of long-term conditions. Access at:
The 'My Condition, My Terms, My Life' self management campaign and website. The campaign, managed by the ALLIANCE is designed to improve public understanding of what self management means for people living with long-term conditions and enable them, as well as those who support them, to adopt a self management approach. Access at: http://www.myconditionmylife.org/
Finding community based resources
A Local Information System for Scotland (ALISS)
Silver Line Scotland (operated by Age Scotland)
Living it Up
Email: Susan Malcolm