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Wrong call from ACC on elderly falls programme

NEWS RELEASE 16 October 2009
New Zealand Society of Physiotherapists

Physiotherapists are dismayed that ACC has cancelled a programme that is just starting to deliver major economic and social gains after a 15-year investment by ACC.

The New Zealand Society of Physiotherapists believes the ACC decision to cancel the Otago Exercise Programme is incredibly short-sighted. “People on this programme are 35% less likely to fall,” says Society President Jonathan Warren, “and 27% of all hospital costs for that age group are due to falls. You don’t have to be a mathematician to work out that savings from the programme can be massive.”

Mr Warren quotes Otago Medical School research funded by ACC which demonstrates the programme’s cost-effectiveness. “Professor John Campbell at the Medical School tells us that the research evidence for this programme is so strong and so well respected internationally that other countries are taking it up – yet ACC is cancelling it in this country where it was developed.”

Professor Campbell comments that the programme’s benefits are just starting to show. “We have people enrolled, health professionals trained to deliver the programme, doctors recognising the need and referring patients, and public acceptance. The numbers of ACC claims for falls are beginning to decline.”

Mr Warren warns that the problem of older adults falling won’t just go away or get any less serious. “Short-term cost saving will mean long-term loss – financially and in terms of quality of life for a significant number of older adults.

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“At this age any broken bones can take away a person’s cherished independence, freedom of movement, and ability to carry out the tasks of daily living. In particular, for a third of all people in this age group a broken hip following a fall results in death within a year. The shock to a frail body, the loss of mobility, being dependent on others – it’s all too much. Those who don’t die, often can’t continue to live in their own homes.”

ACC has funded the rollout of the Otago Exercise Programme, from its Injury Prevention budget, since 2007. Under the programme, a physiotherapist or a nurse trained by a physiotherapist visits an over-80-year-old in their own home six times during the year-long programme, to teach leg-strengthening and balance-retraining exercises. In between, the health professional keeps in touch with the client by phone. The client undertakes to exercise for 30 minutes a day, three times a week and to go for a walk at least twice a week. With increased muscle strength and balance, the person is much less likely to fall. The programme is exclusively for 80+ (or 65+ if Maori or Polynesian) who have had a fall in the last year or are assessed as at high risk of falling.

Mr Warren pointed out that with the ageing population, falls prevention is essential.


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