Current demographic development requires appropriate care (informal/formal) for falls prevention in the growing older population across different settings as well as in the community. The development of new knowledge and research must be echoed in education and training of healthcare staff and also in the society. There is an urgent need to develop an interdisciplinary and interprofessional Master of Gerontology (“Master of Active and Healthy Aging”), which brings together research and practice. The innovative character of the program should be highlighted by the holistic perspective, incorporating courses in medical, nursing, rehabilitation, social, behavioral, psychological, economic, physiological, and management service aspects related to aging. A strong focus should be on active aging as well as the empowerment of self-care and (care) independency leading to falls prevention. In fall prevention work, new educational structures to teach and develop the workways across the Europe is needed.
TopIntroduction
Ageing is a human phenomenon that is occurring globally. In Europe, 13% of the population is aged 65 or more but in 2030, it is expected to be almost doubled to 24% (European Stakeholders Alliance for Active Ageing through Falls Prevention, 2015). This means that the average life expectancy is increasing - largely attributed to the development of medical and technological advances - but so are the challenges in geriatric care such as medical aspects of care, rehabilitation, nursing, psychology, sociology, pharmacy, social aspects, amongst others. According to epidemiological data, about 28-35% of people aged 65 or more fall each year and over 70 years of age, this increases to 32-42% (WHO, 2007). This indicates that falls in older people must be addressed by health care professionals both in acute and chronic care setting.
Falls are considered as alarming adverse event due their consequences such as lacerations, bruises, loss of function, hip and/or skulls fractures or even death. In addition, WHO (2018) classified falls as the second highest cause of accidental injuries in older persons, and highlighted that programs to avoid falls and research in underlying causes of falls should be prioritized. Falls are adverse events that affect not only older people physically but also psychologically and socially. Consequently, falls and falls-related injuries are common problems of Public Health as they are associated with high morbidity and mortality in older persons. Besides these aspects, falls and fall-related injuries increase costs in residential homes, nursing homes, public health services, hospitals and to old people that fall at home but have no health insurance. Therefore, it is relevant to contribute for patient safety by preventing falls in old people. Aspects related to causes of falls and how to prevent them should be taught at universities and higher education institutes. How exactly such education should be provided to the students could be particularly challenging to the teachers of such programs.
Most of the falls are preventable. Therefore, health care professionals such as medical doctors, nurses and physiotherapists can play important roles towards the prevention of falls. Their knowledge and skills to evaluate a patient´s overall health status and the risk of falls is vital and highlights the relevance of working as a team to prevent falls. This can potentially constitute a challenge to many educators, who are often used to work individually. For proper training of health professionals working in geriatrics, universities and universities of applied sciences must come together and develop joint aging related curricula. Inter-professional teachers should educate students as a team when teaching aspects such as falls and how to prevent them. As falls are multifactorial in etiology, the knowhow from different professions is needed. In addition, the health care professional´s skills to advise patients to decrease their falls risk are important. In many cases we need different kind of interventions involving different expertises of health care professionals. Unsurprisingly, what constitutes optimal fall prevention intervention and how to organize multi-professionals to work together, is a challenge. Similarly, another challenging point is teaching falls prevention to health care students in an effective way thus enabling them to educate old persons properly, implement accurate measures to prevent falls and to develop research in this field.