(Third in a series)

MANILA, Philippines—Diane Kenny has been with Philips Lifeline as a personal response associate or PRA for about three years. She monitors the health conditions of Ana Woodman, an elderly. For instance, she often asks Ana: “Do you need help today?”

Diane and the other PRAs or operators underwent two weeks of training. The first was spent on emergency protocol, how to use the system and listening to calls. The second tackled hands-on training—sitting with mentor and doing simulated calls.

After such training, they are out on the floor. These PRAs or operators do not have clinical background. Most of them used to work with call centers.

Caring aspects

The caring and professionally trained operator or PRA adds personal touch to his or her dealings with the elderly.

For instance, when the elderly patient says “I need help right away.” The operator or PRA would ask “Do you need help?” If there is no response from the elderly, he or she would contact the neighbor or relative and stay on the line until help arrives.

Of the 30,000 calls received a day by 714,000 subscribers, only 4 percent of calls need medical or emergency assistance.

Half or 50 percent of the calls requiring assistance are caused by falls. Fifteen percent of these calls are heart-related; 7 percent, noncatastrophic healthcare; 6 percent, help with ADLs (activities of daily living); 3 percent, security; 1 percent, medication assistance; 18 percent, others.

Risks of fall

Philips Lifeline considers the following statistics:

On the average, one-third of adults aged 65 and above fall each year.

The majority of falls by older adults occur in the home.

More than 20-30 percent of falls by older adults result in serious injury like hip fracture or head injury.

With such statistics in mind, Philips Lifeline ensures that its people do everything possible to help the elderly reduce the risk of falling and to get them help quickly if a fall occurs.

According to Lifeline, its service is designed to give the elderly peace of mind in case they fall.

Lifeline came up with a booklet on fall prevention. It points out here that inactivity makes it more likely that the elderly will fall. In other words, a strong body equals fewer falls.

According to the booklet, the elderly should start discussing their concern about falls with their doctor. They should ask for a physical activity “prescription” that’s right for them.

Before consulting a doctor, the elderly can do these exercise suggestions in their home:

• Seated marching. Alternate lifting of knees to chest as if marching.

• Heel and toe raise. Stand straight, feet shoulder width apart, raise up on toes, pause, then lower back down.

• Knee extension. Straighten knee, pause and then lower foot back to the floor.

• Mini squats. Hold back of sturdy chair. Bend knees as far as comfortable. Keep back and head up straight behind toes. Then return to standing position.

• Lateral leg swing. Hold back of sturdy chair. Move right leg straight out to side without bending knee or waist. Keep toes pointed forward.

To enable the elderly to stick to this program, they should ask a friend to be their physical activity buddy. They should listen to music or watch television while their arms or legs are moving, or they should keep track of their progress to see how they improve over time.

Overall safety issues

The booklet also points out that what used to be virtually harmless—carpets, stairs, floors and even pets—start to pose a greater risk as people get older. It provides a checklist which the elderly can use as a guide on determining the overall safety of their home:

• All areas of my home are well lit.

—Improve lighting with light sensitive nightlights and/or motion detector lights that turn on automatically.

• My floor coverings are in good repair.

—Repair torn/worn carpeting and linoleum.

—Secure throw rugs with double-sided tape or no-slip rug pads.

—Replace shag carpet with low pile.

• The main walking areas are free of obstacles.

—Rearrange furniture to allow a clear path.

—Keep plants, tables, etc. along walls or in corners.

—Clean up clutter.

• All my phone and electric cords are out of the way.

—Remove all cords from walkways.

The booklet also includes a checklist of safety issues in the bathroom, bedroom and kitchen areas, indoor stairways and outside the house and their respective follow-up solutions.

Medications

Lifeline provides these tips to avoid medication side effects that could contribute to falls:

• If possible, the elderly should use a single pharmacy to fill all their prescriptions. Their pharmacist can review their medications and communicate concerns to their doctor.

• The elderly should report any new symptoms to their doctor right away. Their doctor will help them decide if the symptoms are cause by the medication.

• They should take medicines as directed.

• They should avoid mixing alcohol and medicine, unless approved by the doctor.

• They should keep a complete, updated list of medications they take.

The Lifeline booklet advises the elderly to be on the lookout for side effects. The medicine they’re taking has side effects if they have experienced any of the following: dizziness and balance problems, fatigue or drowsiness, confusion, loss of coordination and weakness.

The booklet has a chart that the elderly can fill out to help them organize their medications.