Unintentional injury has become the sixth leading cause of death for persons over the age of 65. Most of these injuries are attributed to falls; however, burns and scalds also pose a threat. Experts estimate that one of three persons who live in the over-65 community will fall each year. Additionally, it is predicted that 2/3 of those who have fallen once will fall again within the next six months.
Unintentional injury has a great economic impact on the elderly and their families, as well as on insurance companies and federal assistance programs. Medicare and other public sources pay nearly 75 percent of the direct costs for injured persons 65 years of age and over. The majority of long-stay patients have Medicare as their expected principal source of payment in 1980 and 1990. It is estimated that the cost to the health care industry for falls alone in older adults exceeds $1.5 billion each year. This does not account for medical care costs for other injuries.
The estimated cost per hip fracture and rehabilitation is nearly $40,000. These figures do not include the physical pain and suffering associated with the injury to the individual and the accompanying stress on the family members.
This outreach project was designed to reduce the high numbers of injuries, largely preventable, incurred by older adults in and around their homes. The project, which served the residents of Colquitt and Thomas counties, Georgia, used both individual contacts and community-wide educational programs to reduce hazards in the home and to address individual health problems that increase one's risk of injury.
The project provided older residents with home inspections conducted by injury prevention counselors trained to identify hazards and make safety recommendations. Many of the identified hazards were corrected by simply removing rugs or cords, installing a smoke detector or fire extinguisher, placing safety strips in the tub, or installing a night light in the bedroom. If necessary, grant funds were used to purchase supplies and pay for home repairs.
Injury prevention counselors also conducted personal health assessments of the clients to determine any health conditions that might contribute to potential injury. Many of the clients reported feeling drained or weak frequently, having trouble hearing, or having mobility problems that required a wheelchair, cane, or walker. When the counselors identified a health problem, they made appropriate referrals and assisted in obtaining the necessary services. The project also provided transportation to health care appointments and other services.
The project also developed promotional materials including an injury prevention brochure, video presentation, safety display, and various safety articles that have been used successfully with civic groups, churches and professional organizations. More than 60,000 copies of various safety materials have been disseminated. Articles on injury prevention also have appeared in several publications, newspapers, and newsletters, both statewide and nationally. Additionally, findings and data have been shared with other professionals in the fields of family and consumer sciences, sociology, housing, and public health.
In order to foster community ownership and involvement, the project has organized consortia on both the program administration level and the community level. Three agencies make up the administrative consortium: the Southwest Community Action Council, Inc. Public Service, which hires the injury prevention counselors, provides for client services in the targeted area, and administers funds; the Georgia Center's Family, Consumer, and Other Life Sciences Program Section; and the Georgia Department of Human Resources Older Adult Program. Specialists from the latter two organizations provide training and support for all project activities.
The project has also developed a community-based consortium in each county. Members include representatives of the county extension office, senior center, rehabilitation services, visiting nurses association, health department, fire and police departments, and concerned citizens. These consortia meet informally on a monthly basis and so far have conducted four injury prevention festivals in their communities. In addition, consortia members play a vital role in referring high-risk individuals to the assessment program. They remain active in planning activities related to injury prevention today.
The project encountered two difficulties during its implementation. One was getting approval to make home repairs from the city government and the other was finding qualified contractors willing to work small jobs. Both problems were overcome by making the appropriate community contacts. The injury prevention counselor gained approval from the city to make repairs with no extra fee per home visited, and the local technical school provided students to make some of the home repairs.
The key to this program's success has been the inclusion of individuals from the communities at every stage of development. The programs in both counties will continue after the grant expires because of the involvement of the community-based consortia. Support for these activities is expected to continue because of the commitment of South Georgia Community Action Council, Inc., reimbursement for services, and fundraising.
Response for information about home safety has been received from many individuals throughout the state and nation. As a result of these requests, program specialists from The University of Georgia and the Georgia Department of Human Resources Older Adult Program developed a training manual and provide "Safety Begins at Home" workshops.
For more information, contact Janet S. Valente; Georgia Center for Continuing Education; The University of Georgia; Athens, Georgia 30602-3603; 706-542-5654; e-mail: valentej@gactr.uga.edu.