STAND TALL DON’T FALLElaine Bray, Director of Care

Garden City Aged Care Services

Stand Tall Don’t Fall

A program developed for residents who have severe dementia and are unable to participate in traditional exercise programs

Individualised functional exercise

Facilitated by Occupational Therapist

Evidence based and assessed

Functional Exercises

They focus on building a body capable of doing real-life activities in real-life positions, not just lifting a certain amount of weight in an idealized posture created by a gym machine.

“The key to functional exercise is integration. It's about teaching all the muscles to work together rather than isolating them to work independently." Greg Roskopf, MS, a biomechanics consultant

Why?

Traditional exercise class did not work

Increasing number of falls as disease progresses

Engagement difficulties

A new way had to be found

Process

Think tank – clinical staff, leisure and lifestyle staff, occupational therapist

Literary search – most if not all concentrated on time limited traditional exercise regime

Program designed with functional exercise both group and individual

Funding application successful through Medicare Local

The Program

Took place in Palm Court: 14 bed secure unit

Led by OT but strong involvement from LLM

5 days per week

2 groups (1 of 4: 1of 5)

4 individuals

A4 pictorial program developed for all residents

Total dedicated staff time of 10 -12hrs per week over 8 weeks

Before Commencement

Cohorts and friendship groups were carefully chosen

All participants had to have a high falls risk assessment

And a moderate to severe rating score on PAS

And of course had to be mobile

Letter and consent was sent to each family or EPOA – none withheld

So what does that mean in Palm Court?

Bed Making

Folding Linen

Cooking

Shopping

Setting and Clearing Tables

Gardening

Dusting

Tidying up

Chopping

Walking

Sweeping

Flower Arranging

Sewing

BBQ and Chooks

Breakfast, Flowers and Bedmaking

Gardening and Housecleaning

Table setting and Linen

VALUE

The one thing all of these ‘exercises’ have in common is

that are valued jobs and a normal part of everyday life

Measurement

Falls

Aggressive incidents

Sleep patterns

Family feedback

Resident mood

Resident engagement

Data

Results Table Results Table

Alzheimer’s Queensland, 1800 639 331

Agg Falls

Before 9 11

During 4 5

5 6

Decrease 66% 65%

0

5

10

15

Before

During

Family Members

Thrilled

Comments ranged from ‘amazing’ to ‘life changing’

No negative feedback or comments

Residents family were asked to participate wherever possible e.g. shopping, cooking

Anecdotal reports of improved sleep patterns

Residents

Joyous

Ambience in Palm Court uplifted

Engaged

Responding

More eye contact

More socially aware

More restful when quiet

Alzheimer’s Queensland, 1800 639 331

Barriers

Nursing staff were and are the biggest barrier

No clear data for mood or engagement – ( dementia mapping )

Time and resources to keep program going

Initial cohorts and grouping were artificial and broke down quickly and were really only used for financial purposes

Staff need to think on their feet to adapt o changing capabilities of participants

Positives

Obvious positive resident outcomes

Staff were re energised

Promoted flexible thinking and engagement by all team members especially in daily tasks

Family engagement

Moved away from ‘routine’

Non traditional approach less warehouse more funhouse

47 Tryon St, Upper Mount Gravatt, QLD 4122,Ph: 07 3422 3000, Fax: 07 3343 2557

email: helpline@alzheimersonline.orgwebsite: http://www.alzheimersonline.org

Helpline Freecall 24hours: 1800 639 331

Alzheimer’s Queensland