Project Description
Falls are one of the major factors contributing to injury among older adults. Falls account for 65% of injuries among Canadian seniors. The impact of falls on seniors is immense. Falls account for 84% of injury related hospital admissions, 40% of admissions to nursing homes, and a 10% increase in home care services. The risk of falling increases with age. As the veteran population is proportionately older than the rest of the senior population, falls prevention is a key issue to veterans (Falls Prevention Initiative, 2000).

PEI has the fourth highest percentage of seniors compared to the rest of the country. In Canada, 12.3% of the population is age 65 and older. However, in PEI, 13% of the population is over age 65. This figure is projected to reach 16% by 2011. PEI also has the third highest proportions of seniors in Canada age 85 and older. Whereas in 1996, there were 5,000 Islanders 80 and over, this figure is expected to increase to 12,000 by 2036 (Lilley & Campbell, 1999; Statistics Canada, 1999). This demographic profile indicates that falls prevention is a crucial issue in improving the health of PEI veterans, seniors and their caregivers. However, previous to Phase 1 of this project, very little was known about falls on PEI. We used various sources of information to learn more about the situation of falling on PEI and learned the following:

1) falling is a significant risk factor for institutionalization on PEI 2) older women are at higher risk of falling than men, and the consequences for women are more severe 3) seniors are at highest risk of falling during the fall and winter months 4) tripping, falling from one level to another, and stairs are major causes on falling on PEI 5) Areas of highest risk of falling in senior’s homes include outdoor steps, walkways, driveways and stairs

Senior, veterans, and caregivers have been involved and will continue to be involved in all phases of this project. In phase 1, seniors, veterans and caregivers were involved in participating in partner meetings, focus groups, project evaluation, and input and feedback on project direction. In Phase 3, they will continue to be involved in these areas with the addition that they will be involved in participating in designing and implementing falls prevention programs.

Determinants of Health
We are using the Prince Edward Island’s Circle of Health, Health Promotion Framework in developing our program (1996). This framework is based on 1) health as a resource to meet peoples’ needs (physical, mental, emotional, spiritual), 2) strategies to improve health (build healthy public policy, creative supportive environments, strengthen community action, develop personal skills, and reorient health services), 3) the participants in health promotion (individuals, families, communities, systems, and societies). The determinants of health, or what makes and keeps us healthy is the fourth factor. This framework is very helpful in addressing falls prevention. The factors and conditions that contribute to falls are very complex. This area of study has been most advanced by researchers at the University of Victoria (Gallagher, Hunter & Scott, 1999). This group developed a model examining the antecedents and consequences of falling including a variety of demographic, health, psychological, and psychosocial variables. They found that the likelihood of falling increases directly with age and chronic illness. In addition, older women who are poorer are more likely to have a chronic illness that leads to falls. Falling is directly related to increased assistance with activities of daily living.

Life Stage Priorities
Whereas later life is the primary life stage of focus in this project, there are also critical connections to people of all ages. By modifying the environment to make it safer, all people will benefit. Falls can happen at any age, but falling in old age often results in increased risk for injury. In order to prevent falls in old age, many interventions are effective if begun much earlier in life. In this project, we will primarily address three specific areas of later life as specified by the Population Health Fund Priorities.

First, this project addresses factors leading to illness and disability. Nutrition and physical activity are major factors that contribute to reducing the prevalence of osteoporosis. The combination of osteoporosis and falls has an immense impact on the health of many seniors, and in particular, the health of older women. We will endeavor to develop initiatives that focus on personal health practices in Phase 3 in order to attempt to reduce illness and disability in later life, and may extend life. Educational activities will focus on many risk factors for falling and provide ways to reduce illness and disability in later life in order to increase quality of life.

Second, this project strengthens the capacity to support healthy aging. We have made contact with various groups and have formed partnerships with those interested in working in the area of falls prevention. There is now a broad network on PEI who have an increased awareness for the need to prevent falls. The involvement of veterans, seniors, and caregivers throughout the project are major strengths.

Finally, this project contributes to enhancing personal autonomy and independence. We will foster the development of approaches that focus on improvements in the personal, social, and physical environment.