St Joseph's Hostel

Stronger, fitter - younger!

How the Sisters of St Joseph and Agewell Physiotherapy revitalised their residents

The key to slashing fall rates in aged care facilities? Put the residents to work.

By developing an innovative strength and conditioning program exclusively for aged care residents, the Sisters of St Joseph in Sydney's Hunters Hill, and its physio services provider, Agewell Phsiotherapy, have rolled back the years for many of their residents.

The highly advanced new program - which includes a range of specific exercises and involves the entire nursing program - has been recognised with a Better Practice Award from the Agency for maintaining or improving residents' mobility, dexterity and rehabilitation.

The stats tell the story:

• the program commenced in December 2004 and by the end of 2005, fall rates had fallen by 25 percent
• in 2006, that figure has soared to a stunning 40 percent reduction, proving the program's cumulative effect
• residents have recorded a 71 percent improvement in cardiovascular fitness, using standard 30-second sit-to-stand routine
• resident balance has improved 66 percent against a standard physio test.

Improved quality of life:

• Almost two years into the program, there is a marked increase in the number of residents walking outdoors again.
• Most residents are reporting decreased pain levels.
• Many have returned to using public transport.
• A few have even enrolled in community based tai chi classes.

So, how does it work?
In 2004, Agewell Physiotherapy's Rik Dawson approached the Sisters of St Joseph with an idea: he wanted to trial the Queensland Government's Falls Prevention Program in conjunction with Monash University's No-Falls Exercise Program.

By using data generated by Professor Stephen Lord, Rik developed an exercise program that was appropriate to an aged care facility.

The program focuses on group exercise classes, similar to a gym program but at a reduced intensity. All exercises, similar to a gym program but at a reduced intensity. All exercises are aimed at improving balance, muscle strength and vision.

Agewell worked very closely with Sisters of St Joseph medical and nursing staff to ensure the program was integrated into the resident care plan. By making falls reduction a priority within the facility, the program's effectiveness was multiplied.

Communication was a major factor, as was a high compliance rate among the residents.

Let's sweat it out, people!
The program was run by a trained physiotherapy assistant and consists of three 30-minute classes per week, with 30 residents in each class. The care staff provided motivation and supervision for the residents to complete their own daily programs. Rik assessed every resident for their suitability for the group exercise program, established an individual program and reviewed every resident individually every three months, or on an as-required basis.

The workout includes:

• stretches for the trunk, legs and neck
• simple anti-gravity leg exercises in sitting and standing positions
• specific balance exercises, including reaching and swaying
• specific visual training exercises to help residents track objects, shift their gaze and focus from one object quickly to another, and to move toward and away from objects
• posture correction in a standing position to maintain balance
• fitness - repetitive upper limb workout, plus repeated sit-to-stand routines. Heart rate range is mild to moderate, or 20bpms above resting rate.

For more information, contact Rik Dawson, Agewell Physiotherapy, agewell@bigpond.com