Translating the evidence of falls prevention using a community approach in a remote Scottish Island - The influence of social capital
Overview - updated June 2012
On the island of Islay, Scotland, an action research approach was used to translate the research evidence for preventing falls into practice. Falls are the biggest cause of accidental death for older people nationally, with one third of people aged 65 and over having a serious fall each year, and this figure increases as people age. A community team of older people and interested health and social work services staff was established by an NHS practitioner. Team members were keen to raise the awareness of falls in older people, with younger people. The team approached Islay High School and it was agreed a group of students could work together to address problems related to falls.
The 2nd year students researched the incidence and causes of falls and preventative steps older people could take to maintain their health and prevent falls. Students surveyed and mapped sites of broken pavements and roads in collaboration with the community team. The students interviewed older people about difficulties they faced; and some further areas of concern were noted including inadequate street lightening at night, which inhibited older people from going out. The team and students together took the issues to the local area committee of Argyll and Bute council.
Co-production is defined as "public sector and citizens making better use of each other's assets and resources to achieve better outcomes and improved efficiency" – it’s about the contributions of BOTH citizens AND the public sector.
Linking social capital emerged as an important feature in this research. The researcher as an outsider was valued by the collaborators. Linking social capital helped information and resources to be accessed for use in the local context. The University of the West of Scotland supported the NHS practitioner research with valuable resources including funding, mentoring support and community development.
Benefits for the Community
The action research offered opportunities for younger people and older people to work together to serve their communities and to increase their personal responsibility. Through social capital within a remote island community setting, the message of falls prevention and intergenerational working was socially rebranded for community benefit.
Benefits for the Younger People
Many positive effects of the intergenerational work arose as students highlighted they had been unaware, prior to the falls project, that older people were at risk of falling. They now have a better understanding of the difficulties older people faced. The work the students undertook contributed to part of their Curriculum on Citizenship. The students gained skills in research by: investigating the incidence and causes of falls; preventive steps older people could take to maintain health and prevent falls; and interviewing the older people about the difficulties they faced. Surveyor skills were also gained as they surveyed and mapped the sites of the broken pavements and roads. Six students were given the opportunity to present the findings to the Area Committee of Argyll and Bute Council and at local Educational Events for care providers which enhances communication skills. In all, working on this project, students had the chance to work as part of a team, enhance interpersonal skills and increase a sense of citizenship.
Benefits for the Older People
Empathy and understanding towards older people was expressed through comments such as: ‘we know now that older people are vulnerable, and might be scared of groups of youths, a big group could be intimidating and we would move out the way. We will recognise their presence and give them space’. Stereotypical connotations of old age, such as infirmity, can lead to barriers between generations. The students considered the impact that their actions and behaviour might have on older people. The issue of ‘chap door run/thunder and lightning’ (which is a children’s game involving knocking on someone’s door and running away) was highlighted by the team members and discussed with the students, allowing them to consider the impact of their actions on vulnerable people.
This project contributes to the Scottish National Performance Framework (NPF):
Scottish NPF Objectives
The main NPF objective that this project contributes to is:
Wealthier and Fairer will support activities that address inequalities and enhance skills, employability and job opportunities. It builds on the characteristics of solidarity, cohesion and sustainability to ensure that all of Scotland has an opportunity to flourish.
These NPF objectives could also apply:
Healthier will enable people to live longer and healthier lives.
Smarter will focus on improving literacy, numeracy and attainment and on raising and realising ambition for all.
Scottish NPF Outcomes
We have strong, resilient and supportive communities where people take responsibility for their own actions and how they affect others: Being part of a strong community gives us the support we need locally. It minimises crime, antisocial behaviour and their social and economic costs.
Our young people are successful learners, confident individuals, effective contributors and responsible citizens: To enable children, young people and (subsequently) adults to thrive from an early age, and make a positive contribution in the 21st century.
Our people are able to maintain their independence as they get older and are able to access appropriate support when they need it: Collectively we need to give priority to ensuring that older people receive the care, compassion, support and dignity they need and deserve.
We live longer, healthier lives: Securing longer healthier lives for the people of Scotland will always be a top priority for governments and individuals alike. There are significant challenges which can only be addressed by everyone in Scotland working together, pursuing this goal through improving lifestyles and life circumstances, and a shared ownership of an effective NHS.
Email: Christine McArthur, NHS Co-ordinator Prevention of Falls in Older People, NHS Highland
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