Patients are trained to improve reaction time, while some are given customised treatments thereafter

SINGAPORE - There was a time when an elderly person who suffered a fall might have to visit the hospital a few times for different checks, or he could be given advice and referred to step-down care.

But over the years, hospitals have set up clinics where patients can see doctors and allied healthcare staff during the same visit and obtain a structured programme to help prevent further falls. More patients, it seems, are taking advantage of these specialised falls clinics.

"It improves the patient experience, saves time and provides better care co-ordination for the patient," said consultant geriatrician Dr Vina Doshi, who runs the Falls Clinic at Changi General Hospital (CGH).

The clinic, set up in 2005, saw 223 cases last year, up from 148 cases in 2008 and just 41 cases in 2007. This is largely due to more awareness of the clinic, said Dr Doshi.

Falls can be fatal for the elderly. In the case of CGH patients, poor eyesight (78 per cent last year) and inappropriate footwear (58 per cent), such as rubber slippers, are the main contributors to falls. Elderly patients feel they don't need to get their eyesight corrected as they are old, explained Dr Doshi.

Patients who have had a fall have a 50-per-cent chance of falling again. Half of seniors above 80 fall at least once a year, Dr Doshi added.

"The intervention or treatment (of falls patients) requires interdisciplinary care," said a spokeswoman for Tan Tock Seng Hospital (TTSH), the first to set up a falls and balance clinic in 1998.

For instance, a nurse counsels the patient, a physiotherapist improves a patient's balance and an occupational therapist looks at home safety. The hospital sees some 170 new cases annually.

Activities conducted at a falls clinics include exercises to improve patients' reaction time and a six-to-eight week intervention programme at the Singapore General Hospital (SGH), while at the National University Hospital (NUH), patients are given a customised treatment plan after assessment.

SGH is the latest to set up a falls clinic. The clinic, which opened last December, is now managed by physiotherapists, but is gearing up to have a multi-disciplinary team. NUH's falls clinic has seen yearly increase in patients since it was established in 2006.

Alexandra Hospital - which put its eight-year-old falls clinic on hold last year - hopes to "revive this as a priority" at the Khoo Teck Puat Hospital, said its head of geriatrics and senior consultant James Low.

While all geriatricians are able to manage falls, Dr Low said it is "good" to have a specialised clinic that offers multi-disciplinary care.