Going Outdoors: Falls, Ageing and Resilience ( Go Far)

Lead Research Organisation: University of Salford
Department Name: Sch of the Built Environment

Abstract

Going outdoors is important in preserving good physical, mental and social health for everyone but particularly older people. Approximately one third of people aged 65+ living in the community fall at least once per year, with many suffering multiple falls leading to disability and decreased mobility. This fear of falling can prevent older people from getting outdoors. In 2009 The Department of Health identified a need for research to prevent outdoor falls and decrease the barriers in the environment that prevent physical activity. Many of the barriers such as pavement quality, dilapidation, kerb height appear to be preventable through better design and maintenance. However, research to date has rarely looked at outdoor falls, instead focusing on the indoor environment.

This pilot study explores features of the outdoor environment which shape older people?s resilience to falls by:

? Considering the role of the outdoor environment in shaping inequalities in health through effects on society and geography
? Exploring older people?s perceptions and experiences of falling, and fear of falling outdoors
? Developing innovative methods, tools and techniques to evaluate the relationship between the person who falls, or who has a fear of falling, and the outdoor environment
? Developing practical suggestions for future research that will address the most important issues related to ageing, falls, and the outdoors

This research will take 12 months and have 4 work packages bringing together a multi-disciplinary group from 7 UK Universities plus AGE UK, Toronto Rehab, Marshalls paving, and the Health and Safety Laboratory. These work packages involve mapping of ?hotspots? where older people fall most often; focus groups with older people to identify risk factors for falling; developing of an audit tool to identify environmental changes and the develop ways to test slipping on pavement materials.

The knowledge created by this research will allow us to develop a greater understanding of the many factors involved in outdoor falls and create practical tools which will significantly help older people?s health and wellbeing.

Technical Summary

Going outdoors is a key factor in preserving good physical, mental and social health in all age groups, but particularly as people move into older age. Approximately one third of people aged 65+ living in the community fall at least once per year, with many suffering multiple falls which can lead to disability and decreased mobility. Also, fear of falling is a key inhibitor of getting outdoors for older people. The Department of Health Prevention Package (2009) identified a need for research to prevent outdoor falls and decrease the barriers to physical activity that the environment poses. Many of the environmental risk factors (pavement quality, dilapidation, kerb height) associated with outdoor falls appear to be preventable through better design and maintenance. However, research to date has neglected outdoor falls and focused on the indoor environment.

This pilot study explores features of the outdoor environment which shape older people?s resilience to falls. This aim is achieved through a series of research objectives:

1. To consider the role of the outdoor environment in shaping social and local geographical inequalities in health;
2. To explore older people?s perceptions on, and, experiences of, falling (and fear of falling) outdoors;
3. To develop and test innovative methods, tools and techniques to evaluate the relationship between the person who falls (or who has a fear of falling) and the outdoor environment;
4. To develop a clear road map for future, cross-disciplinary research that will be both robust and practicable, to address the most important issues related to ageing, falls, and the outdoors.

The study is 12 months with 4 work packages which bring together a multi-disciplinary group across 7 UK Universities plus AGE UK, Toronto Rehab, Marshalls paving, and the Health and Safety Laboratory. These work packages involve mapping of geographical ?hotspots? where older people fall most often; focus groups with older people to identify risk factors for falling; the development of a person-environment fit audit tool to identify environmental interventions; and the development of a pilot protocol to test surface slip of pavement materials.

The synergy of knowledge generated by this pilot testing will allow for the development of a greater understanding of the many factors involved in outdoor falls, with the potential for this to feed into a research agenda and practical tools which will significantly impact on older people?s health and wellbeing.

Publications

10 25 50
publication icon
Curl A (2016) Developing an audit checklist to assess outdoor falls risk. in Proceedings of the Institution of Civil Engineers. Urban design and planning

publication icon
Curl, A. (2014) Im(mobility) of elderly fallers in the urban environment in RGS-IBG Annual International Conference 2014

publication icon
Newton, R (2013) Falling out: What do we really know about outdoor falls in British Society of Gerontology

publication icon
Nyman, S.R. (2014) Outdoor falls among older people in the community. in Knowledge to action in falls prevention across the care continuum

publication icon
Nyman, S.R. (2013) Outdoor falls: Characteristics and prevention strategies. in 14th International Conference on Falls and Postural Stability

publication icon
Nyman, S.R. (2013) Learning from older people's experiences of falling over outdoors. in British Society of Gerontology conference

publication icon
Phillips, J. (2014) Older people's experiences of falling outdoors: Challenging the person-environment fit. in British Society of Gerontology conference

 
Description British Standards Institute Stakeholder Forum
Geographic Reach National 
Policy Influence Type Membership of a guidance committee
Impact Hosted and facilitated by the British Standards Institute, the event was chaired by Graham Worsley of the Technology Strategy Board's Special Interest Group, the Assisted Living Innovation Platform. Key items on the agenda included exploring standards priorities for enabling Assisted Living (AL) within UK Government policy and debating the need for new standards or solutions around innovative AL products and services. The impact has yet to be realised, because this will be ongoing work of the BSI Group.
 
Description Cabinet office of Japan
Geographic Reach National 
Policy Influence Type Implementation circular/rapid advice/letter to e.g. Ministry of Health
 
Description Invited meeting with Kathryn Howard, Asst Deputy Minister, Service Innovation and Technology, Government of Canada
Geographic Reach National 
Policy Influence Type Participation in advisory committee
 
Description Local Government Association Fringe Event, Manchester
Geographic Reach Local/Municipal/Regional 
Policy Influence Type Implementation circular/rapid advice/letter to e.g. Ministry of Health
 
Description Presentation to the National Assembly for Wales - Cross Party Group on Older People and Ageing
Geographic Reach National 
Policy Influence Type Participation in advisory committee
 
Description Spring Conference of the political party, Plaid Cymru
Geographic Reach Local/Municipal/Regional 
Policy Influence Type Implementation circular/rapid advice/letter to e.g. Ministry of Health
 
Description 12th International Conference on Falls and Postural Stability, Manchester 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Type Of Presentation Poster Presentation
Geographic Reach International
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact good level of discussion with viewers of poster

suggestions of ways to take the research forward
Year(s) Of Engagement Activity 2011
 
Description Access Association AGM 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact 40 Access officers and policy makers attended their AGM where I was invited to speak on the findings from Go Far

good level of interest from local authority representatives
Year(s) Of Engagement Activity 2013
 
Description British Society of Gerontology conference, Oxford 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach International
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Learning from older people's experiences of falling over outdoors. Oral paper presented.

well received by audience
Year(s) Of Engagement Activity 2013
 
Description Early Career Researcher Impact Training - London 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach National
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Organised by the KT-EQUAL consortium and the New Dynamics of Ageing Programme, the event focused on knowledge exchange; exploring how research can influence the delivery of services, enhance practice, inform policy and drive new product development.

Of particular relevance to researchers in the field of ageing, it involved presentations, debates and activity-led sessions. Rita Newton spoke as part of a panel on Good Practice in Knowledge Exchange (drawing on EOSRC I'DGO and MRC Go Far) , together with Adam Oliver (BT Innovate & Design), Elizabeth White (College of Occupational Therapists) and Laura Bradley (Institute for Public Policy Research).



Since the event was focussed on Impact, it is hoped that it helped young researchers to better understand the do's and dont's of impact.
Year(s) Of Engagement Activity 2012
 
Description Ecobuild 2015 Seminar: Down my street - how does the local outdoor environment support wellbeing? 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Presentation by Catharine Ward Thompson: Down my street: how does the local outdoor environment support wellbeing? Seminar presentation as part of the Ecobuild 2015 Design Seminar Theme on 'Designing to promote well-being in and around buildings?' ExCeL London Exhibition and Conference Centre, 3rd March 2015, with over 40 participants as part of a much larger event.
Year(s) Of Engagement Activity 2015
 
Description Falling out: What do we really know about outdoor falls? British Society of Gerontology conference, Plymouth 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Paper Presentation
Geographic Reach International
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact good level of audience interest in research project

useful networking opportunities
Year(s) Of Engagement Activity 2011
 
Description Go Far Practitioner Event 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? Yes
Type Of Presentation Workshop Facilitator
Geographic Reach National
Primary Audience Health professionals
Results and Impact Falls practitioners were able to discuss the impact strategy for the Go Far pilot project and suggest possible networks. They also identified gaps within current dissemination routes and pathways to impact which they thought the Go Far team might be able to fill.

The practitioners have asked to be involved in the further refinement of the draft outputs from the pilot project, so not a notable impact as yet, but there is potential.
Year(s) Of Engagement Activity 2012
 
Description Kilburn Debates 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact The British Society of Gerontology and the Kilburn Older Voices Exchange (KOVE),jointly hosted the event an event with the theme of tackling 'stressful' local streets through older residents' evidence-led campaigning.

As well as talking to the older participants, and local councillors on good street design, there was a specific session on falling over outdoors in which the participants were able to input into, and inform the development of the Go Far project.


Subsequent to the event, some pf the participants shared their experinces of falling over, and the dramatic effect that this had had on their lives, and the team will be able to use these narratives to bring forward the voices of older people in both the research, and impact from the research.
Year(s) Of Engagement Activity 2012
 
Description Lifelong Health and Wellbeing (LLHW) event, London 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach National
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Single Power Point slide presentation on Impact

commended for impact from research.
Year(s) Of Engagement Activity 2013
 
Description Presentation to older people's groups and campaiging organisations in Scotland 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact Ending Isolation Through Design was held by the Inclusive Design for Getting Outdoors (I'DGO) consortium, of which SURFACE is a member, together with Age Scotland and Planning Aid for Scotland.

Attracting 50 delegates, half of them from older people's groups across Scotland, the event was opened by Sarah Boyack MSP, who spoke of the importance of research feeding into practice and the need to ensure supportive environments for older people. The presentation by the Go Far team focussed on good design including issues around falling over



Older participants were encouraged, with the support of Age Scotland, to take up issues of poor design with their local MSP, and they would be helped by Age Scotland to do this.
Year(s) Of Engagement Activity 2012
 
Description Professorial talks 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach International
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact oral presentation and webinar on current research including Go Far

engagement with other academic staff
Year(s) Of Engagement Activity 2013
 
Description Routledge sponsored webinar on Landscape Architecture and Health 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Presentation by Catharine Ward Thompson: Can Landscape architecture improve health? The evidence on access to green space. Presentation to a Routledge sponsored webinar on the theme: Can landscape design/landscape architecture actually improve health? One of three contributions from UK, New Zealand and USA, 31st March 2015, with over 120 international attendees from practice, academia and interested public.
Year(s) Of Engagement Activity 2015
URL https://www.youtube.com/watch?v=k7IE--03Cb4
 
Description Timchenko Foundation 'Society for all Ages' III National Conference, Moscow 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact Presentation by Catharine Ward Thompson: Inclusive access to outdoor environments and quality of life in an ageing society. Invited presentation at the Elena and Gennady Timchenko Foundation Society for all Ages III National Conference on the theme of 'Where and How we Age', Moscow, 8th October 2015. Attended by policy makers, social service providers and lay people.
Year(s) Of Engagement Activity 2015
URL http://www.ageing-forum.org/en/event/conference-2015-2/
 
Description Urban Mobility round table, EUROCITIES 2015 conference, Copenhagen/Malmo 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact Catharine Ward Thompson was participant in Round table on urban mobility, EUROCITIES 2015 conference, Copenhagen/Malmo 4th - 6th November 2015. c. 45 attendees, city mayors, policy-makers, national and local government employees.
Year(s) Of Engagement Activity 2015
URL http://eurocities2015.kk.dk
 
Description Walkshop - Glasgow 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? Yes
Type Of Presentation Workshop Facilitator
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Walk with me event 100 people walked together, we engaged with older people in the Exhibition Hall and led a Walkshop on the theme of "when I am old I shall wear purple" to go out and look at barriers to getting outdoors for older people.

Older people showed interest in our research and looked forward to outputs from it.
Year(s) Of Engagement Activity 2012