Current challenges/problems that impact long-term fall prevention exercise program adherence:
I interviewed an older adult who was sticking to a home exercise program to increase balance & strength to prevent falls and 3 healthcare providers (physical therapists with significant experience in geriatrics). Some key insights I obtained are:
- Setting specific, achievable, and personalized short-term goals are important
- Tracking progress and measuring success towards set goals is motivating, especially when following an exercise program for months because it takes a while to notice/sense actual improvements in strength and/or balance
- Periodic check-in/follow-up is necessary to revise goals as needed -- however, current care coverage cannot accommodate this
Current affordance of paper-based home exercise programs makes it difficult to satisfy these asks. As a physical therapist-scientist, these insights are not surprising to me. What is surprising is that in today's technological age, we still don't have an affordable and sustainable solution to this problem!
While we can develop various digital health technology solutions including artificial intelligence-based ones to promote and support better exercise adherence (asks 1 & 2), a human touch/check-in (ask 3) is often needed in older adults to make these technology tools actually sticky and effective. Social support is an important factor in improving the mental and physical health of older adults, and can greatly enrich their quality of life. However, our overburdened healthcare system and providers can simply not address this need - this is not feasible.
Teens+Seniors- a community health promotion approach to fall prevention:
As a variant of community health programs, we could recruit high school students as community health workers to perform periodic follow-ups.
High school students who are particularly interested in pursuing healthcare-related educational paths can be incentivized by academic credit for their participation and performance. In addition to learning by doing about healthcare, such a program will also enable these students to develop empathy and compassion at an early age. The community-building and societal impacts of training our next generation like this are huge on its own. More importantly, this will provide an opportunity to provide older adults with enriching and lively interactions with young adults, which can serve as a huge motivation to stick to their exercise goals over a longer time.
Creating this touchpoint for older adults through high school students trained by appropriate clinical teams may indeed serve a significant cost-effective and a much-needed respite for overworked healthcare providers as well. Such a community health promotion approach may indeed help accelerate fall prevention program dissemination as well as promote better long-term adherence in older adults.
Together as a community, we can realize this goal of preventing falls in our seniors and add life to their years instead of merely adding years to their life!