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Onondaga County Integrates Step Up and Stop Falls Program

On July 26, The Americans with Disabilities Act (ADA) will be celebrate its 23rd anniversary. The ADA is one of America's most comprehensive pieces of civil rights legislation.

Modeled after the Civil Rights Act of 1964, which prohibits discrimination on the basis of race, color, religion, sex, or national origin, the ADA is an "equal opportunity" law for people with disabilities.

It prohibits discrimination and guarantees that people with disabilities have the same opportunities as everyone else to participate in mainstream American life; to enjoy employment opportunities, to purchase goods and services, and to participate in State and local government programs and services. A central part of the New York State Office for the Aging's mission is helping older New Yorkers be as independent as possible for as long as possible through inclusive and accessible programs and services. This is accomplished in partnership with the network of public and private organizations which serve older New Yorkers. On a local level, Area Agencies on Aging (AAAs) are innovating to make their programs accessible and responsive to older adults and caregivers with varied abilities, helping to improve the quality of life for the people they serve.

An individual with a disability is defined by the ADA as a person who has a physical or mental impairment that substantially limits one or more major life activities, a person who has a history or record of such an impairment, or a person who is perceived by others as having such an impairment. The ADA does not specifically name all of the impairments that are covered, as disabilities are as diverse as the people living with them. It is helpful to understand that a range of disabilities exist from mobility, cognitive, speech, hearing, vision, chronic health conditions to environmental disabilities or chemical sensitivities and many others. Although some disabilities are more easily visible, many are not as obvious, such as those that impact communication, cognitive function or involve chronic conditions such as asthma, heart disease, or seizures.

You may be surprised to know that almost everyone will experience either a temporary or permanent disability in his or her lifetime. A person may have been born with a disability, or it may occur later in life through an illness, chronic disease, injury, accident or as a result of the aging process. As we age, the likelihood of being affected by disability increases. For those 45 to 54 years old, 22.6 percent have some form of disability; for those 65 to 69 years old, the estimate is 44.9 percent; and for those 80 years old and over, the prevalence of disability is estimated to be 73.6 percent.

It was in the spirit of awareness, access and action that the Onondaga Office for the Aging and Youth recognized an opportunity to make a difference. Onondaga County is reported to have the highest incidence of falls-related deaths among sixteen Western and Central New York counties. In response to this disturbing statistic, a coalition of community partners was formed to address the issue on a variety of levels. The Onondaga County Department of Aging and Youth, the designated Area Agency on Aging, is the lead agency in the initiative. The Department's Commissioner, Lisa Alford, was named the Executive Leader of the Coalition. Other core partners are The Salvation Army; Syracuse Area Services, Visiting Nurse Association of Central New York; St. Camillus Health Rehabilitation Center; Upstate Medical University; and Aurora of Central New York. Extended partners include Excellus/BCBS; St. Joseph's Hospital Health Center; PACE CNY; Interfaith Works; Loretto Health Support; and the Syracuse Veterans Administration Hospital.

The coalition decided to focus their efforts on Individuals age 60 years and above, including those who have limited or no access to community-based falls prevention programs. They developed The Step Up to Stop Falls Program, incorporating a multifaceted approach to address fall prevention. It is inclusive of (but is not limited to) persons with vision and/or hearing loss, rural dwellers, persons with developmental disabilities, and persons with limited English proficiency, low literacy and low income.

The program is now offered throughout Onondaga County, and included tailored adaptive exercises, public information, in-home safety assessments and medication management-all designed to increase awareness and decrease risk of falls.

"Falling can have a huge impact on someone's life. It's not just the injury; it's also the complications from the injury. There might be surgery, a long rehabilitation, and a person can start to spiral down into frailty. We really want older adults to maintain their independence and safety. Most people want to age in place and in order to do that, they have to be safe," said Alford.

When the initial grant was awarded, the Coalition partners met for six months to determine what specific falls-prevention projects should be developed to meet the mission set forth by the Health Foundation for Western and Central New York. In the summer of 2011, a series of programs began to meet the diversity of need within the populations the group set out to serve. The second grant award will fund the project operations through June 30, 2014.

David DeFrancis, Director of Outreach and Education for Aurora of Central New York - an agency dedicated to assisting people with hearing and vision loss- said "for many older adults their biggest fear is nursing homes. It's the first thing they worry about. And a fall can lead to that. Our whole mission is to keep people in their homes as long as possible."

The program has run successfully at several community-based sites. One in particular, The Salvation Army/Syracuse Area Services, runs the program with exercise instructions that are movement specific, so people with low vision or people who are blind can participate. For example, this is accomplished by the instructor detailing how high to raise your arm, or when to sit or stand. Aurora of Central New York, , narrates each exercise so that their clients could attend the classes and gain strength and balance that they need to remain successful at home. This program continues at The Salvation Army/Syracuse Area Services Adult Day Center. There are several other programs operating throughout the county.

As part of the effort, an in-home safety assessment is conducted for clients of the Department of Aging and Youth on a regular basis. The safety assessment was created by the University of Buffalo, under a grant from the Health Foundation for Western and Central New York. Anyone60 and older can contact the department and arrange an assessment. It is particularly important for persons who are blind or have low vision to have an in-home safety assessment.

Aurora of Central New York, one of the core partners of the Coalition, has institutionalized the assessment into their casework services. Moreover, the Department of Aging and Youth continues to support older adults who have hearing and vision disabilities by providing funding for a social worker at Aurora. The Social Worker visits homes and arranges for assistive equipment and other services offered by the Department of Aging as well as other human service organizations. This partnership, which is decades long, has been strengthened because of the Health Foundation for Western and Central New York's leadership in falls prevention. More than 350 people have received an in-home assessment and have committed to making some modifications toward a safer home environment.

For more information about the program in Onondaga County, contact the Onondaga County Department of Aging and Youth at (315) 435-2362 or visit their website.(External Link)

You can visit the Step Up and Stop Falls Program website at The Health Foundation for Western and Central New York State.(External Link) The website contains information about the program as well as counties covered under the grant.

For information about the financial impact of falls and related injuries, visit the Center for Disease Control and Prevention.(External Link)