From isolation to integration

The objectives of this study were (1) to describe the prevalence, determinants, consequences and costs of falls in older home care clients at risk for falls, and (2) to compare the effects and costs of a multifactorial and interdisciplinary team approach to falls prevention with those of usual home care for frail older people at risk for falls. [...] Of the 109 subjects who entered the study, 92 (84.4%) completed the six month follow-up and 98% of the 54 participants randomized to the intervention group, received at least one home visit by a member of the interdisciplinary team. [...] The magnitude of the problem has the potential to increase because of the increasing demand for home care services for older, more vulnerable, and frail adults 5. However, little is known about the determinants and costs of falls and fall-related injuries in this setting, the need for falls prevention, and the best way to provide home care services for the prevention of falls among seniors with ch [...] Based on the potentially important role of home care in falls prevention for frail older people, the compelling evidence for an interdisciplinary team approach, and the increasing pressure for evidence of efficient use of scarce resources, the need for a study of the efficacy and costs of a multifactorial and interdisciplinary team approach to falls prevention was identified. [...] The magnitude of the problem has the potential to increase related to the increasing numbers of those over 75 years of age64, the associated increase in the prevalence of falls, and the increasing demand for home support services.65 Recent data in Canada reported that approximately 90% of the expenditure for home care services for older people with ongoing and non-acute needs was for non-professio