Doha, 5 January, 2021: International evidence has shown that approximately 30% of people over the age 65 fall annually and nearly a third of these often suffer injuries that reduce mobility and independence and can even increase the risk of premature mortality. This rate is even higher for those aged over 75. The new Falls Prevention Clinic located in Qatar Rehabilitation Institute (QRI) aims to enhance patient mobility while preventing falls and fractures through evidence-based practice and research.
The clinic is a referral-based clinic that specializes in preventing falls and fractures among adults aged 60 years and older. That service provides a weekly clinic which receives around 25 patients per month aged over 65 years of age as well as some cases under 65 years of age. The growth in elderly population with various health conditions has led to greater demand for specialized diagnosis and care of people with mobility impairments that lead to falls.
Dr. Hanadi Al Hamad, Qatar’s National Health Strategy lead for Healthy Ageing, has been a driving force behind the development of specialized care for the growing population of older people in Qatar. “Serious falls are among the major reasons for disability and even mortality in people with advanced age, especially if they also have frailty and other pre-existing medical condition. Our mission with this clinic is to identify the reasons why our patients fall, and to address these risk factors in collaboration with multidisciplinary teams.
“QRI is an ideal location for this specialized clinic, as many of the multidisciplinary teams needed in falls risk assessment and care are based here. Our teams use evidence-based best-practice approaches to provide comprehensive geriatric assessment that includes specialized falls risk assessment in order to provide appropriate care recommendations,” added Dr. Al-Hamad.
The impetus for the new QRI based clinic follows the successful establishment of a specialized falls prevention clinic for the elderly at Al Rumailah Hospital a year ago, in December 2019. The successful clinic has been used to screen older adults for their wellbeing and frailty and offer early intervention where possible. A major function is diagnosing the cause of imbalance and falls, and if required, arrange for patients’ referrals to other specialties, such as cardiology or neurology. Medication reconciliation is also important as some medications can contribute to fall incidences. The clinic also prescribes appropriate medication to aid health conditions, such as bone health support.
Dr Kawa Amin, Consultant Geriatrician and falls expert in the Geriatric and Long-Term Care Department at Hamad Medical Corporation (HMC), explained that early assessment is key to limiting potentially devastating effects of falls.
“The seriousness of a fall depends on the nature of the accident and how the person lands when they fall. In many cases it might just lead to bruising and minor skin abrasions, but a more serious fall can lead to broken bones and traumatic brain injury (TBI). The older and more frail a person is, even minor trauma can require hospitalization, and many never regain the level of functionality and confidence they had before falling,” said Dr. Amin. “In our clinic we see patients who have had falls and require assessment of further medical treatment and physiotherapy to help strengthen their muscles. But we also try and see people early on before they have had a fall. Perhaps they have started to experience increased mobility problems and we look to assess their risk of falling and provide them with treatment options to reduce this risk”.
Dr. Amin added that the risk of falling can be significantly lowered by looking at various simple but important aspects in daily life. “A little bit of exercise everyday can provide a lot of benefit; and daily exercises can help maintain balance and muscle strength as well as improve heart health and mental wellbeing. We also recommend patients to periodically review their medication; especially if they are given new medication on top of taking other medicines which may lead to side effects that include dizziness. Many falls take place in the home and one aspect we review with patients in the clinic is to advise them about how to enhance safety at home.”
The falls clinic runs consultant-led session, with assistance from staff nurses and physiotherapists, once weekly in QRI and Rumailah Hospital. The service collaborates with community and outpatient therapists. The main purpose of the clinic is to improve mobility and prevent falls. Clinicians assess the dominant causes of a patient’s falls in order to minimize the risk of further incidences by providing or prescribing appropriate intervention.
The clinic accepts patients aged 65 years and older who have experienced a mobility impairment related fall incident. Referrals are from primary care physician and various HMC services. The clinic can also be contacted on 44393103 between the hours of 7 am to 3 pm Sunday to Thursday.