For the past 18 months, Anita Hin, Monica Fernandez and Chelsea Prado met with first responders and focus groups and coded and analyzed data from fall incident reports. They also worked with an evaluation consultant who was hired by the Novato Fire Department supported by a grant through the County of Marin Mental Health Services Act to look at the link between depression and falls. Falls are the number one call that firefighters respond to, and the numbers are expected to rise with an increase in the elderly population.
“Research shows that it is feasible for first responders to provide services, education, and referrals to older adult fallers. However, it is unclear how effective this strategy is in reducing the number of falls,” says Hin, who drew inspiration for the project from her grandmother who has fallen multiple times yet refused to move into a nursing facility.
“Occupational therapy fall prevention services that emphasize older adults’ personal experiences and daily functioning in a small group setting have been shown to be effective. Therefore, collaboration between occupational therapists first responders in providing occupation-based services may be an effective approach in addressing this major public health concern.”
The students presented their research, along with Dr. Ruth Ramsey, at the annual conference of the Occupational Therapy Association of California in Sacramento last October. They concluded that collaboration between occupational therapists and first responders can reduce falls and fall-related injuries, costs, and ultimately increase the independence and quality of life of older adults.
“This is an exciting and innovative partnership between two groups of professionals working with older adults- health care providers and first responders. As healthcare shifts from intervention to prevention, and as our society ages, these sorts of partnerships are critically important to help keep people and communities healthy,” said Dr. Ramsey, chair of Dominican’s Department of Occupational Therapy. “The students were excited be involved in a ‘real world’ setting outside of health care and to see how they can apply what they have learned at Dominican to addressing critical community health issues.”
Dr. Ramsey was the thesis adviser for the three Dominican OT students who were grouped because of similar interests with older adults and cultural influences. Dr. Ramsey, who is part of the Marin County Fall Prevention Task Force, connected the students with NFD Fire Battalion Chief Ted Peterson, which allowed Dominican students to participate in “ride-alongs” with first responders in emergency vehicles and conduct focus groups with older adults and first responders. They gained a deeper understanding of older adults’ fall experiences and explored a novel practice setting in which occupational therapists can play a vital role.
“We are interested in enabling people to live as independent as possible so this was an opportunity to study the factors of falls in the older adults, the older adults’ perspectives and the first responders’ perspectives as well,” Fernandez said. “As occupational therapists, our main goal is to promote health and a better quality of life through occupations. Our goal was to better understand falls and the causes of those falls.”
Fernandez is currently doing fieldwork at Stonebrook Health Care Center in Concord while Prado is finishing her fieldwork at Hayward Healthcare and Wellness Center.
Along with Hin, their study found that older adult fallers were primarily females living in the community and that first responders may feel uncomfortable talking to older adults about mental health issues.
The next step is refining and expanding research and developing a community program in partnership with the Novato Fire Department. Hin, who is doing her fieldwork at the California Pacific Medical Center’s Kalmanovitz Child Development Center in San Francisco, partnered with two other OT students (Jovita Vasquez and Jennifer Pulido) to develop a proposal for a fall prevention community program for NFD. The program has three components: community fall prevention presentations for community-dwelling older adults; training for first responders on common mental health conditions seen in older adults and various referral resources; and home visits/assessments provided by Dominican OT students. Dr. Ramsey will be working with the NFD to further develop and implement the program, and to seek grant funding to support it.