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Program tool 3. Falls prevention: Tips for supporting older adults at each stage of change

Helping people make changes involves providing the messages and activities that fit their stage of change. This tool describes each stage related to falls prevention. It suggests what people at that stage might say. And, it includes key messages and suggestions for what you can do to support people at each stage. By tailoring your messages to a person’s stage, you can be more effective in helping that person move from one stage to the next.

Individuals in this stage are not thinking about making any change.

People in this stage:

• See no problem with their current behaviour
• Have no intention of making changes to reduce the risk of falling

What they might tell you

• “I’m not at risk of falling. I don’t need to make any changes.”
• “Falls just happen to older people.”

What can you do?

• Help them to understand that they might be at risk for falling. For example, provide them with statistics and stories about falls and risk factors for falls.
• Introduce the idea of change. For example, ask them “Have you ever thought about installing a handrail for your stairs?
• Identify for them the pros of making a change and the cons of not making a change. For example: “Grab bars help you to be safer in your bathroom. If you don’t use grab bars you have a greater chance of falling and hurting yourself. You could even end up not being able to take care of yourself.”

Sample messages:

• Simple changes in your home could keep you from falling and hurting yourself.
• One out of three adults over 65 falls each year. It could happen to you or someone you love. Find out what you can do to prevent falls.
• You don’t need to be frail to be at risk of falling. Find out what you can do to prevent falls

People in this stage are thinking about making a change

Individuals in this stage:

• Recognize that change is useful, but may or may not have plans to change within the next month.
• Are open to advice

What they might tell you:

• “I’d like to do something to keep from falling and I’d like to know what I can do.”

What can you do?

• Motivate and increase their confidence in their ability to change. For example: show them how easy it is to use double sided tape to stick down mats.
• Help them think about some of the decisions they will have to make when they are ready to make changes. For example: look at various shapes of handrails.
• Show how the cost of making changes to prevent falls is much less than the potential cost of a fall. For example: a good, safe pair of shoes is less expensive than an injury from a fall.
• Help them to prioritize what changes they might want to make. For example: installing a bath grab bar or a stair handrail.
• Help them plan how to make changes. For example: how, where and when to install a handrail.
• Help them identify problems they might have when making changes and how to deal with them. For example: installing a handrail requires special tools and knowledge. You can help them find a qualified person to do the work or provide them with instructions on how to do it themselves.
• Point out others who have made changes. For example: someone who has installed a grab bar in their bathroom.

Sample Messages:

• A good pair of shoes costs less than injuries from a fall.
• Making your home safer can be simple! Use our checklist to find out how!
• Fred (name of someone in your group) has made his home safer… you can too.

Individuals in this stage are taking action and are making changes

Individuals in this stage:

• Have started making changes in the past 6 months to reduce their risk of falling
• May need to make more changes
• May be at risk of reverting to old unsafe behaviours

What they might tell you:

• “I’m making changes to prevent falls and wondering what else I can do.”

What can you do?

• Congratulate them on the changes they have already made.
• Encourage them to talk about the benefits that they are getting from preventing falls.
• Help them follow through on changes that they have not yet completed.
• Help them to think about and plan for problem events, for example, going somewhere where there are no handrails.

Sample messages:

• Made your home safer? Congratulations!
• Take a look at what else you can do to make your home safer. (provide checklists)
• Going somewhere new? Watch for hazards. Here’s how…(provide examples of what to do from various checklists)

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