Many older Australians are at a greater risk of falls due to long-term confinement as a result of the Covid-19 pandemic, according to the Australian Physiotherapy Association.

Rik Dawson

Rik Dawson, a gerontological physiotherapist and director of APA, said many of them used to attend exercise classes, or go for long outdoor walks, but haven’t been able to due to fears of community transmission.

“One of the key modifying risk factors to preventing falls is to maintain or improve balance, and also to maintain and improve your leg strength. You need good balance and good leg strength to keep you upright,” he told Community Care Review.

When people don’t exercise or challenge their strength in standing and walking, their balance, strength and fitness decreases, and their risk of falling increases, according to Mr Dawson.

Role of carers

Carers have a huge role to play in promoting physical activity and exercise, he said.

“They can liaise with the physios in their team on what exercises are safe for that person to do, and coach, encourage, motivate and supervise them to do the exercises,” Mr Dawson said.

To help older Australians who are reluctant to move due to high pain levels, he recommends carers ask them what their normal safe levels are and encourage them to stay with that.

“Prior to Covid, if they could walk 20 minutes outside with their walking frame, tell them to walk for 10 minutes and see how they go; we call that exercise pacing,” Mr Dawson said.

A team of physiotherapists across different Australian universities have created a resource for carers and older Australians to exercise safely in unsupervised environments.

One of the key modifying risk factors to preventing falls is to maintain or improve balance.

Rik Dawson

The Safe Exercise at Home website has three levels of exercises, with level one targeted at people with very poor mobility and a high risk of fall.

“Obviously, we encourage anyone who has any specific problems to see a physio, but we’ve created advice and exercises that are progressive… and is a really good resource for carers,” Mr Dawson said.

The APA recently made a submission to the Royal Commission into Aged Care Quality and Safety investigation into the impact of COVID-19 on aged care.

According to the submission, there was a 50 per cent drop in physiotherapy appointments in the home care sector in the first three weeks of the pandemic.

Clients expressed ‘anxiety about allowing practitioners into the house, fear of asymptomatic transmission’ and experienced an increase in ‘falls and physical deconditioning’.

In addition to this, there has also been a decrease in new patient referrals, according to Mr Dawson.

Telehealth is an alternative to face-to-face appointments, but not many are using it. Within in-home care, it is used by about five per cent of clients, according to the APA’s submission.

Mr Dawson, who is currently completing his PhD on the safety and effectiveness of telehealth for frail older Australians, said that exercise can be delivered via telehealth.

“Generic exercise is good but individual targeted exercise is better,” he said.

“That’s the beauty of telehealth because it can deliver targeted individual exercise programs based on that person’s need and weaknesses.”

Mr Dawson is planning on doing a trial of telehealth for frail Australians over the age of 65 and on home care packages to show that it is safe and effective and that older people like it. The trial is due to begin in early 2021.

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