Reversing frailty to curtail ‘alarming’ falls increase

A new program introduced by an aged care provider is helping prevent falls of community-dwelling older people transitioning from hospital to home. 

The project, 'Being your Best', by aged care provider Bolton Clarke aims to reduce or reverse frailty by delivering interventions.

One in two people over 65 are impacted by frailty, which can lead to a cascade of repeated hospitalisations and loss of independence.

"There's been an alarming increase in falls and frailty in older people," research head professor Judy Lowthian says.

"So, that calls for this program more than ever."

More than 60 per cent of hospitalisations and 94 per cent of deaths are caused by falls by people aged 65 and over.

Fall risk and frailty are closely intertwined as they are significant physical and mental health indicators. 

"Frailty is more than just physical," Lowthian says.

"When someone needs a cane to walk and falls more often, it also has to do with people losing weight or not eating well.

"They might also decline cognitively and be less socially connected with other people."

The program targets recently hospitalised older people, assesses their physical and mental wellbeing and then sets up a number of interventions.

By zooming in on four aspects of frailty – nutrition, cognition, exercise and connectedness – the project hopes to prevent older people from becoming more frail.

"We're picking people up after they've had a hospitalisation because we know that, when older people go to the hospital, they often deteriorate," Lowthian says.

"Then, we're linking them with community services and people to do activities with while focusing on these aspects."

Pre-pandemic, up to one in two older Australians were pre-frail, which has now become a reality, Lowthian says.

Recurring lockdowns have led to social isolation and decreased physical activity in community-dwelling older people and those living in residential care.

Interestingly, hospitalisations due to falls were reduced by 14 per cent during the past two years of the pandemic. 

While this might be linked to Covid interrupting the daily lives of many Australians, restrictions did increase frailty in older people. 

"We've all had pretty hefty pandemic restrictions, which have been essential because we've needed to curtail this infection," Lowthian says.

"But now, physical frailty has grown because people haven't moved as much as they were.

"Many, in fact, have been limiting themselves to just one room in the house."

She says older people have become deconditioned to exercise and socialisation necessary to keep frailty at bay.

"Older people are still quite fearful about going out.

"And I think we'll continue to see an increase in physical, cognitive and social frailty."

During lockdowns, Bolton Clarke brought in iPads with appointed care workers to try and keep residents connected with family and loved ones outside the care home. 

Lowthian says it's been difficult for many aged care providers because, at times, they had to keep residents in their rooms instead of socialising during activities and meal breaks.

Research and development of the program was also put on hold for two years because of Covid restrictions.

"We're really ramping up progress at the moment," she says.

"And we're getting positive responses, which is great.

"Hopefully the program will help improve the wellbeing and health of many older people."

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