Private practice-hospital patient pathways for elderly people with falls or at risk of falls: A study in Lille (northern France)

Abstract

Private practice-hospital patient pathways for elderly people with falls or at risk of falls: a study in Lille (northern France). About a third of the over-65 population will fall at least once a year. In France, falls are responsible for more than 9000 deaths among the over-65s and constitute a frequent reason for admission to long-stay care establishments [1] . Many different factors are involved in falls, which prompts the need for multidisciplinary assessments. For the last 15 years, Lille University Medical Centre (Lille, northern France) has been running multidisciplinary assessments at its day hospital for elderly people who have fallen or are at risk of falling. The patients’ medical, rehabilitational and retraining needs are identified during their admission to the day hospital. In 2013, the day hospital and the Lille urban area's existing private-practice care networks (e.g. physiotherapy) were completed by a number of innovative care systems: a care network for fall prevention and home-based rehabilitation (“ESPRAD Chute”), patient education workshops on falls, and a day hospital for follow-up care and geriatric retraining (“HDJ SSR Gériatrique”). The ESPRAD Chute network is based on nurse-led homecare and provides the patient with 15 home-based therapy sessions that complement surgery-based care. Patient education is based on 12 weekly sessions for elderly fallers. The HDJ SSR Gériatrie day hospital provides multidisciplinary rehabilitation for fallers or people at risk of falls and who require intensive rehabilitation and retraining. The interface between the day hospital and existing care structures enabled us to create private practice-hospital pathways for the multidisciplinary management of elderly people at risk of falls. We present our experience of these patient pathways and the associated care systems.