Building Capacity for Elder Exercise Programming in Remote and Rural Communities with
Building Capacity for Elder Exercise Programming in Remote and Rural Indigenous Communities with Ms Denise Taylor, Robert Baxter, Tiffany Gervasi, Kesa Keeash, Nancy Keeskitay, Carol Lyn Saleese, Eabametoong First Nation , Eabamet Lake, Canada, Victoria Order of Nurses, Thunder Bay, Canada, North Caribou Lake First Nation, Weagamow, Canada, St. Joseph's Care Group, Thunder Bay, Canada
Relevance to the Physiotherapy Profession
One-third of seniors over 65 and 50% of seniors over 80 will fall at least once annually (WHO, 2007). Falls are the leading cause of seniors’ injury, deaths and hospitalizations and can lead to loss of independence. Preventative programming is necessary to promote health aging in this rapidly increasing cohort (Sutherland, 2018). Indications show Indigenous fall-related injury rates are considerably higher compared to non-Indigenous older adults (Scott, 2018). Physiotherapists are well positioned to deliver falls and injury preventative opportunities using education and exercise programming for seniors (Sutherland, 2018). In addition, physiotherapy screening and assessment skills promote referral to appropriate services. In many Indigenous communities, additional advocacy is required to develop rehabilitation services, requiring innovative models of care using the strengths and capacity of each community.
Learning Objectives and Session Content
This session will enable participants to:
1) Understand health inequities faced by Indigenous peoples and the Truth and Reconciliation (TRC) Call to Action 19, "to identify and close the gaps in health outcomes between Aboriginal and non-Aboriginal communities"
2) Discuss strength-based, capacity-building models of care to deliver community-based programming, and
3) Describe the innovative use of technology to support a Falls Prevention and Community exercise program delivery for Elders in remote communities, addressing distinct health needs.
This session will be of interest to clinicians, professional and community leaders, managers, educators and researchers interested in expanding current practices into rural or Indigenous communities using technology.
Description of Supporting Evidence
Falls prevention programs and strategies have reduced seniors’ falls by 20%, increasing quality of life and decreasing healthcare costs (SMARTRISK, 2006). Falls are multi-factorial. Risk factors include physiological, socio-demographic, medical, pharmacological, environmental and behavioural. As such, falls prevention programming must address multiple factors. The BEEACH evidence-based model addresses Behaviour, Education, Equipment, Environment, Activity, Clothing & Footwear and Health Management (Scott, 2017). The Elder Falls Prevention and Exercise classes focus on behaviour changes with modelling and experiential learning; education of participants and healthcare staff; and activity with a focus on strength, endurance, balance, and coordination. Exercise is one of the most recommended falls prevention interventions (Gillespie et al., 2009).
Falls prevention and exercise programming in Indigenous communities specifically needs to: consider the entire life course, use a wholistic framework, address local community priorities, provide local healthcare worker training including risk assessment skills, and build relationships within the community and with supporting organizations (Reading et al., 2011). The Elder Falls Prevention and Exercise classes are a community priority; delivered by local, trained healthcare workers using a wholistic framework; build on community strengths and capacity; and are a venue for relationship-building within the community and with rehabilitation organizations.
Description of Session Format
Photographic lecture with discussion of participant organizational experiences.
Conclusions and Implications
The Elder Falls Prevention and Community Exercise program responds to TRC Call to Action to reduce health disparities between Indigenous and non-Indigenous people. The program uses a community, strength-based, capacity-building model supported by kinesiologists and physiotherapists via personal computer videoconference. Each community delivers the program to meet their local capacities, needs, and cultural relevance. Using innovative technological support provides opportunities to expand rehabilitative programming despite limited human resources in remote and rural areas of Canada.
Elders in remote communities are at risk of falls with significant quality of life consequences. Using videoconference-support, the Elder Falls Prevention and Community Exercise program uses a strength-based, capacity-building community model of care to expand rehabilitative programming despite limited human resources and respond to the Truth and Reconciliation Call to Action to reduce health disparities between Indigenous and non-Indigenous people.
Please note that this course was recorded at the Canadian Physiotherapy Association 2019 Forum in Charlottetown, PEI.
Course Material included in this course
Inequities in Aboriginal Communities
Social Support and Food Security
Culture and Resilience
Community Exercise Program
Community Exercise Program (cont-d)