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Stepping On

Stepping On: Building Confidence and Reducing Falls

Copyright Date: 2019
Published by:
Pages: 314
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  • Book Info
    Stepping On
    Book Description:

    The Stepping On program is a community-based falls-prevention program that shows participants how to reduce falls, increase confidence and maintain personal independence. Originally developed in Australia, based on research and scientifically proven to work, the Stepping On program is now internationally recognised as best practice in falls prevention. The Stepping On manual is aimed at health workers with a passion for aged care. It offers a step-by-step guide to running the seven-week group program, plus essential background information. Topics covered include understanding the risk of falls, identifying home hazards, the role of vision in causing and preventing falls, staying safe in public places, strength and balance exercises, and much more. The manual includes a guide to useful resources, handouts for group participants, and suggestions for recruitment and evaluation. This new edition has been thoroughly revised and redesigned to incorporate cutting-edge research, professional feedback, and over fifteen years’ experience of running of the program. As well as the latest fall-prevention research, the revised manual contains an expanded section on working with culturally and linguistically diverse groups, simplified exercises for participants to do at home, and new stories and illustrations. ‘This is an invaluable manual incorporating the latest evidence for falls prevention in the community.’ Professor Lyn March AM, University of Sydney and Royal North Shore Hospital, Sydney ‘This new Stepping On manual will be a wonderful resource for many health professionals like myself who work with patients who have had falls and fractures. It is definitely my “go-to" resource in our very busy clinic!’ Lillias Nairn, North Shore Ryde Health Service A range of handouts and supplementary materials are available for download. Please click on the Table of Contents tab for links to download the supplementary materials.

    eISBN: 978-1-74332-686-2
    Subjects: Sociology

Table of Contents

  1. Introduction
    (pp. 3-10)

    The Stepping On program offers people a way of reducing falls and at the same time increasing self-confidence in situations where they are at risk of falling. The program incorporates a group setting plus individualised follow-up. It covers a range of issues, including falls and risks, strength and balance exercises, home fall hazards, safe footwear, vision and falls, safety in public places, community mobility, coping after a fall, and understanding how to initiate a medication review.

    The Stepping On manual is designed for occupational therapists, physiotherapists, physical therapists, and other health professionals and health promotion staff who work with older...

  2. Part 1 Context
    (pp. 11-68)

    This part provides background information essential for understanding the conceptual underpinning of the program and the group process.

    The Stepping On program is designed to:

    use adult education principles to develop knowledge and skills for preventing falls, recognising that older adults have the capacity for learning and change

    increase awareness of falls risk and help people to be more informed about the factors contributing to their risk¹

    enhance self-confidence in falls risk situations²

    utilise the decision-making process³ to explore barriers and options and to develop skills in risk management

    boost follow-through with safety behaviours⁴

    target those behaviours that will have...

  3. 2 The Stepping On program

    • Stepping On overview
      (pp. 71-73)

      This section provides a quick overview of the program, information on preparing and planning for the program, and detailed outlines of the sessions, including the home visit and the three-month follow-up session. Each session outline begins with a list of the objectives that need to be achieved in that session. Time allocations are suggested for each segment, but flexibility will be needed within the overall constraints, because the time needed to adequately cover the material can vary from group to group. Homework is given to encourage active learning.

      A prerequisite to planning the program is to have read the ‘Background’...

    • Preparing and planning for the program
      (pp. 74-80)

      Seeking out a suitable community-based venue is the first challenge. It needs to be accessible and close to public transport. Participants may need assistance with even small obstacles at the beginning of the course, but as they gain strength and confidence, they will want more independence. Ensure your venue is accessible and inviting, with enough room for all of the activities in each session. A large area is good, but too large will not create a good learning environment.

      Ensuring accessibility is paramount in the first few weeks, while the participants are still building confidence. Make sure the toilets are...

    • Delivery of sessions
      (pp. 81-89)

      The facilitator’s role is central to the functioning of the program. Facilitators need to be good listeners, well organised, positive in attitude, and knowledgeable about falls prevention. Ongoing commitment from the group facilitator is very important and is noticed by group members. The facilitator creates a special bond with each person and inspires hope and a positive attitude to ageing.

      The facilitator needs to maintain an up-to-date list of secondary contacts and ongoing referrals, and a supply of resources and brochures for additional services.

      The facilitator may at times need to refer people on who are unsuitable for the program,...

    • Session 1 Introduction, overview and risk appraisal
      (pp. 90-127)

      The main objectives of this session are for participants:

      1. to build trust so that they feel comfortable to share their knowledge, ideas, questions and answers with one another and with the group facilitators, setting a tone for the rest of the group meetings

      2. to understand that others have falls and that there are a variety of reasons why we may fall

      3. to recognise the importance of exercise, strength and balance in preventing falls

      4. to realise that through this group process, a great deal can be learned from one another.

      Session materials: Session 1 agenda; name tags; attendance sheet; display board...

    • Session 2 Exercise and moving about safely
      (pp. 128-139)

      The main objectives for this session are for participants:

      1. to recognise for themselves the barriers to and the benefits of regular exercise

      2. to be able to do all the exercises correctly and to put on the ankle weights

      3. to improve techniques for safe standing, transfers, and climbing steps and stairs

      4. to understand that there are ways of getting up after a fall

      5. to recognise the importance of not panicking after a fall

      6. to identify a plan of action that might work if they did fall.

      Session materials: Session 2 agenda; name tags; attendance sheet; display board and display items; flip...

    • Session 3 Home falls hazards
      (pp. 140-172)

      The main objectives for this session are:

      1. to raise awareness of the type and range of falls hazards in and about the home

      2. to be able to recognise hazards in one’s own home

      3. to be able to suggest adaptations and find ways to reduce home falls hazards

      4. to make some changes at home to reduce the risk of falling.

      Session materials: Session 3 agenda; name tags; attendance sheet; display board and display items (see ‘Props’ section); flip chart, butcher’s paper or whiteboard; marker pen; door signs; pens for participants to use; summary of ‘Mobility mastery experiences checklists’; Apple Game quiz;...

    • Session 4 Community safety and footwear
      (pp. 173-187)

      The main objectives of this session are:

      1. to raise awareness of the type and range of fall hazards when moving about the local community

      2. to increase observation of various fall hazards

      3. to generate strategies that will increase personal safety and reduce the risk of falls when moving about the local community

      4. to be able to identify the features of a safe shoe

      5. to accomplish an audit of shoes at home

      6. to identify clothing hazards that can cause a fall.

      Session materials: Session 4 agenda; name tags; attendance sheet; display board and display items; flip chart, butcher’s paper or whiteboard; marker...

    • Session 5 Vision, transportation safety, vitamin D and calcium
      (pp. 188-220)

      The main objectives of this session are:

      1. to understand how vision can influence the ability to get around safely

      2. to plan regular vision checks

      3. to explore functional adaptations that will help reduce falls hazards due to poor vision

      4. to understand defensive walking and how to scan ahead

      5. to list safety strategies for safe bus and train travel

      6. to understand the importance of calcium and vitamin D as protection against falls and fall injuries

      7. to become aware of the importance of weekly exposure to sunlight.

      Session materials: Session 5 agenda; name tags; attendance sheet; display board and display items; flip chart,...

    • Session 6 Medication management, sleeping better and mobility mastery experiences
      (pp. 221-245)

      The objectives of this session are to:

      1. Understand the importance of having a regular medications review with your doctor or pharmacist.

      2. Understand the consequences of taking multiple medications.

      3. Understand the consequences of not taking medications in the exact way they are prescribed.

      4. Understand the risks of chronic use of sleeping tablets (sedatives).

      5. Identify alternatives to improve sleep hygiene.

      6. Identify ways of finding out about unwanted effects of medications.

      7. Practise mobility situations in a safe and supportive way.

      8. Improve confidence in mobility situations when applying safe strategies.

      Session materials: Session 6 agenda; name tags; attendance sheet; display board and display items;...

    • Session 7 Reviewing and planning ahead
      (pp. 246-263)

      The objectives of this session are:

      1. to acknowledge personal accomplishments

      2. to identify the scope of participants’ knowledge of falls prevention and to determine attitudes to coping with falling

      3. to complete any topics not yet addressed. These usually include strategies to assist in safe use of transportation

      4. to offer time for farewells and inform participants of planned follow-up activities.

      Session materials: Session 7 agenda; name tags; attendance sheet; door signs; evaluation forms if needed; graduation certificates.

      Handouts: ‘Maintaining the momentum after Stepping On’; ‘Graduation certificate’.

      Catering: snacks and beverages for break, apples for Apple Game.

      Other resources: leg weights, Stepping On...

    • Session 8 Three-month booster session
      (pp. 264-270)

      The objectives of the three-month follow-up session are:

      1. to listen to and acknowledge the ways in which the participants have applied safety strategies in their daily lives since the program

      2. to review ways of ‘keeping it happening’, in particular the exercises

      3. to review key points from the program and reinforce skills that the participants have mastered and put into practice

      4. to practise the exercises if requested.

      Session materials: Session 8 agenda; name tags; attendance sheet; door signs; display board and display items.

      Handouts and flyers: spare ‘Balance and strength exercise manual’; Apple Game quiz; community service flyers for exercise groups....