Surrey is one of the most active counties in England, with levels of adult inactivity slightly below the national average. However, physical activity is proven to decline with age: more than half of those aged over 75 are active for less than 30 minutes per week, while 29% of those aged 65-74 are inactive (Active Lives data May 17/18). Around a fifth of people in Surrey are over 65, and this figure will rise to one in four within 20 years.
Simply keeping active is key to people’s physical health and mental wellbeing, leading to a better quality of life. For older residents, maintaining their independence is fundamental to how they combat the natural decline in their physical abilities, but falls are a major risk for this group.
FALLS: THE COST
According to the Jan 2017 PHE Falls and Fractures Consensus Statement, over a quarter of a million fall-related hospital admissions occur in England every year. 30% of those 65+ will fall at least once a year, and 5% will lead to a fracture – typically wrist, hip or spine. Hip fractures alone are estimated to cost the UK around £2Bn p.a., and over 65,000 people suffered a hip break in 2015, occupying more than 4000 beds at any one time. A fifth of older hip fracture patients die within 3 months of their fall (Age UK).
Many older people will stay silent about falls they experience, some because they are worried about losing their independence if people regard them as at risk.
A POSSIBLE SOLUTION
Strength and balance classes are a proven method of lessening the risk of falls for older people, helping to keep them active and better coordinated. The Otago system – named after the New Zealand area where the programme was developed – was introduced in Autumn 2017, towards the end of Active Surrey’s ‘Get active 50+’ project which encouraged older residents to increase the amount of exercise they regularly undertook.
THE SURREY TRIAL
Trial funding was provided to train 15 instructors who delivered 17 subsidised Otago class programmes, including some in care homes. An average of 16 people took part in each class (272 in total), with 9% attending thanks to recommendations from healthcare professionals that came in large part through a tie-up with Public Health. Attendees tended to be female, who coincidentally are more likely to suffer from bone degeneration which the exercises can help combat.
A variety of channels were used to spread initial news about the classes. For ‘casual’ attendees in this older age group, flyers and posters worked best - 24% found out about the classes through these - beating even word of mouth at 23%.
96% of attendees thought the classes were beneficial or very beneficial, and 88% of them carried on some of the exercises at home in between classes. The friendliness and encouragement of those leading the sessions was key (mentioned by 30% of respondents), suggesting that the selection process and the tailored face to face training had worked.
While some of the attendees unsurprisingly mentioned the physical benefits of the programme, 13% said that the social aspect of coming together with others to exercise was the single thing that they liked most about their class, highlighting the part that physical activity can play in improving overall wellbeing by helping people feel connected.
THE IMPACT ON SOME TYPICAL PARTICIPANTS
Barbara, 82: “I am recovering from a torn Achilles tendon, and decided to try the Otago course at The River Bourne Club. My balance has improved greatly and I have noticed that I have less aching in my legs and knees. My strength has improved and I no longer need my crutch and have been able to progress to a walking stick.”
Pat, 77: ‘’Otago has given me back my confidence after a very nasty fall. It has also helped me to get up from a chair without swaying backwards and forwards to propel myself up. Due to my enjoyment of Otago and the confidence gained I am now a member of the gym and enjoy other exercises.”
TAKING OTAGO FORWARD IN SURREY
Direct funding from the Get active 50+ project stopped in early 2018, but the hope was that the investment in training and the subsidised recruitment of initial attendees would lead to the classes becoming self-sustaining.
While the trial was too small and the duration too short to be able to provide statistical proof of the efficacy of the Surrey classes, research from community based falls interventions in York suggests a strong, positive ROI for programmes like Otago.
73% of Surrey attendees wanted classes to continue. As at October 2018, local councils have brought into the benefits for older residents and are actively supporting the continuation of classes, with programmes running in every Surrey CCG.
For those unable to get to all the classes or who prefer to undertake the exercises at home, Active Surrey have joined with a local provider to give access (and email ‘nudges’) to online videos. These develop slowly to eventually include all 22 exercises included in the Otago sessions.
For more details on the programme pelase contact Bob Pritchard, Marketing and Communications Lead, Active Surrey