Invited Speakers

Margaret Gidgup

PhD Scholar, University of Western Australia, Perth, Western Australia

Bio: Kiya, from Margaret Gidgup, a senior Noongar Wadjuk woman from the South West of Western Australia. Margaret is an early career researcher who has worked for organisations providing services in Aboriginal communities around Australia. Margaret has spent the last 30 plus years working in industries to help improve health and welfare outcomes for Aboriginal and Torres Strait Islander people. Margaret’s past work commitments have taken her to NSW, the Central Desert Region of the Northern Territory and Western Australia Statewide, providing health services to remote communities and regional areas of the South West.

Margaret has a Bachelor of Aboriginal Health (2008) and has just submitted her PhD, titled Impacts of Physical Activity (PA) on Older Aboriginal people living on Noongar Boodja in the South West of Western Australia (2022).

Margaret’s thesis focused on how the Ironbark PA program could be translated into Western Australia on Noongar Boodja. Margaret evaluated the barriers and enablers to older indigenous people engaging in physical activity. She also explored the Elders’ perspectives of the PA program and evaluated mental and physical outcomes of the program. Elders gave positive feedback about the Program and experienced social mental and physical benefits from their participation. Margaret’s research study with the Elders ended in 2020. It is now 2023 and she is still witnessing the incredible changes that some of the Elders made in their lives which has given them a new perspective on physical activity with a renewed interest in maintaining a level of fitness so that they can enjoy their lives more with their family and friends. Many Elders are still attending the new program that is being trialled.

Margaret’s presentation will focus on the ways of working, a Nih Waangkiny Kaadatjiny (listening, learning, knowing) decolonising approach to conducting research with older Indigenous people.

Professor Leigh Hale

Dean of the School of Physiotherapy / Centre for Health, Activity, and Rehabilitation Research, University of Otago, New Zealand

Bio: Professor Leigh Hale is the Dean of the School of Physiotherapy / Centre for Health, Activity, and Rehabilitation Research at the University of Otago, New Zealand. She graduated as a physiotherapist from the University of Cape Town (South Africa) and went on to attain her MSc (Neurorehabilitation) and PhD from the University of the Witwatersrand (South Africa). Leigh primarily researches in the area of community-based physiotherapeutic rehabilitation, falls prevention and supported self-management for people living with disability and with neurological conditions, such as multiple sclerosis, stroke, dementia, and learning disabilities; and in aged care. Her research uses both quantitative and qualitative methodologies and focusses on how physiotherapists can enable and support people to optimally live healthy and engaging lives. She has over 168 peer reviewed publications and six book chapters.

Presentation Title: Advantaging physical activity for life for all: the future challenge

Abstract: Irrefutable evidence now exists for the role of physical activity in the prevention of falling in community dwelling older adults, with a recent systematic review concluding with an urgent call for the provision and scale-up of such programmes. Indeed, the benefits of physical activity for older adults extend far beyond falls prevention, positively impacting all aspects of health – physical, mental, emotional, spiritual, and social. Evidence for these outcomes arise from well controlled, low risk of bias clinical trials and systematic reviews with meta-analyses. The included trial populations, however, are often not representative of disadvantaged populations (for example, low socioeconomic, refugee, rural, indigenous), or are typically participants at the “preparation” or “action” phases of the Transtheoretical Model of behaviour change. Whilst the physiological evidence for physical activity is strong, strategies to successfully enable diverse groups of older adults to engage and progress to the “maintenance” phase are lacking. Better understanding how to encourage those less ready or less advantaged to engage is required, particularly to engage in physical activity for life. And participation for life is what is really required to reap the long-term benefits of physical activity programmes. This presentation will describe collaborative research exploring what people living with a diverse range of backgrounds and long-term conditions consider important to enable lifelong engagement in physical activity programmes. The success, or not, of implementing these recommendations in mixed methods clinical trials will be discussed. Finally, the presentation will challenge the continued use of traditional methodologies and measures, and propose that innovative interventions, research methodologies and means of evaluating outcomes are required if we truly wish to engage all those living with lifelong conditions to be physically active for life.

Dr Jo Hikaka

Pharmacist and Senior Research Fellow, University of Auckland, New Zealand 

Bio: Dr Joanna Hikaka (Ngāruahine) is a pharmacist and Senior Research Fellow at the University of Auckland, New Zealand. Her clinical and research work focuses on older adult and Māori health, spanning primary, secondary, and aged residential care settings, with a current focus on exploring Māori experiences and expectations of kaumātua care. In 2019, Joanna was named New Zealand Pharmacist of the Year, and in 2022, Joanna undertook a Fulbright scholarship at Brown University School of Public Health, exploring pro-equity health intervention development. She holds a number of regional and national governance and advisory roles relating to the responsible use of medicines, dementia, gerontology, and aged residential care. Joanna is a Co-director of the newly established Centre for Co-Created Ageing Research at the University of Auckland and the Principal Investigator on the Whaioranga te Pā Harakeke – Iwi-driven injury prevention and recovery for older Māori. Joanna enjoys supporting others to develop research skills in both academic and non-academic settings and sees value in developing diverse research teams to deliver excellent research that is most likely to be relevant to communities of interest and to impact policy and practice.

Presentation Title: Whaioranga Te Pā Harakeke – Iwi-driven injury prevention and rehabilitation for older Māori

Abstract: Aotearoa New Zealand has a world-leading no-faults injury insurance scheme which drives a national response to injury prevention, care and rehabilitation. Unfortunately the benefits of this scheme are not experienced equitably, with Māori less likely to have access to resourcing than non-Māori and there are limited care options designed for, and with, Māori.

Whaioranga Te Pā Harakeke – Iwi-driven injury prevention and rehabilitation for older Māori is a multi-phase research project designed and delivered through a collaborative academic-iwi (tribal) partnership. Paeārahi (community and health navigators; unregulated workforce) connect older Māori and their families with health and social services, facilitate group exercise and socialisation programmes an undertake ‘mini-health’ assessments and home safety checklists. Central to the intervention is holistic assessment and goal-setting which aims to identify and address an array of aspects that impact on falls and other unintentional injuries.

Results presented will focus on acceptability, feasibility and exploratory efficacy measures, as well as critically reflecting on the realities of working in partnership between Universities and tribal organisations.

Dr Sandra Iuliano

Senior Research Fellow (Honorary), Department of Medicine – Austin Health, The University of Melbourne, Melbourne, Victoria

Bio: Dr. Iuliano is a senior research fellow in the department of medicine, University of Melbourne. She has worked extensively in the aged care sector in particular researching food-based approaches to improving health outcomes in residents. Dr Iuliano’s most recent trial involved over 7000 residents in 60 residential aged care homes that cost-effectively reduced fractures and falls and prevented malnutrition. Dr Iuliano presented evidence at the Royal Commission in aged-care and is a member of the National Aged-care Advisory Council. She is a strong advocate for improving nutritional care and quality of life via improved food provision in aged care.

Presentation Title: Reducing Falls and Fractures in Older Adults in Aged Care Consider Food Quality in Prevention Strategies

Abstract: Falls rates in older adults in aged care are five times higher than age and sex matched peers in the community. Hip fractures are a major outcome from falls, with 30% of the community burden of hip fractures arising from aged care. By 2050 it is expected that over 20,000 hip fractures will occur in aged care homes in Australia. The ageing of the population will see a global increase in hip fracture burden. Interventions targeting this high-risk group would likely reduce the community burden of falls and fractures, but any intervention must be effective, safe, and cost saving. Older adults in aged care homes have inadequate intakes of protein and calcium, so correcting these inadequacies would likely reduce the risk of falls and fractures. Over the 2-year clustered-randomised trial involving over 7000 older adults, 30 intervention care homes provided additional dairy foods (milk, yoghurt, and cheese) on the menu, while 30 control sites continued with their usual menus. The increased dairy intake from 2 to 3.5 servings daily in intervention residents was associated with an 11% reduction in falls, a 33% reduction in fractures, and a 46% reduction in hip fractures. Compliance with the dairy food was maintained perhaps as these foods are familiar to residents and the dairy foods provided were based on their preferences. All-cause mortality remained unaltered in intervention residents, so relative to mortality risk the intervention was safe. The cost of the additional dairy foods was less than AU$1 per resident per day and was cost saving when fractures alone are considered. Appendicular lean mass was maintained with intervention and malnutrition abated, both risk factors for falls. Improving food quality in aged care is an important consideration when implementing falls prevention strategies with all residents benefiting independent of underlying falls risk.

Professor Stephen Lord

NHMRC Senior Principal Research Fellow & Centre Director, Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales

Bio: Stephen Lord is a Scientia Professor at the University of New South Wales and a Senior Principal Research Fellow at Neuroscience Research Australia, Sydney, Australia. His research interests include instability, falls and fractures in older people and clinical groups with balance impairment. His research follows two main themes: the identification of neuropsychological, sensorimotor and balance risk factors for falls and the development and evaluation of fall prevention strategies. His current projects include the development of digital gait biomarkers, reactive step training and cognitive-motor interventions to prevent falls and studies addressing fall risk in people with diabetes mellitus, multiple sclerosis, Parkinson’s disease and cognitive impairment. He is also actively engaged in initiatives aimed at implementing falls prevention evidence into policy and practice.

Presentation Title: New Australian Best Practice Guidelines for Preventing Falls in Older People for Community, Hospital and Residential Aged Care Setting

Abstract: During 2022 and 2023, members of the Australian and New Zealand Falls Prevention Society have been commissioned to update the Australian Best Practice Guidelines for Preventing Falls and Harm from Falls in Older People for Community, Hospital and Residential Aged Care Settings for the Australian Commission on Safety and Quality in Health Care (ACSQHC). The guidelines are designed for health professionals providing care in Australian community settings and offer a nationally consistent approach to preventing falls based on best practice recommendations. They have been developed drawing on: a search of the most recent literature for each risk factor or intervention, the most recent Cochrane reviews of fall prevention interventions in the Community, Hospital and Residential Aged Care Settings, the 2022 World Falls Guidelines, and feedback from health professionals, policy staff and clinical advice from the expert advisory group. This presentation will provide an overview of the guidelines and their key recommendations.

Dr Hannah Seymour

Medical Lead, Electronic Medical Record (EMR) Program Team, Department of Health, Perth, Western Australia

Bio: Dr Hannah Seymour is the Medical Lead of the Electronic Medical Record Program Team, as well as a Consultant Geriatrician at the Fiona Stanley Fremantle Hospitals Group. Hannah has worked in Acute Orthogeriatrics at Fiona Stanley Hospital since 2015 where she shares the care of older people with orthopaedic surgeons. Hannah is passionate about using data to improve the care of older people with fractures across the world by working on the Steering Committee of the ANZ Hip Fracture Registry and as Past President of the Fragility Fracture Network. She has presented internationally on the care of older people with fractures. Hannah has held a number of leadership positions in Western Australia including the Falls and Aged Care Lead in the Department of Health, Leadership of the Four Hour Rule Program at Royal Perth Hospital and Clinical Commissioning Lead and Medical Director at Fiona Stanley Fremantle Hospitals Group. Most recently she was Clinical Nominee on the Sustainable Health Review which was published in April 2019. Dr Seymour has been involved in ICT in WA since 2009 when her first ICT project was developing QoCR (Quality of Care Registry) for collecting hip fracture clinical care standards. Hannah became responsible for a number of Clinical Systems at the commissioning of FSH. These included NaCs, iCm and BOSSnet. Since FSH opened Hannah has been the Lead for ICT at FSH and then SMHS and Chair of the BOSSnet Business User Group. During the last five years there have been many incremental improvements which have delivered significant improvements in the way ICT functions at FSFHG. Hannah does not consider herself an ICT expert and finds Enterprise Architecture rather dull – she has however learnt how to interface between “techies” and clinicians and is excited to deliver ICT benefits to the entire WA Health System in this role.

Presentation Title: How can technology help us in caring for older people at risk of falls and fractures?

Abstract: Information drives improvement. In caring for frail older people with falls how can we use structured routine, clinical information to improve care? Using hip fracture as an example, Hannah will discuss how high quality clinical care standards, structured data and published outcomes have improved the quality of care for older people who fall and fracture their hip. Hip fractures are easy to count – in most developed countries they all present to hospital. The population of people who fracture their hip is comparable between sites allowing valid comparisons of processes and outcomes. The clinical care standards defined in Australia are simple, clear and measurable. Technology such as Electronic Medical Record should enable streamlined collections of a well defined dataset. This data can then be presented back to clinical teams in easily understandable dashboards to enable continuous improvement. But can technology help with retuning people to independence and preventing falls and fractures? Automated intelligence and empowering teams using technology has been proven to reduce hip fractures in the most advanced systems around the world. How do we translate these to exiting systems to ensure they develop to maximise health outcomes for our community.