Author: Jess Harris
The Netherlands’ ageing population increasingly faces issues of reduced physical mobility, declining health, and increased levels of isolation. These principle vulnerabilities that the elderly and elderly-poor face, draw attention to the need for the development of practical skills. One alternative education initiative in The Netherlands is learning how to fall. Such programmes develop a person’s independence for later in life by increasing involvement within their community, and social engagement, as well as personal confidence and mobility.
The Issue of Falling
This issue of falling is serious and prevalent amongst the elderly, and it poses a growing challenge. In 2016, 3884 people in The Netherlands aged 65+ died as a result of a fall (Schuetze 2018). This figure had increased by 38% compared to 2014 data; providing evidence that increasingly more people are suffering from falls (Schuetze 2018).
The elderly are vulnerable to falls both in their homes and on the streets. Uneven ground, steep slopes, unstable seating, and large steps all pose physical problems to walking with confidence and living independently. Furthermore, deteriorating health and physical fitness contribute to a loss of body strength and balance which are two factors that significantly impact a person’s ability to move confidently (WIJKfysio 2018a).
What’s more, the fear of falling causes many seniors to stop venturing outside their homes in fear of not having the assistance available to help them should they fall. Not only are thousands of deaths arising from falls reported each year, but injuries can also prove to be serious and life-altering. Compared to people of a younger age, the elderly are more prone to bruising, and their bones don’t heal as well or as quickly. This fear of falling, however, places individuals at a higher risk of falling as a result of a general lack in confidence in navigating the streets and their homes (Schuetze 2018).
To address this fear and empower the elderly, the town of Leusden have introduced falling courses for people aged 65 and over (WIJKfysio 2018a). The aim is to teach the elderly how to avoid falling, and how to fall correctly if they do.
The organisation WIJKfysio provides different forms of teaching in fall prevention to the elderly. Individual fall prevention training, fall prevention at home, and group fall prevention training are all offered to seniors who practice how to do everyday activities, such as walking, sitting down and standing up, in new ways which better suit their physical capabilities (WIJKfysio 2018a).
Group courses are held in a school gymnasium in Leusden where an obstacle course is laid out for the elderly students (Schuetze 2018). The course is comprised of the “Belgian sidewalk,” a wooden contraption simulating loose tiles; slopes and ramps; and obstacles such as “the pirouette” and “the slalom” (Schuetze 2018). Each stage is devised to teach the elderly how to navigate uneven ground without having to worry about falling, and how to fall if they do. In the first session of each course, an assessment is carried out about individuals’ physical conditions and motor skills, and to identify areas of difficulties that may cause or have caused one to fall already (WIJKfysio 2018a). Exercises targeting muscle strength, balance and improving fitness levels, all supplement the fall prevention training. Developing techniques to fall, improving balance, and gaining insight into the risks of falling are all parts of the course. Sessions are offered to groups of 8-10 people twice a week over five weeks conducted by therapists and a neighbourhood sports coach. For those who regularly fall or are afraid to fall, an individual home exercise program is offered (WIJKfysio 2018a).
Though falling courses are a relatively new development in education for the elderly and yet to be fully assessed in terms of their effects on the absolute number of falls per year in The Netherlands, they have still had considerable success. Various studies show that the number of fall incidents, and the number of injuries caused by falling, are reduced by 35% because of the training programme (WIJKfysio 2018a). This success is reflected in how the Dutch government rates and supports several interventions for fall prevention, and how some Dutch health insurances partially cover course costs (Loketgezondleven.nl 2018). WIJKfysio charges € 200,00 for 10 fall prevention sessions as a standard rate for people who are uninsured (WIJKfysio 2018b). However, if a person is insured with one of the company’s many insurance partners, they are entitled to reimbursement of their treatment. The health insurer reimburses costs directly to the practice, and if it is not or not fully reimbursed, individuals will receive an invoice for the remaining amount determined by tariffs negotiated between WIJKfysio and its insurance partners (WIJKfysio 2018b). These courses enable individuals to develop an awareness of common risk factors; develop better balance and flexibility to maintain independence in everyday living, and build confidence to overcome the fear of falling.
Loketgezondleven.nl (2018). “Interventieoverzicht Valpreventie.” Loketgezondleven.nl. At https://www.loketgezondleven.nl/interventieoverzicht2/Valpreventie.
Schuetze, Christopher, and Jasper Juinen (2018). “Afraid of Falling? For Older Adults, the Dutch Have a Cure.” The New York Times. At https://www.nytimes.com/2018/01/02/world/europe/netherlands-falling-elderly.html.
WIJKfysio (2018a). “Training valpreventie Leusden.” WIJKfysio. Accessed October 17, 2018. https://wijkfysio.nl/valpreventie/
WIJKfysio (2018b). “Tarieven.” WIJKfysio. At https://wijkfysio.nl/Tarieven/.