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Farewell to Falls - Introducing Interactive Follow-up Calls

This idea is to create a pilot program for the use of tablets with the existing Farewell to Falls Program at Stanford Healthcare.

Photo of Raheema Hemraj
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Who is your idea designed for and how does it enable older adults to live their best possible life by preventing falls?

This idea is designed for older adults aged 65+ who have an independent living situation, are able to provide their health history and follow instructions and who are willing to follow a 1/2 hour exercise program at least 3x/week.

Farewell to Falls is a home-based falls prevention program offered for free by Stanford Healthcare. The program includes a medication review, a home safety assessment and the provision of an exercise plan. The program consists of 3 total home visits conducted by Registered Occupational Therapists. The exercises provided are from the Otago Exercise Program which is an evidenced-based program of 17 strength and balance exercises. The program progresses participants over the course of 6-12 months.

Program Details:

Farewell to Falls provides two home visits by a Registered Occupational Therapist, who will:

  • Gather information about health history and daily living skills.

  • Complete a balance and mobility assessment.

  • Get a list of all medications to be reviewed by a pharmacist.

  • Do a complete home safety survey.

  • Recommend fall risk methods and introduce an exercise program.

A third visit will be made one year after enrollment.

During the 10-11 month period between the second visit by the Occupational Therapist and the third visit, participants are contacted via telephone calls by trained volunteers to follow-up on exercises/recommendations provided by the Occupational Therapist. 

The problem:

In these follow-up phone calls, participants are asked about their follow-through with the recommended exercise program. The volunteer can respond to questions and modify exercises as needed (i.e. increasing or decreasing difficulty). While these phone calls are helpful, they are definitely not as impactful as a home visit or in-person exercise modification/review. Unfortunately, providing monthly in-home visits to each participant is not feasible.

The solution:

The Farewell to Falls program could benefit from online "face-to-face" conversations with seniors in order to work together on their exercise program. We are proposing a pilot program using tablets to support this function. While the program is supporting 100+ participants, we would focus on targeting 15-20 participants who would be comfortable being trained on and using tablets. The tablet would be provided to the older adult participant at the end of their second visit and training could be provided by the Occupational Therapist on how to use the device at this time. Volunteers could then contact the participant via Skype to conduct the monthly follow-up sessions. The OT would retrieve the tablet at the third  and final visit.

The expected outcome:

The goal of the program is to prevent future falls. With the addition of tablets to enhance follow-ups in between the home visits, the idea is to increase the effectiveness of the program by encouraging follow-through with the Otago exercise program.  

What early, lightweight experiment might you try out in your own community to find out if the idea will meet your expectations?

Use current chat methods on smartphones to test out how participants would respond to this idea.

What skills, input, or guidance from the OpenIDEO community would be most helpful in building out or refining your idea?

-guidance on designing the pilot program

How long has your idea existed?

  • 0-3 months

This idea emerged from

  • A group brainstorm

Tell us about your work experience:

We are a team of Occupational Therapists who provide the Farewell to Falls program through Stanford Healthcare.

7 comments

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Photo of An Old Friend
Team

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Photo of Kate Rushton
Team

Hi Raheema!

Would this be like a Skype call where the older adults perform exercises and receive feedback in real-time so they can adapt their workout and maintain the correct posture etc.?

Photo of Raheema Hemraj
Team

Hi Kate!
Yes, exactly. Currently the follow-ups are done over the phone and the volunteer will have to rely on a description from the older adult on how they are performing a particular exercise or what they may be finding too easy/hard. Being able to provide feedback in real-time and ensure correct posture, etc. could make a significant difference in adherence to the program.
Raheema

Photo of Nick
Team

Raheema,

do you anticpate people willing to disclose their health records and history?

Photo of Raheema Hemraj
Team

Hi Nick,
I have modified the idea to remove the storing of health records/history.
Thanks!
Raheema

Photo of Susan Jackewicz
Team

Hi Raheema,
What if you were able to incorporate various notifications or mini-challenges during the course of the month between the "face-to-face" conversations using the tablets, so participants had at least weekly encouragement? Imagine maybe even a weekly (simple) video message going out to all participants?

Photo of Raheema Hemraj
Team

Hi Susan,
That is a great idea! Currently we provide a paper calendar for participants to track/log their exercise routine. Perhaps this could be done directly on the tablet so that feedback/encouragement could be given more often, as you suggested.
Raheema