The room was bustling with activity. Residents talked and laughed with a team of student health professionals sitting at a table with them, all focused on making a connection and helping them better understand how to prevent falls.
Falls are the leading cause of injury for adults ages 65 years and older, according to the Centers for Disease Control and Prevention (CDC). The CDC developed the STEADI (Stopping Elderly Accidents, Deaths & Injuries) initiative to equip health care providers with educational materials and tools to improve fall prevention.
Western University of Health Sciences College of Graduate Nursing Master of Science in Nursing-Entry (MSN-E) students and WesternU College of Health Sciences Doctor of Physical Therapy (DPT) students provided an interprofessional fall prevention clinic at the Claremont Manor retirement community in Claremont, California Jan. 29, 2024. They were joined by medical students from Kaiser Permanente Bernard J. Tyson School of Medicine (KPSOM), PharmD students from the University of Southern California (USC) Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, and faculty preceptors from the three institutions.
Each station included two medical students, one PharmD student, two DPT students and one nursing student. They took vitals, talked with residents about their medications and assessed their fall risk utilizing CDC fall prevention protocols.
It’s important for nurses, physicians, pharmacists, physical therapists and other health care providers to learn how to care for patients together – that’s the foundation of WesternU’s interprofessional education (IPE), said College of Graduate Nursing Dean Mary Lopez, PhD, MSN, RN.
“Now is the time to take the next step forward to have our students work with patients as a team, which is a higher level than doing IPE with standardized patients or with each other,” Lopez said. “It’s time to have interprofessional education happen in clinical settings. This is our first step in getting that to happen. Students need to connect with patients right away and learn how to work with patients not only within their own professions, but to communicate their findings with other parts of the team to develop a care plan.”
The clinic included 24 nursing students, 50 physical therapy students, 100 medical students, 30 pharmacy students and 15 faculty examining about 100 Claremont Manor residents.
WesternU’s DPT program always wants to contribute to the health and wellness of our community, said College of Health Sciences Assistant Dean of Research and Chair of the Department of Physical Therapy Education – California Harsha Deoghare, PT, PhD.
“Students don’t just get to practice their assessment and communication skills, they dive deep into how to keep patients informed and engaged in preventing falls,” Deoghare said. “They learn that teamwork is the key. It’s all about bringing different health professions together. A medication that a pharmacist knows inside out could be the reason a patient’s balance is off. Or a nurse’s insight into blood pressure could explain the dizziness and fall risk. Physicians play a crucial role in assessing chronic illnesses and mental health disorders that might increase fall risk. It’s this mix of expertise that helps us tackle fall risks from every angle.
Falls within the senior community are far from simple accidents. They represent critical events with the potential to profoundly change an elder’s life course. These incidents can lead to severe injuries, such as fractures and traumatic brain injuries that may require hospitalization or necessitate a move to assisted living, and in the gravest of circumstances, they can lead to death, Deoghare said. Each fall acts as a wake-up call, signaling the possible need for more supportive care or even a transition to a nursing home. The cornerstone of preventing these significant, life-altering events is proactive intervention.
“Fall prevention events like this are preventing the fall, keeping the seniors safe and functional at home, which is the best outcome we want to achieve,” Deoghare said. “We need the whole team working together with the patient to do that.”
Claremont Manor provides independent living, assisted living, skilled nursing, and memory care for adults over 65. Claremont Manor resident Dennis Tolle said his experience talking with the students during the fall prevention clinic was great.
“The students were very professional. They were asking good questions. It seemed like they were concerned about me,” Tolle said. “They did a good job assessing my background and my abilities.”
Tolle said he has severe neuropathy in his feet and legs. He is unsteady on his feet and he does fall a lot. Talking with the students helped him decide to return to physical therapy.
“I have a fear of falling. I have been avoiding physical therapy because of the falls, but they assured me they can adapt a PT program around my needs,” Tolle said.
Second-year DPT students Michael Guillen-Villa and Gurneal Sahota evaluated Tolle and talked to him about potentially starting physical therapy again.
“He liked physical therapy, so we made sure we helped him gain those memories back,” Guillen-Villa said. “We told him in physical therapy we create a safe environment that will help him do what he wants to do and gain his independence back.”
Students typically examine each other to practice their skills, so they are dealing primarily with healthy individuals, Sahota said.
“This provides exposure to a different population,” she said. “It really helped having a normal conversation, asking how their day was. Taking the time to make them feel acknowledged helped a lot.”
CGN student Nguyen Truong said this volunteer opportunity allowed her to connect with patients in a different setting.
“In the hospital, you approach a patient differently. You bring up the concern first and then relate with them,” Truong said. “The population here is more stable. In this setting, you promote health and wellness. It’s a different approach. It’s good to get more experiences approaching patients in different settings.”
Juan Guido, Claremont Manor Director of Fitness and Aquatics, said the resident turnout for this fall prevention clinic has been great. He hopes to have this type of activity more frequently, possibly quarterly.
“From a resident’s point of view, the social aspect, they are getting to know the students in the capacity of what respective careers they are going into,” Guido said. “The residents are very talkative. They like to ask a lot of questions. They always like seeing new faces.”