A Comprehensive, Home-Based, Fall Prevention Initiative: Preliminary Data From the Raise'Age Program.

Abstract

Background: Although falls among older adults pose substantial health risks and are often preventable, many fallers do not seek medical care. The Raise'Age program addresses this challenge by offering proactive fall prevention for older adults who require "lift assistance" but are not taken to hospital. The program includes (i) screening by emergency medical services (EMSs), (ii) referrals for a comprehensive geriatric assessment, (iii) in-home evaluations by a mobile geriatric team (MGT), and (iv) referrals to primary care physicians (PCPs). Here, we outline the program's design, development, and implementation.

Methods: The program's activity in 2023 was assessed with regard to the number of EMS fall reports, the reports' completeness, the program's eligibility, and acceptance by physicians and patients, in-home assessments, adherence to geriatric follow-up programs, and coordination delays.

Results: In 2023, the Raise'Age program received 959 reports, accounting for 48% of lift assistances by paramedics. Of these, 37% of the reports were reviewed for eligibility. Reports were often archived due to irrelevance, a recent hospital stay, or difficulty contacting PCPs. Among eligible reports, 77% were approved for in-home evaluations, and the remainder were referred to a geriatrician or scheduled for hospital admission. The median processing time was 26 days. Of 228 patients eligible for home visits, 150 accepted the intervention. Visit acceptance rates were higher when a PCP endorsed the program. Follow-up was provided to 36% of the patients- primarily via teleconsultation. Finally, 15.6% of the patients for whom a lift assistance report was sent to the MGT completed the Raise'Age program.

Conclusions: The Raise'Age program demonstrates that EMS screening and collaboration with MGTs are feasible, although some patients may decline the services offered. Continuous evaluations and interventions by MGTs and referrals to community-based medical and social services effectively address the needs of older adults.