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Sep 21
Aging in Place: How the Prevention and Wellness Trust Fund (PWTF) is Making Elderly Falls a Public Health Issue

​Arnetta Baty is a woman of conviction. She is 63 years old and a fierce advocate in the Dorchester community. She and her husband Carl, 64, run a business called Rounding the Bases, LLC, connecting community residents in recovery with various social services. She continues to be active and involved despite experiencing over 10 falls in the past year alone. She lives with several health conditions such as diabetes, lung disease, asthma, and poor eyesight. Arnetta is aware of the burden and possible consequences of just one fall. "We make it through the other conditions but it's the fall that puts someone in the hospital."

Falls are not just an individual burden but a societal one with deep financial effects – falls-related medical costs in the U.S. reached $34 billion in 2013.

"You get older your balance goes, your legs aren't as strong as they used to be…your reflexes aren't as quick, things that you caught when you were 20, 30, 40 now become falls," said Carl.

The Prevention and Wellness Trust Fund (PWTF) aims to empower the elderly like Arnetta to live their fullest and safest lives.  The mortality rates for elderly falls are 29.2 and 27.7 per 100,000 people for North Dorchester and Roxbury, where the PWTF services are focused. PWTF is tackling this major public health issue by connecting clinically-sound interventions and housing with community health services. Elderly falls prevention focuses on Tai Chi classes, Matter of Balance classes, and Elderly Falls Home Safety Assessments. These PWTF classes and home safety assessments are carried out by community health workers (CHWs) who have a strong presence in the community.

Arnetta's home safety assessment revealed helpful home improvements to prevent further falls: securing handrails, raising the bathroom toilet seat and installing bathtub grab bars. Her gratitude to BPHC for the referral and her positive experience with the CHW, Tammy of Boston Senior Home Care who conducted the assessment and connected her with home resources, led Arnetta to recommend it to 10 of her friends and even her 94 year old mother.

"Tammy presented herself in a very professional and likable way. She didn't mind us asking questions and gave us the information we needed…the assessment showed us things we can change to keep me from falling as much as I did before. Tammy connected us to other resources to secure handrails, grab bars and raised toilet seats," Arnetta explained.

When asked what it would take to increase awareness of elderly falls as a public health issue, Arnetta was transparent in discussing the many barriers that must be considered. "The fear of falling is the worst fear in the world." Our most uncomfortable emotions are associated with falls – embarrassment, shame, fear of stigma. And with knowing that a fall can lead to more debilitating health complications and expensive hospitalizations, many avoid seeking help altogether.

The Battys are African-American and shared that the issue is always worse for people of color. When a history of oppression is the context to health, access to care and services is more dismal. "Service providers must lead with race," Carl states. His sentiment is echoed in the work of PWTF in two of Boston's most vulnerable neighborhoods.

Aging is a natural part of the life process and it is evident that we need to better plan for the needs of our quickly aging population. By 2050, almost a quarter of the U.S. population will be 65 years and older, the time in life when 1/3 of people will experience a fall. The Battys shared that building trust is important to engage senior citizens with services and understanding that "although we are old, we still like to be social and mobile." PWTF is equipping seniors with the tools and skills necessary to reclaim their physical strength and independence so that they may stay out of hospitals and facilities and age in place within their homes and Boston's neighborhoods. 

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