1. English
  2. English

Frailty, falls & fractures: Assessment and management at specialised clinics/liaison services supporting older adults – what can we learn from each other?

29/10/2020

Different perspectives have created and shaped somewhat different models of care, working with the same group of patients; often frail, osteosarcopenic, older adults with risks of falls and fragility fractures. This workshop sought to explain the rationales and working methods of some existing models and to discuss possible further improvements and collaborations within and beyond the existing organisations.

 

Introduction

On 13th October, Reference Site Skåne organised a webinar on the role of falls clinics and fracture liaison services in meeting the mounting challenge of an ageing population. Three different services were presented by Bodil Jørgensen (Denmark), Anna Holmberg (Sweden) and Leocadio Rodríguez Mañas (Spain), showcasing their work in supporting frail older adults withs risks of (recurrent) falls and fragility fractures. The presentations included a wide variety of aspects, e.g. details of thorough investigations by geriatricians and physiotherapists on the causes behind individual risks of falls (Denmark), the important role which a fracture coordinator can play (Sweden), and the reasons for establishing an integrated approach in the service (Spain). This latter aims explicitly to reduce both the number of falls and the number of fractures, and some interventions clearly contribute to both outcomes, e.g. by improving the quality of bones as well as muscles. ICT-platforms and other technologies can be of help in a continued screening and comprehensive assessment, treatment, and follow-up.  

Professor Patrik Eklund gave a presentation on different aspects of how we could think to broaden and improve collection and analysis of data, for better prevention and personalised care, health and wellbeing. He also talked about how organisations would need to classify, label, and register data in a comparable way, using standardised taxonomies, and the possibilities of ICF.

In the following discussion moderated by Regina Roller-Wirnsberger, all the participants and the speakers had the opportunity to go deeper into a couple of themes; aspects of drugs, exercise and nutrition for old people with frailty, and to address the needs of the organisations and the effectiveness and efficiency of the measures in the different services.

Beyond spreading the knowledge and insights from valuable and interesting experiences in a selection of reference sites, the more long-term aim of the workshop was to facilitate future exchanges of best practices in the work of supporting frail older adults. The workshop sought to identify innovative solutions and new collaborations by which the organisations could further improve their services. For this, the use of digital tools was also emphasised. Both established, and not yet established services could benefit from digital tools for citizen empowerment and person-centred care, by improving quality of screening and monitoring, adherence, feedback, and evaluation.

Conclusions

All European countries are facing the same challenges, with an ageing population, making collaborations on all levels ever more important. Despite some uncertainties concerning formal support from 2021 on, and the current difficulties of meeting face-to-face, several very fruitful insights have been made, and contacts have been established, in organising and carrying through this webinar. A steady increase of older adults with risks of (recurrent) falls and fragility fractures is one of the challenges that will continue to be an important issue for the health care sector to meet. For this, specialised falls and fractures clinics have an important role to play and, even though adjustments to local conditions will be needed, the importance of inspiration from others will not diminish in coming years but will be a requirement for successful and continuous improvements in the area.

View the presentations from the workshop. 

Related action groups: 
A1 Adherence to prescription, A2 Falls prevention, A3 Lifespan Health Promotion & Prevention of Age Related Frailty and Disease, B3 Integrated care, C2 Independent living solutions, D4 Age friendly environments
Relevance to partnership: 
Active ageing and independent living, Care and cure, Horizontal issues and framework conditions, Prevention, screening and early diagnosis