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Supporting older people with diabetes to stay independent

Photo: Supporting older people with diabetes to stay independent
A new project to identify community nursing clients with diabetes who are at risk of falls - and train staff to help with prevention strategies - is expected to help people stay independent for longer.

The RDNS Institute project, which started this month, will generate a risk profile for diabetes-related falls and develop a preventative training program for RSL Care + RDNS nurses.

Ultimately, the training could be delivered to other organisations through the RSL Care + RDNS Education and Learning Centre to improve the lives of people with diabetes.

Institute research fellow Dr Claudia Meyer said older people with diabetes were 17 times more likely to fall than the average older person.

“Older people with diabetes are at higher risk due to potential peripheral neuropathy (numbness and tingling in the feet) which affects balance and mobility; high numbers of medications, including those which may cause dizziness; vision impairment from diabetic retinopathy (causing blurred vision); possible osteoporosis (decreased bone strength); and possible cognitive impairment affecting the planning of movements,” she said.
“More than 80 per cent of injury-related hospital admissions in people aged 65 years and over are due to falls and fall related injuries.

“If an older person falls once, even without injury such as a broken bone, there is a 67 per cent they will fall again within the next year. Their confidence and sense of independence may be reduced, increasing the risk of entering residential care.”

Dr Meyer said a recent systemic review had found a deficit in falls and diabetes knowledge and care practices in community settings.

“This is further impacted by limited resourcing within the health and aged care sector to assess every person for falls risk and therefore it is important to differentiate those at high risk and those not at risk and create strategies that prioritise those most in need,” she said.

“While exercise programs exist to encourage people with diabetes to manage their blood glucose levels, these programs often do not target falls prevention and most didn’t follow guidelines for exercise for falls prevention.”

Project co-lead Dr Anna Chapman said the research will use data from the RSL Care + RDNS registry, the National Aged Care Data Clearinghouse and the Australian Bureau of Statistics to provide an overview of the interaction between diabetes, falls, falls-related injuries and health and aged care service needs.

The RSL Care + RDNS registry is a unique registry of longitudinal community care data for more than 150,000 people aged 65 or older living in Victoria, of which more than 35,000 (24.8 per cent) are recorded as having diabetes.

Once information has been collated and processed the research team will work with the RDNS Education and Learning centre and older people with diabetes in a co-design process to develop a training workshop and run trial sessions.

“Individual risk prevention plans can then be developed for clients identified as at-risk, reducing hospital admissions and helping older people with diabetes maintain their independence for longer,” Dr Chapman said.

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