Case study2nd March 2017
A municipal council identified many frail older people in their community care program who were living at home and required support to maintain mobility and improve social connectedness. The council sought to use Ophelia to develop interventions that could be delivered in community settings to improve mobility and social engagement for frail older people, with the ultimate aim of reducing their risk of falling.
Location: Metropolitan Type of organisation: Municipal council
Type of Intervention: Health literacy mentors to support older people at risk of falls
The City of Greater Dandenong provides services to enhance and prolong the independence of older people who wish to remain living at home. Ongoing home and community care services provided by the council include home care, respite care, and community groups. Community care services are delivered in numerous sites around the municipality such as residents’ homes, council-owned centres and other public spaces. The region has a high proportion of culturally and linguistically diverse community members.
What was the problem?
The municipal council identified many frail older people in their community care program who were living at home and required support to maintain mobility and improve social connectedness. The council sought to use Ophelia to develop interventions that could be delivered in community settings to improve mobility and social engagement for frail older people, with the ultimate aim of reducing their risk of falling.
Staff from the council’s community care program collected health literacy and demographic data between July and December 2013 from 55 clients in the program, all aged over 65 years. Clients surveyed were at risk of increased falls because of limited mobility, and they had low social support. The team also surveyed 24 members of the local branch of the Country Women’s Association (CWA) who met in council venues. The CWA is a national volunteer organisation with a focus on personal development and advocacy including supporting their local community.
The health literacy data were analysed and the findings discussed in a workshop with clinicians, administrative staff and managers. Findings from the survey and the workshop identified that:
- Many clients in the service had limited ability to actively manage their health, a low level of social support for health, and difficulties engaging with healthcare providers.
- CWA members had higher health literacy overall. These participants reported being actively engaged in managing their health, with good social support for health, and strong abilities to engage with health care providers and navigate the healthcare system.
What solutions were found?
The council determined their intervention would be to train CWA volunteers to act as mentors during group-based exercise programs for frail, older community members. The gentle exercise programs ran over 6 weeks and were facilitated by council staff. In addition to exercise, each session included a 5-minute, informal education discussion about falls prevention, led by a CWA mentor. Mentors attended a short training session run by the council before starting in the role. The intervention was implemented between August 2014 and July 2015 in two different groups: a senior citizens’ group and an Arabic-speaking women’s group. Programs for both groups were held in low-income, poorly-resourced neighbourhoods.
What was the impact?
Interviews and focus groups with 18 participants (senior citizens and mentors) found increased mobility and benefits from the social engagement. Mentors also felt more confident to support others. The group facilitator noted that belonging to a multicultural group broke stereotypes related to different cultures, as well as reminding participants they had more in common than previously perceived.