Falls prevention activities among community-dwelling elderly in the Netherlands

Introduction: This study aimed to provide an overview of the current falls prevention activities in community-dwelling elderly with an increased risk of falling in the Netherlands. Therefore, we determined:
a) how health professionals detect community-dwelling elderly with an increased risk of falling;
b) which falls prevention activities are used by health professionals and why;
c) how elderly can be stimulated to participate in falls prevention programs; and
d) how to finance falls prevention.
Methods: A two-round online Delphi study among health experts was conducted. The panel of experts (n = 125) consisted of community physiotherapists, community nurses, general practitioners, occupational therapists and geriatricians, from all over the Netherlands. The median and Inter Quartile Deviation (IQD) were reported for the questions with 5-point Likert scales, ranging from ‘least’ (1) to ‘most’ (5).
Results: Respectively 68% and 58% of the panel completely filled in the first and second round questionnaires. According to the panel, regular detection of fall risk of community-dwelling elderly with an increased risk of falling hardly takes place. Furthermore, these elderly are reluctant to participate in annual detection of fall risk. According to 73% of the panel, 0–40% of the elderly with an increased risk of falling are referred to exercise programs. In general, the panel indicated that structural follow-up is often lacking. Namely, after one month, three months, and six months follow-up is never or hardly ever offered. Participation of elderly in falls prevention programs could be stimulated by a combination of measures. Should a combination of national health education, healthcare counseling, and removal of financial barriers be applied, 41–80% of the elderly is assumed to participate in falls prevention programs. None of the panel members indicated full financing of falls prevention by the elderly. A number of individuals are considered key in falls prevention activities, such as the general practitioner, physiotherapist, and informal caregiver.
Conclusion: This Delphi study showed clear directions for improving falls prevention activities and how to increase participation rates.