By Amy Milgrub Marshall and Melissa Kaye, Penn State
UNIVERSITY PARK – I’ve fallen and I can’t get up.” That familiar refrain from an old television commercial may elicit chuckles from some, but falls among the elderly are a serious concern. One-third of people age 65 and older fall each year, often due to safety issues in their own homes. That’s why the Penn State Milton S. Hershey Medical Center, Penn State Cooperative Extension and other partners are working together to remove in-home hazards through a network of health professionals targeting residents of Mifflin and Juniata counties.
The Rural Embedded Assistants for Community Health (REACH) Network, established in March 2009, is a community-based research project developed to help reduce in-home falls and increase seasonal flu vaccines in adults age 65 and older. In Pennsylvania, rural elderly are the fastest growing segment of the population and are projected to increase by 30 percent over the next 20 years.
The study is using local nurses and EMTs, referred to as Community Health Assistants (CHAs), to collect data from participants using an iPod Touch app. The data are then used to create personalized home safety recommendation brochures.
Kimbra Shoop has been certified as an EMT for 20 years and her personal experience prompted her to participate as a CHA. “We have a scanner at home and I hear so many ambulance calls for falls. This made me realize the importance of fall prevention,” she explained.
Each year, more than 1.6 million older U.S. adults go to emergency departments for fall-related injuries. Hip fractures are one of the most serious types of fall injury and are a leading cause of loss of independence among older adults.
While there are a number of risk factors for falls, including chronic disease, the elderly participants’ homes tend to have minor issues that could lead to major injuries, such as slippery bathroom floors, loose throw rugs and poor lighting. The CHAs do a home safety assessment during their initial visit, and then follow up during quarterly in-home meetings. They began administering flu vaccine surveys and recommendations in September 2010.
The iPod Touch app used to survey the participants was developed by Jessica Cook, former project coordinator for the Penn State Hamer Center for Community Design, another partner in the REACH Network. The Hamer Center, a unit of the H. Campbell and Eleanor R. Stuckeman School of Architecture and Landscape Architecture, got involved through center director Mallika Bose’s work with the Smart Spaces initiative, a University-wide effort that promotes aging in one’s own home rather than in an assisted living facility or nursing home.
According to Bose, people are more comfortable and healthy in their own environment, with their own support network. “When the elderly are able to age in their own homes, there is a naturally occurring retirement community,” she explained.
Community involvement — among the elderly, the CHAs, and project partners — is key to REACH Network’s success, said Leigh Gordon, project coordinator. Gordon recruited the CHAs, who in turn identified potential participants. “We have to engage the community to learn what residents need, health-wise,” she said.
According to Thomas Terndrup, principal investigator for the project, using local nurses to reach out to the elderly in their communities just makes sense. “I grew up a rural farm kid, and my father was an extension officer in Cambria County for 35 years,” said Terndrup, professor and chair of the Department of Emergency Medicine and associate dean for clinical research at the Penn State Milton S. Hershey Medical Center. “I know from experience that extension work has unique capabilities in rural areas.” Marilyn Corbin, associate director and state program leader for children, youth and families with Penn State Extension, is co-principal investigator.
Terndrup said that long-term goals include expanding the program to other counties and states, as well as addressing other public health issues, such as obesity and smoking cessation.
Participation in the REACH network is voluntary. As of June 2010, there were approximately 155 seniors, with eight CHAs. The goal is to have 200–400 seniors taking part in the study over its two-year duration. Data collection began in January 2010 and will continue through January 2012.
For more information on the REACH Network, contact Gordon at firstname.lastname@example.org.
This story is from the fall issue of Penn State Outreach magazine.