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Toolkit

Assistive Devices to Help Prevent Falls

III

Preface
Preventing falls is a community-wide problem. Assistive devices are
tools to help people stay independent and safe while taking part
in the activities of everyday living. Some assistive devices such as
canes and bathtub grab bars may prevent falls or reduce the risk of
injuries in the event of a fall. While convention would suggest that
the promotion of assistive devices is up to the health professional,
businesses too can be involved in increasing access to, and
awareness of, assistive devices.
Tools for Living Well is designed to help communities:
increase awareness of, and access to, assistive devices;
encourage local businesses to promote assistive devices;
educate seniors and their caregivers to make informed
choices about assistive devices and to use them correctly;
and
support a shift in social norms from assistive devices as
tools for persons with disabilities to assistive devices as
tools for independent living.
Tools for Living Well is intended for use by individuals or organizations
interested in tackling the problem of falls among older adults in the
community. Information and strategies included might be of interest to:
local coalitions, seniors groups, business associations, legions, home
care programs, and others.

Word short cuts:


To avoid long, explanatory
phrases throughout the
Toolkit we have used the
term seniors to refer to
older adults, including
veterans.
Although we have focused
on seniors as a target
group in this program, it is
important to know that the
assistive devices listed here
are beneficial for all ages.
Assistive devices are
tools to help people stay
independent and safe while
taking part in the activities
of everyday living.

Tools for Living Well promotes bathtub safety devices, canes and hip
protectors. It will help you help the businesses in your community to
contribute to fall prevention and support independent aging.
Tools for Living Well focuses on three business domains - retailers,
homebuilders, and hoteliers. However, the strategies and approaches
presented here could also be used with other businesses.
The program provides a variety of materials or tools to help
promote these assistive devices, including:

statistics on falls and information on the preventative


benefits of assistive devices;

information to help build awareness of assistive devices in


your community;

Tools for Living Well

IV

Preface

point of purchase information to assist the purchaser and


consumer;

suggestions for working with businesses to promote


assistive devices; and

tips on how to evaluate your program.

Chapter 1 Introduction describes the goals, objectives,


framework and rationale for the program.
Chapter 2 Preventing Falls provides information on the incidence
of falls among Canadian Seniors, the causes and costs of falls, risk
factors and strategies to prevent falls.
Chapter 3 Assistive Devices and Fall Prevention provides
information on each of the assistive devices that are targeted in this
program.
Chapter 4 Getting Started: Mobilizing Your Community
describes ways in which you can -- engage people in your
community in supporting your efforts.
Chapter 5 Selecting and Planning Your Approach to
Businesses offers strategies to help you identify which businesses
to approach and how to approach them.
Chapter 6 Approaching and Working with Businesses will help
you approach and support businesses in their promotion of assistive
devices.
Chapter 7 Evaluating Your Program offers suggestions on how
you can determine if your efforts have been effective.
Program Tools and Evaluation Tools included in the Toolkit may
be photocopied or adapted to your audience.
Brochures have been developed for use with seniors, caregivers,
businesses, and other community members.
Appendix 1 illustrates the way the Toolkit was used in pilot program
sites in 4 cities across Canada, and highlights some of the lessons
learned from those experiences.

Tools for Living Well

Acknowledgements
Tools for Living Well was co-written and produced by the Community
Health Research Unit (CHRU) at the University of Ottawa and the
Canadian Association of Occupational Therapists (CAOT).
Funding for the development of this Toolkit was provided by the
Health Canada/Veterans Affairs Canada Fall Prevention Initiative.
The Toolkit was produced and developed by the University of
Ottawa and CAOT. Contributions to the development of the Toolkit
were made by:
Donna Lockett
Community Health Research Unit, University of Ottawa
Nancy Edwards
Community Health Research Unit, University of Ottawa
Mary Lou Boudreau
National Project Coordinator, Tools for Living Well
Darene Toal Sullivan
Canadian Association of Occupational Therapists
Heidi Sveistrup
University of Ottawa
Claudia von Zweck
Canadian Association of Occupational Therapists
Christy-Ann Drouin
Project Coordinator of Operations,
University of Ottawa
Judith Wilson provided consultation on approaching businesses.
Graphics were done by Meghan Thomas.
Appreciation is extended to our National Program Advisory Team,
who gave us their benefit of their expertise:
Ginette Asselin
City of Ottawa Seniors Health and Caregiver Support
Doris Pringle
Senior,
City of Ottawa Falls Prevention Coalition

Tools for Living Well

VI

Acknowledgements

Helen Allard
Royal Canadian Legion, Ottawa
Bill Turney
Active Living Coalition for Older Adults (ALCOA)
Dr. Jan Polgar
University of Western Ontario,
School of Occupational Therapy
Brent Cliff
New Brunswick Homebuilders Association
Tom Parker
Canada Mortgage and Housing Corporation (CMHC)
Brian Stowe
Canadian Pharmacists Association
Mary Frances Laughton
Industry Canada,
Assistive Devices Industry Office
Deborah Finn
Industry Canada,
Assistive Devices Industry Office
Jane Stewart-Grey
Canadian Physiotherapy Association
Mario Giannetti
Preston Hardware, Ottawa, Ontario
Scott Puddicombe
Puddicombe Access Solutions, Inc.,
Ottawa, Ontario
A big thanks to our five Site Coordinators who piloted the programs in
their own communities:

Marie Brine in Prince Edward Island;

Ginette Asselin in Gatineau, Quebec;

Carie Lee Watters and Margaret Usherwood in Calgary,


Alberta;

Heather Gillespie in Nanaimo, British Columbia.

Thanks also to their enthusiastic Program Volunteers and Community


Advisory Teams who were so important in implementing the pilot
projects and for teaching us from their experience.

Tools for Living Well

VII

Terms of use
The Tools for Living Well Toolkit was created by the Community
Health Research Unit (CHRU), University of Ottawa and the
Canadian Association of Occupational Therapists (CAOT) with
funding from the Health Canada/Veterans Affairs Canada Falls
Prevention Initiative. The views expressed herein do not necessarily
represent the official policies of the CHRU, University of Ottawa,
CAOT, or its funders or partners.
Not medical advice: The information provided in the Toolkit is intended for educational purposes only. It is not and should not be taken as
advice or treatment from a doctor or health care professional. Never
disregard professional medical or health care advice or delay in seeking it because of something you have read in this Toolkit.
Copyright and permission to use: All materials in Tools for Living
Well are protected by Canadian copyright law. The Content of Tools
for Living Well may be used without specific permission for noncommercial or educational purposes. No part of this information may
be reproduced for any other purpose without the written permission
of the CAOT (CAOT, CTTC Building, Suite 3400, 1125 Colonel By
Dr., Ottawa Ontario, K1S 5R1, www.caot.ca) or CHRU (CHRU,
University of Ottawa, 451 Smyth Road, Ottawa, Ontario, K1H 8M5).
Limitation of Liability: In no event shall the Community Health
Research Unit, University of Ottawa, the CAOT, Health Canada
or Veterans Affairs Canada, its directors, employees, agents, or
licensors be liable for damages of any kind arising from the use of
information in Tools for Living Well.
Disclaimer of warranties: The Toolkit and the content are provided
as is. While we endeavour to provide content that is correct, accurate
and timely, no representations or warranties are made regarding
the Tools for Living Well Toolkit. By using the Toolkit, the users
acknowledge and agree they are using it at their own risk and liability.
Referencing this Toolkit: Please use the following reference:
Lockett, D., Edwards, N., Boudreau, ML, Toal-Sullivan, D.,
Sveistrup, H., and von Zweck, C. (2004). Tools for Living Well:
Assistive Devices to Prevent Falls among Seniors and Veterans.
University of Ottawa and Canadian Association of Occupational
Therapists. Ottawa, Ontario, Canada.
Tools for Living Well

VIII

Table of Contents
Chapter ONE - Introduction ................................................................................ 1
1.
2.
3.
4.
5.

Why retailers? ...................................................................................................................... 1


Why hoteliers and homebuilders? ....................................................................................... 2
Building on precedence ........................................................................................................ 2
Looking forward .................................................................................................................... 3
Working together to prevent falls .......................................................................................... 3

Chapter TWO - Preventing Falls ........................................................................ 5


1.
2.
3.
4.
5.

Prevalence of falls among seniors and veterans ................................................................. 5


Personal cost of falls ........................................................................................................... 5
Cost of falls to our health care system ................................................................................. 6
Risk factors for falls .............................................................................................................. 6
Reducing the risk of falls for seniors .................................................................................... 9

Chapter THREE - Assistive Devices and Fall Prevention ............................ 11


1.
2.
3.
4.
5.

Canes.................................................................................................................................. 11
Hip protectors ..................................................................................................................... 15
Grab bars ............................................................................................................................ 17
Bathtub and shower seats .................................................................................................. 20
Non-slip bathtub and shower mats ..................................................................................... 21

Chapter FOUR - Getting Started: Mobilizing Your Community ................... 23


1.
2.
3.
4.
5.

Getting to know your community ........................................................................................ 23


Using volunteers for this program....................................................................................... 23
Community meetings and presentations ............................................................................ 28
Collect local stories ............................................................................................................. 29
Media Advocacy .................................................................................................................. 30

Chapter FIVE - Selecting and Planning your Approach to Businesses ..... 31

1. Selecting businesses to target............................................................................................ 31


2. Planning your approach ..................................................................................................... 32

Chapter SIX - Approaching and Working with Businesses ......................... 33

1. Approaching businesses ..................................................................................................... 33


2. General approach to supporting businesses ...................................................................... 36
3. Supporting businesses in change....................................................................................... 37

Tools for Living Well

IX

Chapter SEVEN - Evaluating your Program ...................................................... 41


1.
2.
3.
4.
5.

Introduction to evaluation ................................................................................................... 41


What should you consider evaluating? ............................................................................... 41
Interviews with participating business representatives ....................................................... 43
Businesses environmental scans ....................................................................................... 43
Interpreting results and sharing your findings ................................................................... 44

References ......................................................................................................... 47
Appendix ONE - An Overview of the Tools for Living Well Pilot Program with
Lessons Learned ............................................................................................... 49
Purpose and scope of this overview ....................................................................................... 49
The Pilot Sites ......................................................................................................................... 50
The Site Coordinators ............................................................................................................. 50
A) Overview of variability of program implementation in each site .............................................51
B) Recommendations based on lessons Learned ................................................................. 57
Summary ................................................................................................................................. 60

Appendix TWO - Other Resources That You Might Find Useful .................. 61

Health Canada and Veterans Affairs ..................................................................................... 61


Canada Mortgage and Housing ............................................................................................. 61

Evaluation Tools ................................................................................................. 63


Evaluation Tool
Evaluation Tool
Evaluation Tool
Evaluation Tool
Evaluation Tool
Evaluation Tool
Evaluation Tool
Evaluation Tool
Evaluation Tool

1:
2:
3:
4:
5:
6:
7:
8:
9:

Retailer Initial Interview ............................................................................. 65


Retail Store Environmental Scan ............................................................. 69
Retailer Follow-Up Interview ..................................................................... 71
Hotelier Initial Interview ............................................................................. 75
Hotel/Motel Environmental Scan ............................................................... 79
Hotelier Follow-up Interview ..................................................................... 81
Homebuilder Initial Interview ..................................................................... 83
Model Home Environmental Scan ............................................................ 87
Homebuilder Follow-up Interview .............................................................. 89

Program Tools .................................................................................................... 93

Program Tool 1: Community presentation .............................................................................. 95


Program Tool 2: Community profile ........................................................................................ 99
Program Tool 3: Priority setting exercise .............................................................................. 109

Tools for Living Well

Table of Contents

Program Tool 4: Strategic planning exercise ........................................................................ 115


Program Tool 5: Sample introductory letter to businesses ................................................... 117
Program Tool 6: Sample script for follow-up call to businesses .......................................... 119
Program Tool 7: Sample thank you letter for businesses ..................................................... 121
Program Tool 8: What you should know before you approach homebuilders ...................... 123
Program Tool 9: What you should know before you approach hoteliers .............................. 125
Program Tool 10: What you should know before you approach retailers ............................. 127
Program Tool 11: Staged interventions for working with businesses ................................... 129
Program Tool 12: Program Summary .................................................................................... 133

Brochures ........................................................................................................ 135


Brochure
Brochure
Brochure
Brochure
Brochure
Brochure
Brochure
Brochure
Brochure
Brochure
Brochure

1: Seniors are Good for Business! ........................................................................ 137


2: Use a cane! ....................................................................................................... 139
3: Wear hip protectors! ......................................................................................... 141
4: Use grab bars! .................................................................................................. 143
5: Use a bath seat! ............................................................................................... 145
6: Use non-slip mats in your bathroom! ............................................................... 147
7: Invest in your Independence! ............................................................................ 149
8: Avoid falls while travelling! ................................................................................ 151
9: Have a safe home and lifestyle! ....................................................................... 153
10: Protect yourself from falls! .............................................................................. 155
11: Hip Protector Supplier List .............................................................................. 157

Tools for Living Well

1
Chapter ONE

Introduction
Falls are a significant problem for older adults. Many factors
contribute to falls. This program aims to support independent living
and reduce the rate of fall injury by promoting the appropriate use of
selected assistive devices.
Tools for Living Well is designed to help communities:
increase awareness of, and access to, assistive devices;
encourage local businesses to promote assistive devices;
educate seniors and their caregivers to make informed choices about assistive devices and to use them correctly; and
support a shift in social norms from assistive devices as
tools for persons with disabilities to assistive devices as
tools for independent living.

Tools for Living Well


concentrates on canes,
hip protectors and bathtub
devices (bathtub or shower
grab bars, bathtub or shower
benches, and non-slip mats).

1. Why retailers?
Accessing assistive devices can be a problem. Research has
shown that seniors are discouraged from purchasing assistive
devices because they dont know where to buy them and dont
know how to select an appropriate device.1 Seniors may also
decide not to use assistive devices because they believe only
frail or disabled people need them.1 This program is designed
to promote assistive devices in mainstream stores as a way of
normalizing their use and increasing their availability. It also
provides information required by retailers and customers for the
proper fitting and use of devices.

a) Retailers can help by:

making assistive devices available in local neighbourhood


stores and display them as they would appear in the home;
ensuring that store staff have information available on the
choice, installation and proper use of the assistive devices
they sell;
providing point of purchase information for potential
consumers.

Tools for Living Well

Chapter ONE - Introduction

2. Why hoteliers and homebuilders?


Research has demonstrated that seniors who have access to bath
safety devices such as grab bars in their homes, for the most part,
use them.1, 2 If seniors have a chance to see and use a bath
safety device while in a hotel, they may think about purchasing one
for their home. If homebuilders offer the installation of grab bars as
part of the purchase price of a home, buyers may be more likely to
include these devices as standard home equipment.

a) Hoteliers can help by:

installing bathtub and shower grab bars and non-slip surfaces


on tubs, showers and bathroom floors in all guest rooms;
promoting the fact that these devices are available in all
guest rooms; and
promoting the availability of bathtub seats in hotel
advertising and guest service brochures.

b) Homebuilders can help by:

installing and displaying assistive devices in model homes;


promoting assistive devices as a standard upgrade feature
for new buyers; and
providing reinforcement in bath areas for retrofitting of
bathtub grab bars.

3. Building on precedence
Stereotyped views of assistive devices need to be replaced with
more open views. This program aims to begin the process of
reshaping social norms and shifting stereotypes, which surround the
use of assistive devices.
There are many examples of protective devices and assistive
devices that have successfully been integrated, even legislated, into
everyday life. For example:

Tools for Living Well

Walking sticks in Europe are associated with hiking and


other vigorous outdoor activities. They are also displayed
and sold in mountaineering and hiking stores, and sports
equipment stores.
Cooking utensils with large grip handles are now displayed
along with regular kitchenware. They are easy to spot and in
your face when you shop. There are even designer versions

Chapter ONE - Introduction

for which some consumers are willing to pay more money.


Bicycle helmets are usually prominently displayed in stores
alongside bicycles. This promotion, together with educational
campaigns and legislation, has significantly increased
the use of bicycle helmets by children and reduced head
injuries. Although helmets are not legislated for use by
adults the norm is for recreational riders to wear one.
Helmets for downhill skiing and snowboarding are not
legislated but have become one of the new trends over the
past few years.

Links with other fall


prevention partners are an
important dimension of this
program. These links will
help to ensure that program
activities complement each
other and that a spirit of
collaboration is nurtured in
your community.

4. Looking forward
As norms shift, it is expected that the products will no longer be
viewed as optional, but rather necessary and welcomed tools.
Activities outlined in this Toolkit can lay the groundwork for more
sustainable initiatives, such as:

lobbying governments to include bathtub grab bars as part


of the building codes;
encouraging municipalities to adopt legislation for retrofitting
all bathtubs with grab bars;
lobbying insurance companies to provide insurance rebates for
homes with bathtub grab bars and other assistive devices; and
advocating lower mortgage rates for homes that are built to
accommodate universally accessible design principles.

5. Working together to prevent falls


The activities of this program are not meant to work in isolation.
This program is designed to complement other falls prevention
programs, such as monitoring hazards in the environment,
educating seniors about the benefits of active lifestyles and exercise
programs, and individual counselling on personal risk factors for
falls such as medications and lifestyle issues.
Links with other fall prevention partners are an important dimension
of this program. These links will help to ensure that program
activities complement each other and that a spirit of collaboration is
nurtured in your community.
The ProgramFramework on the following page outlines anticipated
impacts of the program and highlights opportunities that may
enhance these impacts.

Tools for Living Well

Approach and
support retailers, hoteliers,
homebuilders
to promote
assistive
devices

Tools for Living Well

Empirical evidence (e.g.


like statistics)

Changes to product and


building standards

Changes to policy

Greater visibility and


availability of assistive
devices in new homes,
stores, hotels

Better awareness and


capacity among retailers to
support and service their
consumers

Greater acceptance of
assistive devices

Other fall
prevention
initiatives

Increase in
public demand
for greater
access and
choices

Increase community
demand (sales) and
informed choices for
ADs by seniors and
veterans

Increased proper
use of ADs among
seniors and
veterans

Figure 1: PROGRAM FRAMEWORK

Enhance
independent living,
lower risk and
severity of falls

4
Chapter ONE - Introduction

5
Chapter TWO

Preventing Falls
Most of us have slips and trips with no serious consequences.
However, among older adults, falls are more common and often
result in serious injuries. The costs of falls are high for those who
fall, their family, and their community. The good news is that older
adults can reduce their risk of falling. This chapter will provide an
overview on the prevalence and costs of falls, risk factors for falls,
and some key strategies to prevent falls.

One in three seniors


fall. It could happen to you
or someone you love.

1. Prevalence of falls among seniors


and veterans
A fall is an event that results in a person coming to rest
inadvertently on the ground or floor, or other lower level.
Research shows that:
1 in 3 older Canadian adults fall each year, and this risk
increases as they get older1,3

2. Personal cost of falls


Falls can result in many costs for older adults and their families.
The most obvious is personal injury. However, fear of falling, loss of
independent living and even death related to injuries from falls are
also possible consequences. Here are some brief facts:

a) Injuries

Falls are the most common cause of injury for elderly


people.4
Over 90% of hip fractures among seniors are the result of a
fall.5 Of those who suffer hip fractures:
o up to 24% will die in one year; and
o 80% will be unable to perform at least one instrumental
activity of daily living (e.g. driving, house cleaning). 6

b) Fear of falling
Seniors who fall may limit their activities for fear of falling again. By
limiting their activities, they are less physically active and begin to
loose strength and flexibility. This can increase the risk of falling.7
Tools for Living Well

Chapter TWO - Preventing Falls

c) Loss of independent living

About 40% of nursing home admissions are the direct result


of a fall.8
Older adults who have fallen are three times more likely to
be admitted permanently to an institution than those who
have not fallen.9

d) Death

Falls account for 57% of deaths due to injury among senior


females, and 36% among males.4
Falls are the 6th leading cause of death among older adults
in Canada.9

3. Cost of falls to our health care


system

Falls carry a high cost for


both those who fall and for
society.

In 1994, fall-related injuries in Canada cost approximately 2.8 billion


dollars.10 This estimate does not take into account the long-term
consequences of fall-related injuries that result from higher rates
of mortality and morbidity, increased vulnerability to future falls,
loss of independence, and lowered quality of life. Given our aging
population, this figure will continue to increase unless we work
together to prevent falls.

4. Risk factors for falls


Risk factors for falls are traditionally grouped into two categories:
personal, environmental. 11,12,13 Personal risk factors include poor
health and choices related to behaviours, lifestyle, or daily activities.
Environmental risk factors include indoor and outdoor hazards that
often are the result of poor design, construction or poor maintenance.
Because different activities can also pose different levels of risk for falls,
we add to risk factors the activity at the time of the fall.

a) Personal risk factors include:

Tools for Living Well

Health: As we age, our bodies change. Many of us


experience changes in vision (e.g. reduced peripheral
vision, poor night vision) balance problems, loss of
muscle and bone strength, chronic illnesses, and urinary
incontinence. We tend to use more medications, and
many of these, in particular sleep medications and antidepressants, lead to dizziness and balance problems. Any
and all of these may increase our risk of falling.

Chapter TWO - Preventing Falls

Behaviour and lifestyle choices: Certain behaviour and


lifestyle choices can contribute to our risk of falling. For
example, being physically inactive, not using handrails, or
rushing around can increase our risk of falling.

b) Environmental factors include:

Hazards indoors: There are things inside the home and


community buildings that can increase our risk of falling. These
may include scatter mats that are not well secured to the floor;
electrical or telephone cords across the floor, and stairs with
poor lighting, no handrails, or uneven steps. In addition, NOT
having safety devices such as grab bars and non-slip mats in
the bathtub or shower can increase our risk of falling.

Hazards outside: There are hazards outside that can


increase our risk of falling. Poor lighting, broken sidewalks,

This fictional story of Tom and Mary is, unfortunately, not uncommon. It highlights how falls are often
the result of an interaction between the individual and the environment. Notice the reasons given for
Toms fall. They illustrate how several risk factors can be at play in one incident.
Tom is 75. He has experienced many of the natural changes that occur with aging. He does not
hear as well as he used too. He has poorer vision. He used to walk on a regular basis but now
believes that exercising is not needed at his age and walks only infrequently. As a result, he has
experienced loss of muscle, reduced strength, and poorer balance. Although he was told by his
doctor that he should use his cane, especially when he walks around outside, he does not feel he is
old enough to use a cane, so he leaves it at home.
One day Tom was out walking with his friend Mary. Mary has experienced losses in vision and
hearing similar to Tom, but she has continued to walk daily and has retained her strength and
balance. She uses a cane to help keep her balance when she is on her walks.
Tom and Mary were enjoying their walk, chatting as they made their way down the sidewalk.
Although they had only been walking a few minutes, Tom was feeling a little fatigued. Suddenly, they
both stumbled on a crack in the sidewalk. Neither had seen it because of their visual challenges. The
fact that they were so busy chatting also contributed to their not seeing the crack. Mary was able to
use her cane to steady herself. She regained her balance and did not fall.
Tom was not so lucky. He lost his balance and fell. He was not able to get up on his own. Mary called
for help. When they examined Tom at the hospital, they discovered that he had broken his hip. Tom
never really recovered from the fall. He became fearful of falling and did even less outside of the
home. His strength deteriorated even more. That was last year. Today, Tom is in a nursing home.

Tools for Living Well

Chapter TWO - Preventing Falls

stairs that are not well marked, poor snow or ice removal
are examples of these risks.

c) Activity-related factors:

Choice of Activity: Some activities inherently have more


risks than others. Climbing a ladder is an example of an
activity-related risk factor. While it is important to keep on
doing the activities that are pleasurable, some activities
may need to be adapted with age. For example, they may
need to be performed during times of greater alertness, or
they may need to be done with the support of an assistive
device or another person.

The following diagram provides examples of some personal,


environmental and activity-related risk factors for falls. These are
only a sample and do not represent ALL risk factors for falls. It also
highlights the dynamic relationship among various risks that is often
at work when an older adult falls.

Personal
Health
Poor balance
Behaviour
Not using a cane

ed
at
l
e

Lifestyle
Being inactive

Taking a bath
Walking outside
in winter

Env
iro
n

Indoors
No grab bars in tub

tal
en
m

Activit
yR

Outdoors
Uneven sidewalks,
Poor snow removal

Personal risk factors can add up to a fall

Personal risk + Environmental risk + Activity = fall


For example, poor balance + uneven sidewalks + walking = fall

Tools for Living Well

Chapter TWO - Preventing Falls

5. Reducing the risk of falls for


seniors

Many falls are preventable.

Many older adults believe that there is nothing they can do to


prevent falls. However, many falls dont JUST happen. Although
older adults cant prevent all falls, they can minimize some of the
risks. Best practices for falls prevention and the prevention of
injuries resulting from falls, include a combination of:14

exercises that work on balance and strength, such as Tai


Chi and strength training;
environmental modifications, including installing and using
grab bars and other safety devices in bathrooms and
removing hazards in the home;
psychotropic drug withdrawal (i.e. sleeping medications,
medications for depression);
clinical screenings for physical and cognitive risk factors
for falls;
education programs to increase seniors awareness and
knowledge of fall risk factors; and
the use of hip protectors to reduce fall-related hip fractures.

Tools for Living Well

10

Chapter TWO - Preventing Falls

Tools for Living Well

11
Chapter THREE

Assistive Devices and


Fall Prevention
The dictionary defines a tool as a handheld device that aids in
accomplishing a task15. Assistive devices are tools tools to help
people stay independent and safe, while engaging in the activities
of everyday living. Just as one might use a hammer to pound a
nail, or a wrench to grab the head of a bolt and increase power
in turning it, one would use a grab bar to provide stability while
showering or bathing, or a cane to help maintain balance when
walking.

Asisstive devices can help


people stay independent
and safe while taking part
in the activities of everyday
living.

This chapter provides an overview of five assistive devices: canes,


bathtub or shower grab bars, bathtub or shower seats, non-slip
bathtub mats for inside and outside the bathtub or shower, and hip
protectors - what they are, how they work, and tips for safe use.
Brochures on each of these devices have been designed to share
with your community. They are provided at the end of the Toolkit
(Brochures 2-6).

1. Canes
Research has found that cane use is associated with improved
confidence and functional ability.16 By compensating for difficulties
with balance or weakness, a cane may also prevent a fall. Some
people may need to use a cane if they are weak on one side of
their body. People with balance problems may also need to use a
cane. A cane may also help with fatigue and/or reduce pain when
walking. Brochure 2 is a handout on canes that you can share with
your community and businesses.

a) Types of canes
There are many kinds of canes. Most are made of metal, wood, or
plastic. Canes come in many different sizes and can be adjusted in
length to fit the users height. It is important that the height of the
cane be correct. The 3 most common types of canes are:
Standard canes: This type of cane is usually made of
wood or metal. These canes are typically between 34 to 42
inches (86 to 107 cm) long and often have a rounded crook

Choosing a
cane:
If heavy support is needed,
the broad based quad
cane is the best one. If
the cane is needed for
balance or light to medium
support, the standard and
straight handled canes work
well. The best approach is
for the user to try out the
two styles, and see which
one he or she finds more
comfortable.

Tools for Living Well

12

Chapter THREE - Assistive Devices and Fall Prevention

handle. These canes are easy to use and are typically the
least expensive. A cane with a wooden or plastic handle is
often preferred to one with a metal handle. A metal handle
may slip from the users hand if the hand sweats. In cold
weather the metal handle may get too cold to touch.
Straight-handled canes: This cane may also be called a
T-handle cane and is usually made of wood, plastic, or
metal. This type of handle works well if the users hand is
weak. Using a T-handle cane may offer more stability than a
standard cane.
Broad-based canes: This is a lightweight metal cane with
4 short legs coming out of the bottom. They are sometimes
called quad canes because of the four small feet. These
legs provide more support than other canes. The legs also
allow the cane to stand-up when not in use. This type of cane
is recommended when a lot of support is needed to maintain
balance or if the user has a disability (e.g. after a stroke).

b) Sizing a cane
Canes must be fitted to the user. There are two methods recommended to measure a cane. Either will do.

Method 1 for sizing a cane

Method #1 Have the client:


1. Turn the cane upside down and put the handle on the floor.
2. Stand with arms at your sides.
3. The tip of the cane should be at the level of the wrist.

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Method 2 for sizing a cane

Tools for Living Well

Method #2 Have the client:


1. Stand straight with arms at side.
2. Measure the distance from the point where the wrist bends
(where one wears a wrist watch) to the floor.
A poster has been developed with this Toolkit (See Appendix 2) to
facilitate method #2 by allowing the individual to stand next to the
measurement chart and easily see the length of cane needed.
If a cane appears to be ill-fitted to the user, it may be adjusted.
For wooden canes, the steps to adjust the size of the cane
are:
1. Place the cane upside down and mark the cane at the
level of the users wrist.
2. Remove rubber tip.

Chapter THREE - Assistive Devices and Fall Prevention

3.
4.

Cut the cane 1/2 inch shorter than where it was


marked. The rubber tip will make up this difference.
Replace rubber tip.

For aluminium canes, simply adjust as permitted by the


cane. Most aluminum canes can be easily adjusted within
an inch of the desired height by a push-button.

c) Tips for using a cane


There is a right and wrong way to use a cane. Many people use
their canes incorrectly. The following will help you to teach others
how to use a cane correctly. *
Walking With a Cane:
Make sure the cane is the correct height.
If the user has a weaker leg, the cane should be held on the
stronger side. If neither leg is good or particularly bad, it
should be held on the strongest side.
The cane should be held about 4 inches (10cm) to the side
(far enough that the user will not trip over it, but not so far
that the tip slides away).
The cane and the opposite leg should move together.
Going

Weaker leg

Walking with a cane

up the stairs with a cane: To go up stairs, the user should:


Take the first step up with the stronger good leg.
Move the cane up to the same step.
Then, move the weaker bad leg to that same step.

Going down the stairs: To go down stairs, the user should:


Take the first step down with the cane and the weaker
bad leg.
Then, lower the stronger good leg to that same step.

Going up stairs

Using

a cane to get into a chair: The individual should:


Stand with the back of his or her legs against the chair seat.
Rest the cane against the chair.
Reach to grip chair arms with both arms. If the chair has no
arms, hands may support on the seat.
Lift the weaker leg slightly off the floor and put weight on the
stronger leg.
Sit down slowly and slide backwards into the chair.

* Some of the nformation and graphics on pages 11-14 were adapted from
Cherish Your Independence, City of Ottawa, Public Health Branch, Fall
Prevention Program

Going down stairs


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Chapter THREE - Assistive Devices and Fall Prevention

Using a cane to get out of a chair: the individual should:


Hold the cane with his or her stronger hand.
Grasp the chair arm with the other hand. If the chair has no
arms, hands may support the seat.
Place his or her stronger foot a little forward.
Lean a little forward and push on the arms (or seat) of the
chair to rise.
Stand with the cane about 4 inches (10 cm) to the side of
the stronger foot.

d) Typical costs of canes and cane accessories


Canes range in price between $25 and $100 (all prices listed are in
Canadian dollars as of 2004). They can be purchased in some retail
stores and in specialty shops. In addition to the cane, there are a
number of cane accessories available, including:

Getting into and out of a chair

Wrist straps for canes (price range: $5 to $10)


Cane holders that will fit on a chair or table (price range: $7
to $12)
Ice picks for the bottom of the cane (price range: $10 to $15)
Replacement rubber tips (price range: $2 to $4)

Safety tips when using a cane

The end of the cane should have a non-skid rubber tip to prevent it from slipping. Rubber tips
should be inspected and worn rubber tips replaced.

Canes should be equipped with an ice pick for outdoor use in winter months. These should be
raised or removed when walking around indoors.

Floors should be checked to be sure they are safe for using the cane. Floors should be dry,
well lit and clutter free. Throw rugs should be removed as they slide easily and can cause a
trip or slip. Loose carpet edges should be taped down.

When walking with a cane, look straight ahead to avoid running into or tripping over
something.

Heavy objects or loads should not be carried when using a cane as they may compromise
balance. If things need to be carried, using a backpack or carry bag is safer.

Tools for Living Well

Chapter THREE - Assistive Devices and Fall Prevention

2. Hip protectors
In 1993/94, there were 23,375 hip fractures reported in Canada.
With our aging population, it has been projected that this number
will increase almost fourfold, to 88,124 annually by the year 2041.17
Ninety percent of fractures among people over age 70 are the result
of a fall.18

Most hip fractures are the


result of the impact of a fall.
Hip protectors can prevent a
hip fracture if a fall happens.

Hip protectors are pads that are worn over the hip area. Although
hip protectors will not prevent a fall, research suggests that they will
decrease the risk of a hip fracture when a fall occurs.19
Hip protectors reduce the risk of a hip fracture by:
distributing the impact of a force in the hip area, especially
where it is most vulnerable to breaking, in the neck of the
femur; and
absorbing some of the force associated with the fall onto
the hip.
Brochure 3 is a handout on hip protectors that you can share with
your community and businesses.

a) Hip protector options


Hip protectors are commonly made of hard plastic shields, foam
pads or silicone pads. Some hip protectors combine two materials,
using foam in an airtight waterproof pouch. In the event of a fall, the
foam first absorbs force, and then the pouch is inflated similar to a
miniature automobile air bag to distribute the force.

Example of brief style hip


protectors

Some hip protectors are designed to fit into pockets of specially


designed undergarments or sweaters. Others are designed to be
worn as a belt over clothing.
Certain models have front crotch panels that snap off permitting a
quick and easy incontinent pad/liner change without having to pull
the brief down.
Hip protectors models ARE NOT bulky and awkward. In fact, there
are styles that do not show under most clothing.
Brochure #11 offers a table containing hip protectors and suppliers,
as of 2004.

Example of belt style hip


protectors

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Chapter THREE - Assistive Devices and Fall Prevention

b) Sizing hip protectors


Hip protectors come in different styles and sizes. Sizing is usually
based on hip measurement. Where feasible, the user should try a
variety of sizes to find the one that fits best. Instructions for proper
use should be included on the manufacturers packaging.

c) Typical cost of hip protectors


Hip protectors range in price between $50 and $200 CND (as of
2004). Hip protectors can typically be purchased over the Internet or
from specialty medical stores.

Safety Tips for Hip Protectors

Wear the hip protector both indoors and outdoors.


Hip protectors should be worn at night as well as during the day. Many falls occur as people
get out of bed at night to go to the bathroom.
Hip protectors should be examined after a fall, even if the user did not sustain an injury. The
fall may have resulted in cracks to the shells or other changes to the hip protector. If the hip
protector appears damaged, it should be replaced. Some hip protectors may need to be
changed if they receive an impact force regardless of whether there is visible damage. Read
the instructions for use.

How do I wear them?


The hip protector should be worn over the uppermost area at the top and outside of your leg where
the thigh ends. This region is called the trochanter. Do not confuse this area with the ileum, which is
the bone below the waist and at the front of your stomach. To find the trochanter, lower your arms
so that the palms of your hands are resting against the outside of your thighs. Move your hands up
and down until you feel a bony area at the top of your leg. The hard surface
of the trochanter should be felt under the palms or fingers of your hands. If
not, try lifting one leg a few inches off the ground and turning your foot in
and out (i.e., towards your other leg and away from you). This action will
reveal the indented area of flesh covering the top of the trochanter. Another
method of locating your trochanter is to try lifting your leg up and down
sideways to locate the indentation of flesh.
This diagram shows where the hip protector
should be placed over the hip bone (Trochanter).

Tools for Living Well

Chapter THREE - Assistive Devices and Fall Prevention

3. Grab bars
Difficulty using the bathtub or shower is a common problem among
older adults.1

Grab bars are not only


for seniors or people with
disabilities... EVERYONE
can benefit from them.

As many as 15% of falls happen in the bathroom. Of these,


more than half (55%) occur while getting into and out of the
bathtub, or raising or lowering into the bathtub.
Up to 1/3 of seniors restrict their bathing practices,
sometimes only sponge bathing at the sink, because they
have difficulty with getting in or out of the bathtub.

Bathtub and shower grab bars can compensate for the effects of
age-related changes that increase the risk of falling while bathing.
A grab bar, made of stainless steel, aluminum, or plastic, firmly
fixed in the wall of the bathtub or shower stall, allows the user
to steady him/herself while stepping into or out of the bathtub or
shower, and while raising or lowering him/herself into the bathtub.

Example of a straight grab bar

Brochure 4 is a handout on grab bars that you can share with your
community and businesses.

a) Bathtub and shower grab bar options


Grab bars for the bathtub and shower come in various styles,
shapes, and sizes. Grab bars in the bathtub or shower stall can be
wall mounted or portable.

Wall mounted bathtub or shower grab bars should be firmly


anchored into the studs of the wall. Things you should know
about wall-mounted grab bars:
o They can help the user to steady him/herself while
stepping in and out of the bathtub or shower stall and help
the user safely lower into and raise up from the bathtub.
o They are either straight or L-shaped and can be fitted
onto the wall in various angles and configurations.
o The length of the grab bar will depend, in part, on the
distance between the studs in the bathtub or shower
stall wall. Someone who knows how to find wall studs
should figure out this measurement to make sure that
the attachment plates on the bar will fit on the centres of
the wall studs.

Example of an L-shaped grab


bar

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Chapter THREE - Assistive Devices and Fall Prevention

Portable bathtub grab bars, usually shaped like a horseshoe,


are installed on the bathtub rim.
o Portable grab bars can be installed with minimal effort
and are removable, so they can be detached and taken
when the user moves.
o Portable bathtub rim bars will only help the user to
steady him/herself while stepping in and out of the
bathtub. They are NOT designed to support the user
when sitting into or getting up from the bottom of the
bathtub.

b) Choosing a grab bar


Example of bathtub grab bar
placement

Example of shower stall grab


bar placement
In Gatineau, Quebec, a
condominium builder for
older adults offered new
homeowners the option to
have a grab bar installed in
their bathtub, free of cost. A
total of 27% accepted.

Tools for Living Well

There are several things to consider when selecting grab bars.


These include:
Number of bars: Although individual needs vary, a minimum
of two grab bars in a bathtub are most useful for most older
adults; one to help enter and leave the bathtub, and one to
help with sitting into and getting up from the bottom of the
bathtub.
Weight limitation: Most grab bars will support the weight of
a person up to 113 kg (250 lbs). Grab bar manufacturers will
often list a specific weight limitation on their packaging. If a
users weight exceeds 113 kg (250 lbs), wall mounted grab
bars that will hold up to 454 kg (1000 lbs) can be special
ordered from the retailer or manufacturer.
Correct diameter: The best diameter for grab bars is
between 3 to 4.5 cm (1 and 1 inches) for adults. Each
person should try different sizes to see which is more
comfortable for their hand and their grip strength.
Textured, non-slip surface: It is essential that the surface
of the bar has a non-slip surface where the individual is
most likely to grab the bar so that it is not slippery when the
user grabs it with wet hands.
Aesthetics: Grab bars come in a variety of colours so you
can match the bathroom dcor. However, safety is the most
important consideration when choosing grab bars!

c) Tips for installation


Because individual needs and characteristics vary, it may be
important to have a health care professional determine the specific
placement of the grab bar(s). In general, for bathtubs, most people
should have:
a bar located on the wall closest to where the user enters
the bathtub; and

Chapter THREE - Assistive Devices and Fall Prevention

a horizontal, angled (45 degrees) or L-shaped bar on the


back wall can be used to provide support and stability when
sitting down or getting up

Ceramic tiles are a concern when installing grab bars as they can
crack very easily. However, a professional tradesman should be able
to install grab bars through ceramic tiles.
If seniors are purchasing moulded bathtubs or shower stalls (e.g.
fibreglass), they should ask whether or not grab bars can be
installed in these units.

d) Typical cost of grab bars


Generally, a grab bar costs anywhere from $20 to $150 CDN (as
of 2004). Bathtub and shower grab bars can be purchased in
many department stores, hardware stores and specialty medical
supply stores.

Example of wall studs

Grab Bar Safety Tips


Although grab bars are designed to improve safety when bathing or showering, an improperly
installed grab bar can be more dangerous than no bar at all. It is therefore recommended that:

All wall mounted grab bars be installed by a professional with experience in installing them.

Installation height: the Canadian Standard Association recommend that a wall mounted grab
bar be installed at a height of 18-28 cm above the rim above the rim of the bathtub.

Length: should be at least 120 cm long.

If a bar is horizontally mounted on a wall, it should have wall clearance of only approximately
3.5 to 4.5 cm (1 3/8 to 1 inches) from the wall where the grab bar is mounted. This is a
safety feature. If the individual slips and grabs the bar, he or she wont catch his or her arm in
the gap between the wall and the bar.

Grab bars must be mounted to the wood framing (studs) behind the ceramic tile of a bathtub
or shower stall.

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Chapter THREE - Assistive Devices and Fall Prevention

4. Bathtub and shower seats

Example of a bath/shower
seat

A bathtub or shower seat may also be referred to as a chair, bench


or stool. Bathtub and shower seats are devices used in the bathtub
or shower that allow the user to sit without having to get right to
the bottom of the bathtub. They are designed for people who have
difficulty raising or lowering themselves into the bottom of the tub
and for those with limited tolerance for standing in the shower. They
are usually used with a hand held shower head, which allows the
user to direct the water as desired from the seated position.
Brochure 5 is a handout on bathtub and shower seats that you can
share with your community and businesses.

a) Bathtub and shower seat options


A variety of bathtub and shower seats are available.
Bathtub and shower seats are usually made of plastic, wood
or metal.
Some bathtub benches fit inside the bathtub. Others extend
outside of the bathtub (transfer bench), so the user can sit
on the bench outside of the bathtub, slide his/her legs over
the bathtub rim, and then slide further along the bench until
he/she is in the bathtub.
Some bathtub and shower seats have padding to make
them more comfortable to sit on; others have a plastic seat.
Some have non-slip seat surfaces.
Some bathtub and shower seats have a back support to
increase stability and comfort while sitting.
Some bathtub and shower seats are height adjustable.
Bathtub and shower seats must have non-slip feet.

b) Choosing a bathtub or shower seat


Example of a transfer bench
with a backrest (extends over
the side of the tub for easier
access into and out of the
bathtub

Tools for Living Well

The specific requirements for a bathtub or shower seat depend in


part, on the users needs. For example, for users who have difficulty
balancing for whatever reason and require additional support,
bathtub or shower seats with back support are best. Similarly,
for people who have difficulty balancing themselves to enter the
bathtub, bath benches that extend over the bathtub rim are safest
because the person can sit down on the bench first, and then bring
each leg into the tub.

Chapter THREE - Assistive Devices and Fall Prevention

c) Cost of bathtub and shower seats


Generally, a bathtub or shower seat costs between $40 and $100
CDN (as of 2004). Bathtub and shower seats can be purchased at
specialty medical stores. Some department stores, pharmacies and
hardware stores may also carry them.

5. Non-slip bathtub and shower mats


Non-slip surfaces are a basic safety feature for both inside and outside the bathtub and shower to prevent slipping. Bathtub or shower
mats will help prevent falls in the bathtub and shower by providing
traction while moving around, especially when stepping in and out of
the bathtub or shower stall.
Brochure 6 is a handout on non-slip bathtub and shower mats that
you should share with your community and businesses.
Mats for inside the bathtub or shower should have many suction
cups on the back to make them stick to the bottom of the tub. A
good quality bath mat is thick, flexible, and has good suction. A safe
bath mat covers the full bottom surface of the tub.
Always pull the mat up after bathing is finished and clean the
top and bottom of the mat. If left on the bottom of the tub and not
cleaned, water gets trapped under and around the suction cups and
can cause mildew and other unsanitary conditions. Many rubber
bath mats can be washed in the washing machine on gentle
cycle. Washing them with a couple of towels will help to remove any
soap residue from the bath mat that may prevent it from properly
sticking to the surface of the tub.
When bath mats get older, they dry out and crack, and do not stick
well. Bathmats should be replaced periodically. Bathroom floor
mats (or rugs) on the floor outside the tub or shower need to be
non-slip as well. Many bathroom floors are made of tile or vinyl.
Thus, bath mats without a rubber backing may slide on the floor
when stepping in or out of the tub or shower, causing a fall. A solid
rubber backing is essential to ensure the mat will not slip. Floor
mats should also be checked regularly for wear, to ensure that they
provide friction.

Safety tips for


bathtub and
shower seats
Bath seats should be adjusted
so that it is easy and safe
for the user to get up and sit
down, and to feel balanced
and secure when sitting.
Bathtub or shower seats
should have non-slip rubber
tips on the legs. Rubber tips
will provide suction on the
tub bottom.
A bathtub bench or shower
seat should be stable enough
to support the user who may
need to put weight on it to
help him or her sit down.
Non-slip seats are safest.

Everybody is vulnerable to
slipping, so we recommend
that everyone use non-slip
mats for inside and outside
bathtubs and shower stalls.

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Chapter THREE - Assistive Devices and Fall Prevention

We DO NOT recommend non-slip strips or decals as an alternative to non-slip bath or shower mats.
With time, the rubber that safety treads are made from dries out and no longer provides sufficient
stability for the user. In addition, it is difficult to tell when safety treads need to be replaced and
therefore can become dangerous to the user.
Thus, someone with safety treads already installed on the bathtub or shower floor should still use a
non-slip mat.

Tools for Living Well

23
Chapter FOUR

Getting Started: Mobilizing


Your Community
Strategies identified in Tools for Living Well are designed to be
implemented in a community setting. Each community has unique
strengths and experiences. The strategies offered in this chapter
will help you:

identify and develop potential partnerships and


collaborations for this program;
recruit volunteers to advise you and work with you;
increase community awareness around falls prevention and
assistive devices; and
tailor the program to your communitys needs.

1. Getting to know your community


The Tools for Living Well program relies on community knowledge
and participation. We have developed a tool (Program Tool 2:
Community Profile) to help you to get to know your community better. Even if you are well connected in your community, you may
find the Community Profile very helpful. Creating this Community
Profile will help you gather information that you may need as you
approach businesses (e.g. number of seniors in your region). The
Profile will also allow you to identify and explore potential organizations and partners that may have similar goals and who can help
support you. Finally, this profile will also help you to identify businesses that you may wish to approach.

2. Using volunteers for this program


There are a number of ways that volunteers can be involved in
this program. One group of volunteers may form a team of local
advisers known as a Community Advisory Team (CAT). In addition, Program/Senior Volunteers may help you work with and support the business community.

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Chapter FOUR - Getting Started: Mobilizing Your Community

You may also wish to involve volunteers in approaching and supporting businesses. We will refer to these people as Program
Volunteers. Adults of any age can be Program Volunteers, but there
may be some special advantages in recruiting seniors to fill this role,
as we did in our pilot programs (see Appendix 1).
Some volunteers may wish to take on both roles, participating on
the CAT and interacting with businesses. Others may wish to take
on only one of these roles. It is important to be clear about the
requirements and the time commitments for the two roles when
recruiting volunteers. This will allow each individual to choose the
role he or she prefers.
A Community Advisory
Team can be vital to the
success of your program.

a) Community Advisory Team (CAT)


A Community Advisory Team (CAT) may be crucial to the success of
community-based programs, such as this program. CAT members
are community members who know their community well. The CAT
may comprise seniors and veterans, health care professionals, and
representatives of businesses or senior organizations. The CAT can
help you identify the best approach for selecting local businesses,
select businesses, identify other key stakeholders or seniors who
might support your efforts, and provide general guidance.
The size of your CAT will vary with the size of the community, but
should probably include 6 to 12 members, drawn from a variety of
organizations and backgrounds. A variety of talents are needed, and
the team members should be allowed to select the jobs that most
interest them and match their skills. You will likely want to choose
CAT members who:

Tools for Living Well

show an interest, enthusiasm and a willingness to offer their


time and energy to the program;
show an interest or knowledge of assistive devices and
have a positive attitude towards their use in the general
community;
have a background in sales, retail, construction,
homebuilding, hotel management, or similar business type.
It is essential to have businesses represented on the CAT.
The skills and contacts picked up in these areas will be of
great assistance in the approach to the businesses;
have links with businesses or organizations and can help
make these links and/or advocate within their organizations
and communities; and

Chapter FOUR - Getting Started: Mobilizing Your Community

have public relations or media related experience.

Note: These are simply guidelines. No CAT member is expected to


meet all of these criteria.
Some sources for CAT members might be:
the local health care community, including the public health
unit, geriatric programs, occupational therapy or physical
therapy departments and providers, home care programs,
geriatricians;
the Chamber of Commerce, the local association of home
builders, retailers, pharmacists or hoteliers;*
local legions, senior centres or other senior groups such as
the Active Living Coalition for Older Adults (ALCOA), senior
walking clubs, etc.; and
local service clubs such as Rotary, Lions;
disability or senior advocacy groups and coalitions such as
Access Canada; and
representatives from Veterans Affairs Canada, Health
Canada, the provincial ministry of health, or the local health
boards.

b) Program Volunteers

Tips:
Do not exclude key people
in the community whose
knowledge and skills would
be beneficial to the program
but who do not have the
time to commit to regular
meetings.
A list of contacts who
are willing to come to
one meeting to address
a specific issue (e.g.
an architect) or who will
meet with you from time
to time to answer specific
questions (e.g. someone
from the municipal by-law
enforcement office) may
also be valuable.

Program Volunteers should be people, perhaps seniors, who are:

influential members of the community;


interested in their own healthy lifestyles; and
committed to improving health awareness and conditions in
their community.

Engaging Program Volunteers is based on a train the trainer model,


where one individual receives education in a particular program, and
then returns to the community and passes the information and skills
on to another group of participants. The role of the Program Volunteer
could be to help spread the word to seniors. With proper training,
Program Volunteers can be involved in approaching and supporting
businesses themselves.
* To find local branches of your local organizations, look up the provincial or
national associations on the internet, and follow links to the local members
(e.g. The Canadian Homebuilders Associations web site is http://www.chba.
ca/. They have links to provincial and local branches.)

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Chapter FOUR - Getting Started: Mobilizing Your Community

Engaging community members in this process promotes community ownership of the problem and the program activities. By
actively participating in planning and implementing of the programs,
Program Volunteers will promote community control and ownership
of the program.
It is important to know that the job requires a number of skills and
some training is required. Engaging volunteers requires fewer program dollars but does require support and coordination.
The number of Program Volunteers you recruit will depend, in
part, on the geographic size and population of your community, and
the amount of time each of these volunteers is able to give. In estimating the number of Program Volunteers to recruit, you will need
to consider the following:
How quickly does the work need to be done?
How much time, in an average week, can the Program
Volunteers devote to the program?
How many businesses will your Program Volunteers need
to visit?
What transportation services are available to reach these
businesses?
How many of your Program Volunteers are likely to be
away or unable to participate for periods of time during your
program implementation? (Ex. Summer holidays)
How long will Program Volunteers continue with the
program?
When selecting Program Volunteers, consider people who:
show an interest in community service in the area of falls
prevention and an ability to understand the problem of
falls. They dont need to know much about the topic if they
demonstrate a willingness to learn;
have an interest in or knowledge of assistive devices, and
have a positive attitude towards their use in the general
community;
are able to convey ideas enthusiastically and have the time
and energy to commit to the program;
know the community well;
are comfortable approaching both people they know and
dont know; and
have good communication skills for the business community.

Tools for Living Well

Chapter FOUR - Getting Started: Mobilizing Your Community

We recommend that you recruit Program Volunteers who come from


a variety of backgrounds and have complementary skills. It is helpful but not essential to find volunteers who have a background in
health, sales, retail, construction, architecture, engineering, municipal
planning, hotel management, or business. This type of background
equips the Program Volunteer with skills and contacts that will be of
great assistance when approaching businesses.
The Community Profile and your work in the community (meetings,
presentations) may help you to identify potential veterans for this
program. Some particularly useful organizations that you may want to
connect with to recruit your Program Volunteers are:

Tips:
Personal phone calls and
meetings over coffee with
friends and people who are
referred to you by your CAT
members or other contacts
are particularly effective
strategies for recruiting
volunteers.

Chamber of Commerce they may know of some retired


business people who would make excellent Program
Volunteers;
Rotary Club, Lions Club, Kiwanis Club or similar groups of
community supporters;
local Probus Club, which is particularly aimed at retired
business people; and
local Seniors Associations and/or legions.

Other strategies to consider when recruiting volunteers include:


local radio or cable television ads;
newspaper ads (be sure to emphasize that the position is
volunteer);
notices on parish bulletin boards or in church bulletins; and
local volunteer boards.
Seniors as Program Volunteers
Involving seniors as Program Volunteers may offer several advantages over volunteers of other ages.

Senior Volunteers can act as peer models, demonstrating


prevention activities through their own actions.
Seniors who can tell stories about their own fall or near fall
experiences with enthusiasm and speak from the heart may
have more credibility than health care providers.
If they have lived in their community for many years, they
may know it well. This will give them connections they can
use when contacting businesses.
Because their community already knows them, they have
credibility. Senior Volunteers can act as facilitators to the
community and can help shape community opinions.
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Chapter FOUR - Getting Started: Mobilizing Your Community

Tips:
Involving volunteers to
work with businesses has
advantages and challenges.
You should decide if using
Program Volunteers to work
with businesses makes
sense for your community.

Seniors are the target market that we are trying to get


businesses to think about. Having seniors provide the
messages you want out in the community may make
the resources more compelling. Seniors may have more
success at convincing a retailer that a senior might buy the
product if it is displayed.

However, working with Senior Volunteers may also present challenges.

Recruiting and educating Senior Volunteers can be time


consuming.
Senior volunteers may require a great deal of support, which
means time on your part.
Senior Volunteers may take prolonged vacations or become ill.

3. Community meetings and


presentations
A key strategy for increasing awareness around falls and the benefits of assistive devices for promoting independent living in your
community will be community meetings and presentations. These
can provide opportunities to garner support from community partners, volunteers, and businesses.
As you consider community meetings you will need to be strategic. Senior and veteran organizations might offer good venues. For
example, legions, senior centres or clubs. Other groups that you
may consider sharing information with include:

caregiver groups (e.g. Alzheimers support groups,


Osteoporosis Society);

Tips:
When preparing presentations, it is important to keep in mind the target audience. For example,
when presenting to business groups you may emphasize the value of meeting the senior
consumers needs. But when presenting to seniors or veterans groups, it might be more
beneficial to highlight the benefits of assistive devices.

Identify the two or three key messages you want them to take away.
Provide your audience with stories and ideas that they can easily transmit to others. Youll be
invited to meetings where you have 5 minutes to speak, others where youre the main speaker,
and may be requested to speak for 30 or 45 minutes. Be prepared for a variety of situations.

Tools for Living Well

Chapter FOUR - Getting Started: Mobilizing Your Community

health care professionals (e.g. day hospital staff,


physiotherapists, occupational therapists, public health
nurses);
local business associations or groups (e.g. hotel
associations, Chamber of Commerce);
service clubs (Rotary Club, Lions Club, etc.);
local legions; and
church groups.

We have prepared a presentation for you to consider using


(Program Tool 1 on disk). This presentation may be modified as
appropriate for your region (e.g. include local statistics on falls,
examples of fall prevention successes in your region) and audience. Information from this presentation may also be used for
media releases.

Tips:
You may wish to approach
some community
organizations and partner
with them in running these
events.
For example, a local church
group might partner with
you to run a fashion show,
or a student group might
assist with the assembly
and sales of the Christmas
baskets.

a) Community events
You may wish to run some community events to increase awareness
around the issue of falls and assistive devices and to highlight this
program and the businesses who support the program. Examples
include:

Setting up and staffing information and demonstration


booths at seniors fairs, wellness fairs, home shows or in the
stores of participating businesses;
Selling Christmas gift baskets which include various fall
prevention oriented items, e.g. a decorative cane, an ice
pick tip for the cane, non-slip ice grips that slip over boots.
Running a fashion show that features fashionable canes to
go with different outfits.

4. Collect local stories


Stories and anecdotes are an important means of communication.
Collecting local stories about falls, maintaining independence, as
well as assistive devices provides a way of talking about the issues
and highlights the relevance of the program to your community.
Stories can help people develop a new way of understanding, and
reflecting and taking action on a problem. They can get people to
envision new possibilities for their community. Finally, a good story
line is what every reporter is looking for it is an effective way of
getting media attention.

Tips:
Many large organizations (e.g.
public health departments)
will have a communications
department with professionals
who are skilled in media
relations.
Individuals working in a
communications department
in a public health department
may be potential partners for
the program if they have the
time to assist with some of the
media advocacy work.
Be sure to find out
about these important
communication resources
as you complete your
Community Profile.

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Chapter FOUR - Getting Started: Mobilizing Your Community

5. Media Advocacy
Media advocacy involves working with mass media (television, community and regional newspapers, radio) to raise awareness of the
issues the program is tackling. Media are a way to reach the public, organizations and politicians. In the short-term, effective media
coverage shapes public opinion and expectations, and begins to
mobilize community support around an issue. In the longer term,
sustained media coverage can set the stage for policy change.
Working successfully with media is a skill honed over time. If
you have little experience working with media, you might want to
consider approaching someone with solid media experience to
assist you.

Tips:
Brief stories of falls may be useful. Success stories related to falls prevention are also potentially
powerful.

Avoid using stories that embarrass, humiliate, or make organizations and/or individuals look like
the bad guy.

Always use sound professional judgement to ensure appropriate anonymity for individuals or
organizations that are the basis for a story.

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31
Chapter FIVE

Selecting and Planning your


Approach to Businesses
Now that you have identified and recruited your team and identified
community partners and potential businesses in your region through
the Community Profile, you are ready to begin your approach to
businesses. This chapter will outline tips and strategies that you and
your team (CAT and Program Volunteers, if you have them) can use
for: a) selecting businesses (priority setting); and b) planning your
approach to businesses.

1. Selecting businesses to target


There are several approaches to selecting the businesses that you
wish to target.
Send an introductory mailing to all of the businesses in your
area inviting them to participate.
Use a priority setting exercise to select the businesses that
you and your team feel would be most likely to participate
and have the biggest impact in your community. You may
wish to concentrate on one category at a time (e.g. begin
with retailers), and add the other business types (e.g.
hoteliers, homebuilders) later. Or you may want to identify a
couple of businesses within each category at the same time.

a) Using a blanket introductory mailing


If your region has a smaller number of businesses or if you have
many volunteers who can help you with the follow-up appointments,
you may wish to do a blanket mailing to all of the businesses in
each of the three target areas (retailers, hoteliers and homebuilders).
Program Tool 5 provides the template of an introductory letter that
can assist you. Follow that up with a phone call to arrange a visit for
those who are interested.

b) Priority setting businesses


If you have a large area or a limited amount of time, you will
not likely be able to target all of the retailers, hoteliers, and
homebuilders in your region. You will need to make decisions about
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Chapter FIVE - Selecting and Planning your Approach to Businesses

which businesses you will work with in the short term. This does
not preclude working with other businesses at a later time, but it
does mean setting priorities, based on your available resources
and anticipated impacts. It may be most efficient to target
businesses that you know might be sensitized to the issue of falls
prevention first, then slowly work your way to those that may be
more resistant. The more businesses you have on board, the
easier it may be to engage others that may have been resistant at
the beginning of the program.
Setting priorities is best done with a group of people who know the
community well, such as your Community Advisory Team (CAT)
and Program Volunteers. Although this is not an exact science, the
exercise in Program Tool 3 should at least give you a basis to get
you started in selecting target businesses.

2. Planning your approach


Now that you have identified the businesses you want to approach
first, you need to identify an effective strategy to use. The Strategic
Planning Exercise in Program Tool 4 can help you in this task. It
prompts you to gather any information from other team members
that might be helpful to the person who will be making the contact,
including identifying what approach might work best with this business. An example would be a retailer who offers senior discount
days. One of the CAT members knows that this particular retailer
also sits on the board of a local Alzheimers Society. The best
approach for this particular retailer, therefore, might be to emphasize the service to the community and support for independent living
for seniors.

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33
Chapter SIX

Approaching and Working


with Businesses
You are now ready to approach businesses. If you are working with
a CAT or with Program Volunteers, you may want to consider who
might be best suited to make the initial contact. It may be most
appropriate for you to make the initial call. However, if a member of
your CAT or a Program Volunteer is comfortable doing so, or knows
the business owner or manager, you may want to encourage him or
her to establish initial contact on behalf of the program.

If you are planning to


evaluate this program, we
highly recommend you
read chapter 7 before
approaching businesses.

Program Tools 8-10 outline specific information that you may want to
share with homebuilders, hoteliers, and retailers, respectively.

1. Approaching businesses
Step 1: Making the initial contact

Your initial approach with businesses will, in most cases, determine


whether or not you will be successful in convincing them to become
involved in the promotion of assistive devices. If approaching businesses is new to you, the following steps may serve to guide you:

Send an introductory letter letting the business know that


you will be contacting them to make an appointment.
A sample letter is included as Program Tool 5 for your
convenience.
Follow-up with a phone call to set an appointment time.
Before calling, make sure you know the appropriate contact
position (e.g. manager, owner) and name of the person to
speak to. Call at a time that is convenient for the business.
Be prepared to play telephone tag. If you cant reach them
by phone, a face-to-face visit may be required. During this
contact, your objective is to set up a time where you can
meet with the business representative for 15-30 minutes to
let them know more about assistive devices and how YOU
can help THEM. Stress that you wish to meet at a time
that is convenient for THEM. Be flexible in meeting their

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Chapter SIX - Approaching and Working with Businesses

Tips:
Businesses are more likely
to respond positively to an
approach that emphasizes
mutual benefit and
collaboration.
Sharing information on
the issue of falls and the
role that assistive devices
could play in reducing falls,
and offering assistance to
them should they choose to
promote assistive devices is
more likely to be successful
than using an aggressive
sell approach.

busy schedule. A sample script, Program Tool 6, has been


developed for you to use.
If the business representative is not interested or will not meet
with you, you can either re-evaluate (maybe another strategy
might be more effective) or move on to another business.

Step 2: Meeting to make your case

The goal of this face-to-face meeting with the business


representative is to make your case. You will want to provide the
business representative with a little more information about assistive
devices. You may also take this opportunity to educate the business
representative about the specific types of assistive devices that they
can promote and how Tools for Living Well can help to support them
in promoting the device(s). Presentation information should include
the following:

A brief overview of the target market for the devices,


including size of the senior market in your community,
buying habits and, if applicable, other businesses in your
community that promote the product. Brochure 1 (Seniors
are Good for Business!) provides information that you may
want to share.
An overview of the seriousness of falls and how assistive
devices can help. You can share information from Brochure
10 (Protect yourself from falls!) and leave a copy of the
brochure with them.
An overview of the assistive devices that the business is
best suited to promote, including features, benefits and
samples, if available. Program Tools 8-10 provide guidance
on specific information pieces that will be most relevant for
the different business types (homebuilders, hoteliers, and
retailers, respectively).

Information on the specific devices that the business may be able


to promote and share with customers is detailed in Brochures
2-6. Hotels may also be interested in the travel safety brochure
(Brochure 8 Avoid falls while travelling!). Retailers may be
interested in the brochure on funding (Brochure 7 Invest in your
independence!).

Step 3: Follow-up thank you

Whether or not the business elects to support this initiative, send


a letter thanking the representative for their time. Program Tool 7
provides you with a sample letter
Tools for Living Well

Chapter SIX - Approaching and Working with Businesses

a) Handling concerns
Some of the businesses may have objections to the suggestion
that they should do more (or anything!) to promote assistive devices. It is important to hear and understand their concerns. The table
below lists some of the common concerns or objections that might
be raised by businesses and suggested ways of handling these.

Concerns

Way of handling concern

I dont make the decisions.


Its done at our corporate
head office.

Ask for the name, address and telephone/email of the individual


you should contact at the head office.

This will cost a lot and take


time.

Provide information about the cost of assistive devices.


Most of the items are not high cost items. While it may cost a bit
of money up front, the potential to increase their market share
may be worth it. Provide strategies to reduce costs. For example,
for hoteliers, you may suggest that rather than put grab bars in all
of their rooms they can set a goal of installing grab bars in 10% of
bathrooms per year or install them as they are renovating.

I dont see why this is so


important weve done
without them for a long time
and never had complaints
from customers.

Review the information about the serious impact of falls on


seniors, the information about how important seniors are as
customers, and the number of seniors in their community.

Seniors arent my customers.

Provide statistics on the growing senior population.

I dont know any sources of


supply for these products.

Provide a list of suppliers in your area or a website with a list.

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Chapter SIX - Approaching and Working with Businesses

Tips:
You may wish to emphasize that devices such as bathtub bars or non-slip mats are useful for
all ages, including the small child stepping over the side of the tub, the pregnant woman whose
balance may be compromised or sleepy adult who may be a bit unsteady on his or her feet, etc.

Dont be disappointed or surprised if the business representative doesnt show for the meeting or
cancels at the last minute. In competitive businesses, customers and sales always come first.

2. General approach to supporting


businesses
Together with your CAT team and Program Volunteers, you can decide
who might be best suited to provide ongoing support or follow-up to the
business. The first step in supporting a business is to gain an understanding of their current knowledge and practices around promoting
assistive devices so that together you can map out a plan that will best
address their needs. A brief interview and environmental scan can help
you (See evaluation chapter, Chapter 7).
Once you have a clear sense of what the business may need,
you should establish regular contact with them. We propose that
contact with each business be made on a monthly basis. You may
choose to do this yourself or train a volunteer to make the regular
contacts. Each contact should last no more than 15 minutes. These
visits can provide and opportunity to:

Tools for Living Well

Determine how things are going.


Offer your support.
Identify if they have made changes to their practices. If they
have, reinforce these changes. If they have not, ask how
you can help them overcome any barriers.
Provide information and answer questions.
Inform them of special events related to assistive devices
that are relevant to their business.
Assist them in making connections with suppliers of
assistive devices.
Replenish their supply of customer brochures (if applicable).

Chapter SIX - Approaching and Working with Businesses

In addition, for retailers, ongoing contact provides opportunities to:

Put up or replace posters or set up displays for the


promotion of assistive devices.

3. Supporting businesses in change


In supporting businesses, you will need to tailor your support to
their experiences, knowledge, and capacities to promote assistive
devices.
People tend to make changes in stages. They typically go through a
series of steps as they move from thinking about making a change
towards adopting new practices. Businesses are no different. In
general, when considering their readiness to promote assistive
devices, consider which stage the business is at and gently encourage it to move up the various steps.*

Precontemplation or contemplation. Businesses in this


stage do not promote assistive devices (i.e. stores do not
carry them, homebuilders and hotels do not make them
available). These businesses may not be aware how they
can make a difference and may know little about assistive
devices. Your goal in working with them may be to
introduce them to the issue, increase their awareness and
support them in taking steps to begin incorporating assistive
devices into their business plan.

Early action. Businesses in this stage have thought about


how they can start promoting assistive devices and may
even have a limited number of devices available. Your goal
may be to offer them ideas and support for expanding their
stock of assistive devices to ensure that they have different
types and sizes to meet different consumer needs. You may
also want to help them identify suppliers.

Action-maintenance. Businesses in this stage already


promote a good range of assistive devices. Your goal may
be to help them better market that they offer a good range of

Tips:
There are times of the year
that are demanding for
different businesses and
they are less likely to have
the time to meet with you
or consider new programs.
Spring and summer, for
example, are very busy
times for construction and
homebuilders. Consider
approaching them in winter
months. Retailers are
very busy during the preChristmas season.

* These stages were adapted from the Stages of Change Theory20 and
Rogers Diffusion of Innovation theory.21

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Chapter SIX - Approaching and Working with Businesses

assistive devices, for example, helping them to better display


what they offer or helping them with promotional materials.

Tips:
It may not be appropriate
or feasible to expect all
businesses to progress at
the same rate.
For example it may not
be feasible to expect all
retailers to carry a variety of
assistive devices once they
are on board.
For some, simply beginning
to carry one brand may be
success.
Similarly, the notion of
providing grab bars as a
standard amenity to new
homebuyers may be quite
novel to homebuilders and
you will not likely be able to
convince them all, but you
may have success in getting
them to begin displaying
bars in their model homes.

Tools for Living Well

Diffusion of innovation. Businesses in this stage are


working toward supporting other businesses or head office
and are serving as models. Your goal may be to reinforce
their leadership role and to help them in their desire to
reach out to their head office (if they are part of a chain) or
other businesses. Program Tool 11 addresses the stages
of change more explicitly according to each business type
(retailer, homebuilder, hotel), along with a description of
concrete ways to help you approach the business at each
of these stages.

Supporting businesses in making changes


The diagram on the next page illustrates the stages of change, as
we have adapted and applied them to the Tools for Living Well program, along with the goal at each stage.

Chapter SIX - Approaching and Working with Businesses

Working with Businesses:


Goals According to Adapted Stages of Change

Diffusion of innovation (have changed and are willing


to assist others to change)
reinforce their leadership role
help them to reach out to head ofce & other businesses

Action-maintenance (have changed practices and may


need help to maintain the change)
helping them to better display what they offer
help them with promotional materials

Early action (beginning to make small changes)


offer them ideas and support for expanding their stock
help them identify suppliers

Precontemplation or contemplation (not thinking about change at this time)


introduce them to the issue
increase their awareness
support them in taking steps to begin

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Chapter SIX - Approaching and Working with Businesses

Tools for Living Well

41
Chapter SEVEN

Evaluating your Program


1. Introduction to evaluation
Evaluation is something we do every day. We gather and look
at information about things that we do in order to learn from our
experiences. As you become involved with falls prevention and the
promotion of assistive devices, you will likely have questions about
how effective your efforts have been.

Evaluation consists of
setting a goal, collecting
feedback while you work,
gathering information on
your results, and learning.

An evaluation provides useful feedback to the program team, as


well as participants, stakeholders, community groups, and other
interested persons. The evaluation process can:
affirm your successes;
help you to understand any problems;
identify improvements in the program; and
and inform your planning for further action.
This chapter will outline what aspects of this program you need to
evaluate, and provide a step-by-step guide to collecting your data.

2. What should you consider


evaluating?
The two most common areas of evaluation are process and outcome.
1. Process evaluation will give you information on how things
are being done. It helps to describe the steps that you took
along the way, and give you ideas on how to improve them.
Process evaluation can be formal (structured interviews,
surveys or observations) or informal (discussion and questions).
The questions you ask could include:

the effectiveness of the advisory team processes;


the level of confidence of volunteers (if you are using
them); and
the effectiveness of workshops or presentations.

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Chapter SEVEN - Evaluating your Program

Tips:
Businesses are more likely
to respond positively to an
approach that emphasizes
mutual benefit and
collaboration.
Sharing information on
the issue of falls and the
role that assistive devices
could play in reducing falls,
and offering assistance to
them should they choose to
promote assistive devices is
more likely to be successful
than using an aggressive
sell approach.

2. Outcome evaluation looks at whether the program has been


effective or how it has made an impact on your community.
The most effective way to do this is to take a snapshot of
the way things are before your program starts (called the
pre-implementation assessment), and then take the same
snapshot at the end of the program (post-implementation
evaluation). Comparing the information will tell you whether
changes have occurred during the course of the program.
A few points to remember about the pre-implementation and postimplementation comparison:

Noticing that a change took place during the course of the


program does not necessarily mean that the program has
caused the change. Many factors may have contributed
to a change, positive or negative. You want to look for
information to support a connection between the change
and the program. For example, comments from retailers
stating that customers have been coming to them with the
brochures in hand to ask for the devices.

A negative change does not necessarily mean that the


program has caused damage, or has failed. There may
have been other factors that occurred during the same time
frame that influenced these changes. For example, the
number of falls may have increased during the year you ran
the program because of a particularly harsh winter.

Think carefully about the questions that you want to


ask, and the information that you want to gather preimplementation and post-implementation so that these
questions can be answered. For example, if your question
is how effective are the brochures at helping consumers
identify the best cane for their needs, sales figures may
not give you that information. A decrease in return rates of
canes might be a better thing to measure.

Two strategies can help evaluate the success of the program: interviews with business representatives and an environmental scan.

Tools for Living Well

Chapter SEVEN - Evaluating your Program

3. Interviews with participating


business representatives
You may want to assess how this program impacts on participating
businesses knowledge, views, and capacity to promote assistive
devices. You can also gain valuable feedback on what worked well
and what did not work well. Given their busy schedules, an interview
process is a useful way to get feedback from your businesses.
A sample initial interview for each type of business is included as
Evaluation Tools 1,4, and 7. Sample final interviews for various
types of business, are included as Evaluation Tools 3, 6, and 9.

4. Businesses environmental scans


The environmental scan is designed to assess the extent to which
the businesses that participate in this program visibly display the
assistive devices we are targeting. An environmental scan tool has
been developed for each business type. You may wish to do an
environmental scan for every business that participates in the program.

Tips on interviewing:
The following strategies may help you to fine tune your interviewing skills:
Create a friendly and safe atmosphere by maintaining a non-judgemental and calm appearance.
Probe or ask for clarification when the respondent gives you inadequate, redundant, or irrelevant
information. You can probe by:

Repeating the question verbatim. If the respondent misheard or misunderstood the question
the rst time, hearing the question again will be useful and allow them to answer the question.
Questions should be repeated as a probe the rst time the respondent asks for clarication.

Staying quiet after the respondent appears to have nished. This lets the respondent know you
expect more in the answer and gives the respondent time to collect their thoughts.

Repeating the respondents reply. By repeating the respondents reply the respondent may
hear that they have only partly answered the question. They will often expand and explain their
answer.

Asking neutral questions. Neutral questions such as: Anything more? Do you have any other
reasons? How does that work? Could you explain a bit more? Could you give me an example?

Asking for clarication. Do you mean.... (summarize what you think has been said).
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Chapter SEVEN - Evaluating your Program

Results must always be


interpreted in the context
of the community. Use your
community experts to help
you make sense of the
results.

For participating stores, the scan provides an audit of the different


types of assistive devices that are displayed in the store, how easy
they are to find, and whether relevant brochures are prominently
displayed. A sample environmental scan for retail outlets is found in
Evaluation Tool 2.
For participating homebuilder, the scan provides an audit of whether
bathroom safety devices are displayed in model homes. A sample
environmental scan for model homes is found in Evaluation Tool 8.
For participating hotels/motels/resorts, the scan provides an audit
of whether bathroom safety devices are available in rooms and
whether their availability is clearly indicated on establishment brochures/promotional materials. A sample environmental scan for
hotels/motels/resorts is found in Evaluation Tool 5.

5. Interpreting results and sharing


your findings
Evaluations are more than numbers. A completed evaluation is
a milestone! Take time to analyze and interpret the information.
Celebrate what you have done well! Look at what you have learned
from the challenges along the way these lessons learned will
help your organization, and others, to more efficiently and effectively
promote the use of assistive devices in future programs and initiatives.

a) Interpreting your results


The questions you asked when you were planning the evaluation
are the starting point for interpreting your results. What does the
information you gathered tell you about the questions you asked?

Tips for completing the environmental scan


Inform the business when you would like to do the scan and ensure that it will not pose an
inconvenience. Upon arrival, notify the person in authority that you are there.

Remind the business representative that the information collected during the scan is confidential
and will in no way be released to the public or anyone else. Emphasize that there will be no
identifying information associated with the scans (e.g., business or personnel names). There are
no right or wrong responses to the scan.

Do not interfere with other patrons or business transactions when completing the environmental scan.

Tools for Living Well

Chapter SEVEN - Evaluating your Program

Why questions are always harder to answer than what questions.


Knowing you increased the number of assistive devices sold in the
year of the program is great. However, knowing why this has happened is probably more important. Once you have your results, take
the time to bring a few people together. Discuss each of the questions
you asked when you started the program. This dialogue can help
interpret the results. Several people are usually better than one in providing insight into what has been happening.

b) Presenting your findings


Too many evaluations sit on a shelf. Wide access to modern
technologies such as computers, video recorders and colour printers
offer many opportunities for creatively presenting your results.
Consider your different audiences and what might be the most
appropriate way of presenting your results to them. In part, how
you present your findings will depend on what your objective is. For
example, you may:
Prepare a formal report for funders or your organization, as
a way of meeting a deliverable. You will need to show that
you have completed your obligations and you will want to
think creatively about how to use the results so that funders
or your organization will want to continue supporting you.

Prepare a brief written summary, poster or presentation


for your businesses, CAT members, Program Volunteers,
and funders to celebrate achievements. It might be useful
to have a thank you summary list of what has been
accomplished with the program. Present your messages
in ways that highlight improved social, mental and physical
health of older adults. Use pictures or stories to give your
message a personal touch.

Prepare a brief slide or video presentation for community


stakeholders to reinforce the mobilization process and
reinforce similar future initiatives.

Prepare a brief abstract to post on websites to help spread


the word and entice others to undertake similar projects in
other communities.

Prepare a short press release that could interest a journalist


in doing a story about fall prevention or assistive devices.
This could give you a chance to promote your group and
your cause and to attract new members.

Make sure the results dont


sit on a shelf. Find a way
to make them known so
people can use them.

How you present the


information from your
evaluation may be limited by
your resources, but should
not be limited by your
imagination.

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Chapter SEVEN - Evaluating your Program

Tips

If youre considering an evaluation strategy that challenges your resources or skill level, consider
where you might look for help. Your Public Health department may be able to offer some
suggestions. Also, if you have a local community college or university, contact them. They may
have faculty members who teach evaluation in education, social work, law, public health or other
disciplines who are looking for real world projects for their students. There may be a graduate
student who is willing to give you some advice along the way.

Tools for Living Well

47

References
1. Aminzadeh, F., Edwards, N., Lockett, D., & Nair, R. (2001).
Patterns of bathing, device utilisation and acceptability of
bathroom safety devices among community living older adults.
Technology and Disability, 13 (2), 95-103.
2. Sveistrup, H., Lockett, D., Edwards, N., & Aminzadeh, F. (2004).
Optimal grab bar placement for seniors. BC Injury Prevention
Conference, Richmond, BD, April 9-11. (poster presentation).
3. Tinetti, M.E., Speechley, M. (1989). Prevention of falls among the
elderly. New England Journal of Medicine, 320(16), 1055-1059
4. Raina, P., Dukenshire, S., Chambers, L., Toivonen, D., & Lindsay,
J. (1997). Prevalence, risk factors, and health care utilization for
injuries among Canadian seniors: An analysis of the 1994 National
Population Health Survey (IESOP Research Report No. 15).
Hamilton, ON: McMaster University.
5. Zuckerman, J.D. (1996). Hip fracture. New England Journal of
Medicine, 334(23), 1519-1525.
6. National Osteoporosis foundation.(2001). Disease Statistics.
Retrieved from http://www.nof.org/osteoporosis/stats.htm
7. Tinetti, M.E., Mendes de Leon, C.F., Doucette, J.T., Baker,
D.I.(1994). Fear of falling and fall-related efficacy in relationship
to functioning among community-living elders. Journal of
Gerontology, 49(3),M140-7
8. Rawsky, E. (1998). Review of the literature on falls among the
elderly. Image - The Journal of Nursing Scholarship, 30(1),47-52.
9. Wilkins, K. (1999). Health care consequences of falls for seniors.
Health Reports,10(4). Statistics Canada, Catalogue 82-003.
10. Asche, C., Gallagher, E., & Cotote, P. (2000). Economic impact
of falls among Canadian Seniors. Unpublished manuscript,
University of Toronto, Department of Health Administration,
Faculty of Medicine
Tools for Living Well

48

References

11. Tinetti, M.E., Speechley, M., 7 Ginter, S.F. (1988). Risk factors
for falls among elderly persons living in the community. New
England Journal of Medicine, 320(16), 1055-1059.
12. Berg, W.P., Alessio, Mills, E.M., & Tong, C. (1997). Circumstances
and consequences of falls in independent community-dwelling
older adults. Age and Aging, 26, 261-268.
13. Connell, R.B, & Wolfe, S.L., for the Atlanta FISCIT Group. (1997)
Environmental and Behavioral Circumstances Associated with
falls at home among healthy elderly individuals. Archives Physical
Medicine Rehabilitation, 78, 179-186.
14. Health Canada (2001) Health Canadas Best Practice Guidelines
for Falls Prevention (2001),Prepared on behalf of the Federal/
Provincial/Territorial Committee of Officials (Seniors) for the
Ministers Responsible for Seniors, http://www.hc-sc.gc.ca/seniorsaines/pubs/best_practices/bp_toc_e.htm
15. Merriam Webster On-Line Dictionary, retrieved from http://
www.m-w.com/cgi-bin/dictionary?book=Dictionary&va=tool&x=
15&y=18
16. Dean, E., & Ross., J, 1993 , Relationships among cane fitting,
function and falls. Physical Therapy, 73 (8), 494-500.
17. Papadimitropoulos,E.A., Coyte,P.C., Josse,R.G., Greenwood,C.
E.(1998). Current and projected rates of hip fracture in Canada.
CMAJ Canadian Medical Association Journal,158(7),870-1
18. Conner-Kerr,T. (2002).Forgetting the apple: a hip protector a
day keeps the doctor away. Wandering/Fall Prevention, 8-10
19. Parker, M.J., Gillespie, L.D., Gillespie, W.J. (2002). Hip
protectors for preventing hip fractures in the elderly: The
Cochrane Library, http://www.cochrane.org/cochrane/revabstr/
ab001255.htm
20. Prochaska, J.O., & DiClemente, C.C. (1982).Transtheoretical
therapy toward a more integrative model of change
Psychotherapy: Theory, Research and Practice, 19(3), 276-287.
21. Rogers EM. Diffusion of innovations. New York: The Free Press;
1995.
Tools for Living Well

49
Appendix ONE

An Overview of the Tools


for Living Well Pilot Project
with Lessons Learned
Purpose and scope of this overview
The Tools for Living Well Toolkit was developed as part of a
two-year pilot project. The first nine months of the project (April
2002-December 2002) were used to identify key opportunities
and barriers to promoting assistive devices, develop the program
(including the Toolkit and resources), gain entry into pilot
communities and hire Site Coordinators.
The Tools for Living Well program was pilot tested in four
communities across Canada. Implementation began January 2003
and ended January 2004 in all sites, except Pilot Site #4 where
the project was extended until February 2004. As part of the
implementation, it was anticipated that each site would:

recruit a local Community Advisory Team (CAT) to help


tailor the program to community needs and capacities;
recruit and train Program Volunteers to help support
businesses;
recruit and support local businesses willing to participate in
the project; and
increase community awareness of assistive devices.

In addition, each site underwent a comprehensive evaluation. We


used feedback from the four communities, including evaluation data,
to refine the Program Tools and Toolkit manual.
The purpose of this overview is to provide a synopsis of how
the program was used in the four communities. Specifically, this
overview will:
a) demonstrate the variability in how Tools for Living Well was
implemented in different communities; and

Tools for Living Well

50

Appendix ONE - An Overview of the Tools for Living Well Pilot Project with Lessons Learned

b) offer suggestions, based on lessons learned, on how this


program may best be implemented in your community.
To begin, we provide you with a brief description of each pilot site.
In addition, we have included brief overviews on how the different
sites mobilized their communities to promote assistive devices.
And, in conclusion we give concrete recommendations for you to
consider as you implement Tools for Living Well in your community.

The Pilot Sites


The socio-demographic profile of the four communities is
summarized in the table below:
Population

% over the age


of 65

Primary language

Average income

Pilot Site #1

32,531

13%

English

$21,802

Pilot Site #2

136,000

8%

English

$27,171

Pilot Site #3

228,052

10.1%

French

$23,259

Pilot Site #4

904,987

9%

English

$32,804

(Data taken from Statistics Canada and municipal web sites)

The Site Coordinators


A part-time coordinator was hired to oversee the program in each
community1. A brief description of each coordinator is provided in
the table on the next page:
The four Site Coordinators were brought together for training in
January 2003. Training was interactive, and focused on the content
of the Toolkit. Training subjects included:

Education on assistive devices and supporting people through


the process of change.
Skill building to:
o increase community awareness;
o assess community capacity and identify potential community
partners;

1 In site#4, the Site Coordinator position began as part time, had a gap of four
months, and then changed to a full-time position for the last three months.

Tools for Living Well

Appendix ONE - An Overview of the Tools for Living Well Pilot Project with Lessons Learned

Site Coordinator
Pilot Site #1

Pilot Site #2

experienced occupational therapist


lived in the community for approximately 3 years
had worked on a casual basis for both the local hospital and home care

experienced occupational therapist


well connected in the community,
had a private practice
was a pre-existing member of the city Chamber of Commerce

programs
Pilot Site #3

Pilot Site #4

experienced Francophone public health nurse


had worked in falls prevention for a number of years in a neighbouring city
lived in the pilot site region
First Site Coordinator:

experienced occupational therapist


lived in the city all of her life
had a private practice
Second Site Coordinator:
background in nursing, marketing for a medical manufacturing company and
managing seniors residential housing (see below)

o
o
o

recruit and support a CAT and Program Volunteers;


select, recruit, and support businesses;
evaluate community process and impacts.

A) Overview of variability of program


implementation in each site
Step 1: Recruiting a CAT
Community Advisory Team (CAT) members were recruited for each
site. Recruiting the CAT took time and effort. However, the guidance
and input they provided for the local implementations of the program
were invaluable. For example, CAT members helped:
identify Program Volunteers;
identify businesses and strategies to approach them;
helped increase community awareness; and
were instrumental in ensuring that the momentum for the
promotion of assistive devices was maintained.
Tools for Living Well

51

52

Appendix ONE - An Overview of the Tools for Living Well Pilot Project with Lessons Learned

A general profile of CAT members is provided in the table below.


Note: In pilot site #4, the CAT was recruited early in the project.
However, initial enthusiasm by CAT members waned during the
four-month break in activities. When the new Site Coordinator was
hired, there were challenges in bringing the CAT team together.
The new Site Coordinator met individually with members of the CAT
team before bringing them together as a group. The group met three
times between October 15, 2003 and the projects end on February
29, 2004. These meetings helped regenerate momentum among the
CAT members.
CAT Members
Pilot Site #1

12 member CAT recruited by March 31, 2003


The team included representatives from:

a fall prevention coalition


Veterans Affairs Canada
Canada Mortgage and Housing Corporation
local Pharmacists Association
Quality Tourism Services (an organization that rates hotels for their level of
services)

home care
a seniors day program
Pilot Site #2

6 member CAT recruited by April 30, 2003


The team included representatives from:

Pilot Site #3

health care for seniors


Veterans Affairs Canada
home care
occupational therapy
a pharmacy

11 member CAT recruited by April 30, 2003


The team included representatives from:

Tools for Living Well

a local legion
home care
a local pharmacy
a local seniors centre
a day hospital
occupational therapy
a local hotel

Appendix ONE - An Overview of the Tools for Living Well Pilot Project with Lessons Learned

CAT Members
Pilot Site #4

5 member CAT recruited by April 30, 2003


The team included representatives from

the local health authority


a local Geriatric program
a local seniors oriented private business
a retirement home
a senior who was active on several local seniors organizations and the citys
advisory committee on the needs of people with disabilities

Step 2: Recruitment and Training of Program


Volunteers
Program Volunteers were recruited in two of the four sites. In these
two sites, the volunteers were active in approaching and supporting
businesses. A breakdown by site of Program Volunteers is offered in
the table on the next page.
Program Volunteers were trained as a group. Training focused on

education on the assistive devices; and


skill building around supporting businesses.

To enhance their professional image, Program Volunteers were


provided with the following:

Business cards with the name and contact information of


the volunteer, the project logo and the Site Coordinators
name and contact information.
Folders containing brochures and information to share with
interested businesses.
A portfolio to carry their materials.

Program Volunteers
Pilot Site #1

5 seniors recruited by April 30, 2003

Pilot Site #2

4 seniors recruited by July 31, 2003 (1 senior expressed an interest, but became ill
and had to drop out)

Pilot Site #3

0 (1 senior expressed an interest, but became ill and had to drop out)

Pilot Site #4

Tools for Living Well

53

54

Appendix ONE - An Overview of the Tools for Living Well Pilot Project with Lessons Learned

In both cities where Program Volunteers were used, the CAT and
the Program Volunteers met as one team once the work with
businesses began.

Step 3: Approaching Businesses


Various approaches were used to select businesses in each
site. These, as well as decisions regarding who would support
businesses, are outlined in the table below.
In all cases, the initial approach to businesses followed a similar
process. The Site Coordinator sent a letter introducing the project
and informing the business that a project representative would be
calling them to set up an appointment. This was followed by an
initial visit to the business by the Program Volunteer or the Site
Coordinator. If the business was interested in participating in the
program, arrangements were made for the Site Coordinator to
conduct an initial interview and environmental scan of the business.

Tactics used when Approaching Businesses


Pilot Site #1

Used the priority-setting exercise to select businesses


Program Volunteers selected the businesses that he or she wished to support

Pilot Site #2

Businesses were selected through discussion at the CAT meeting


Program Volunteers selected the businesses that he or she wished to support

Pilot Site #3

Sent a letter to all businesses that might be interested then made a follow-up
phone call

The Site Coordinator supported all businesses


Pilot Site #4

Businesses were chosen based on suggestions from the CAT


The Site Coordinator supported all businesses

Tools for Living Well

Appendix ONE - An Overview of the Tools for Living Well Pilot Project with Lessons Learned

Participating Businesses
Pilot Site #1

18 businesses:
8 pharmacies
1 medical supply store
5 hardware or building supply stores
1 department store
2 hotels
1 bed & breakfast

Pilot Site #2

5 businesses:
2 pharmacies
1 hardware store
1 department store
1 hotel

Pilot Site #3

11 businesses:
7 pharmacies
1 department store
1 hardware store
1 hotel and
1 builder *

Pilot Site #4

9 businesses:
4 pharmacies and 1 home health care businesses
1 department store
1 hardware store
2 hotels

* The Site Coordinator approached a salesperson at an open house for a new seniors condo that was
being built and, with the salespersons help, was able to contact the developer. The developer agreed to
be part of the program. After getting information from our Site Coordinator, the builder reinforced all bathtub
and shower walls in the complex to allow for retrofitting of grab bars and offered free grab bar installation to
buyers who requested it. To date, 27% of the condos have been sold with grab bars installed.

Step 4: Recruiting and Supporting Businesses


The level and type of business participation varied in each site. The
table below outlines the businesses that participated in each site.
Most participating businesses had little knowledge of assistive
devices prior to the project. Many became involved because of their
commitment to seniors issues, improving customer service and
increasing their market share.
Designated team members offered support through monthly visits.
Tools for Living Well

55

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Appendix ONE - An Overview of the Tools for Living Well Pilot Project with Lessons Learned

In all cases, support included encouragement, education and


awareness building (through sharing information, brochures, supplier
information and display suggestions) and skill building (e.g. proper
sizing of canes). In addition, in-services were offered to business
staff upon request.

Ongoing: Community Awareness Activities


Community awareness was a priority at each site. Awareness
activities focused on both the issue (falls prevention and the use of
assistive devices to help prevent falls) and the Tools for Living Well
project. In many cases, these activities were useful for recruiting CAT
members and/or Program Volunteers. Awareness raising activities
are identified in the table below.

Community Awareness Activities


Pilot Site #1

4 presentations to community and health care groups


6 articles in local and seniors newspapers
health fair *
displays at participating retail stores

Pilot Site #2

15 presentations to community and health care groups


7 articles in local newspapers
a radio talk show
2 cable television interviews
displays at participating retail stores

Pilot Site #3

6 presentations to community and health care groups


display at a shopping centre
displays at participating retail stores

Pilot Site #4

14 presentations to community and health care groups


display at a local seniors fair and a seniors skating club
television news segment
displays at participating retail stores

* The health fair was held, with permission of the local mall manager, at the local mall. It included
display tables with information, demonstrations, and draw prizes that were obtained from participating
businesses. Five other organizations participated in the event.

Tools for Living Well

Appendix ONE - An Overview of the Tools for Living Well Pilot Project with Lessons Learned

B) Recommendations based on
lessons Learned
The pilot projects highlighted some key issues and useful strategies
for implementing and supporting the project in different communities.
We invite you to consider these as you prepare to implement Tools
for Living Well in your community.

1. Tailor the program to the needs and


resources of the community
Every community has different needs, characteristics and resources.
For example, two of our communities had existing fall prevention
coalitions. These communities had more experience and expertise
in the area of falls prevention. As a result, the focus for the
community was building on fall prevention efforts that had already
been undertaken rather than awareness building and education.
The other two communities had no experience in community-based
falls prevention programs. As a result, initial efforts focused on
awareness building.

2. Recruit a diversified CAT


The more diversity in CAT membership, the wider the range of
experiences, contacts and resources. CAT members helped find
Program Volunteers, made introductory calls to businesses and
arranged for presentations to be made to community agencies.
CAT members from the various business sectors also provided
Site Coordinators with guidance on how to best relate to retailers,
hoteliers and homebuilders.

3. Recruit an energetic, organized and


knowledgeable Site Coordinator
In one of the focus groups run with CAT members and volunteers,
the Site Coordinator was described as the glue that held the
project together. Skills and characteristics of a Site Coordinator that
were found most valuable include:
enthusiasm and good people skills;
good oral and written communication skills;
knowledge about the issue of falls and assistive devices;
experience in marketing, advertising, and/or media relations;
experience in human resources and/or project coordination;
flexibility to accommodate irregular hours.
strong organization skills;

Tools for Living Well

57

58

Appendix ONE - An Overview of the Tools for Living Well Pilot Project with Lessons Learned

good knowledge of the community and connections with


businesses and community organizations;
affiliation with a credible health profession. The
Occupational Therapists and Public Health Nurses in our
pilot sites were viewed as credible and knowledgeable.

4. Involve Program Volunteers in approaching


businesses
Two of our sites made use of Program Volunteers. Two did not.
Advantages to using Program Volunteers include:
Seniors are often retired. While it is a mistake to assume
that seniors are not busy with a variety of commitments and
activities, they are more likely to have discretionary time
during the peak work-week hours (Monday to Friday day
time), which are the times when you are most likely to be
able to speak to a business manager.
Seniors have skills developed over a lifetime. They may
have specific business skills. They may have pre-existing
relationships with business owners and may be life-long
customers.
Seniors will pay more attention to their peer group. Seniors
connect with other seniors as peers and contemporaries.
They may be better able to convince other seniors (more
effectively than could health professionals) that ALL seniors
are susceptible to a fall. In particular, seniors can be
effective spokespeople at displays and community events.
Program Volunteers can make a point of saying that Im
a volunteer. Im doing this because I believe in it. They
may use the product themselves, and may therefore
have credibility.
However, supporting seniors can be time consuming. The sites
where seniors were not available and where Site Coordinators
made all contacts with businesses were no more or less
successful. It comes down to a matter of choice and what fits
best in your community.

5. Allow for at least a 2-year time period for


implementation
These pilot projects ran over a 1-year period. This year was used
to recruit CAT members, Program Volunteers, and businesses; to
increase community awareness; and to support businesses through
change. Although this time frame allowed us to test the tools and
Tools for Living Well

Appendix ONE - An Overview of the Tools for Living Well Pilot Project with Lessons Learned

learn from our experiences, it was not long enough to have an


impact on business sales of assistive devices, assistive device
use by seniors, or on the rate of falls (in particular injurious falls)
in the communities. All 4 sites expressed disappointment when the
program ended, saying that they just had time to establish good
relationships with their businesses and had started to get community
recognition for the project when the implementation phase of the
project formally came to a close. A 2-year time frame for project
implementation would have allowed:
1 month for training a Site Coordinator;
6 months to recruit the CAT and Program Volunteers;
6 months to recruit businesses;
10 months to work with the businesses and run community
events to promote the products and the businesses; and,
1 month for evaluation.
A 3-year time frame would have provided sufficient time to focus
on retailers (in our experience, the most receptive business group)
in the first 12-18 months while spending time to learn more about
the hotel and homebuilder community. The last year could be spent
concentrating on builders and working with hoteliers.

6. Approach businesses at a convenient time


of the year
Different businesses run on different annual schedules, which need
to be considered. Fall and pre-Christmas is a very busy time for
retailers. Spring and summer is busy for homebuilders. A longer time
frame would allow Site Coordinators to select the time of year that
would work optimally for the different business communities, rather
than time frames that were project-driven

7. Offer businesses the opportunity to


promote their affiliation with the
sponsoring organizations
Businesses appreciated being affiliated with Tools for Living Well,
the CAOT and the University of Ottawa. We offered a small poster
that businesses could display stating that they supported the Tools
for Living Well project. It also highlighted which assistive devices
they were promoting and who to contact to get more information on
assistive devices. For the business, this demonstrated their good will
in the community. For customers, this provided an opportunity to learn
more about assistive devices.

Tools for Living Well

59

60

Appendix ONE - An Overview of the Tools for Living Well Pilot Project with Lessons Learned

Summary
The goal of this Overview is to provide you with a sense of how
Tools for Living Well was implemented in four distinct and varied
communities across Canada. What we hope you take away from this,
is that every community is unique. As such, you will need to tailor
the Tools for Living Well program in consideration of your unique
community needs and capacity. Flexibility and creative problem
solving will help you make the program your own.
Congratulations on your desire to promote assistive devices in your
community. You are embarking on a very important endeavour. We
wish you success as you bring this program to your community.

Tools for Living Well

61
Appendix TWO

Other Resources That You


Might Find Useful
Health Canada and Veterans Affairs
The Health Canada and Veterans Affairs Falls Prevention Initiative
package has a variety of brochures available on the topic of
Fall Prevention. They are written for seniors, and offer practical
suggestions on preventing falls. They include:
1. You
2. You
3. You
4. You
5. You
6. You
7. You
8. You

can
can
can
can
can
can
can
can

prevent
prevent
prevent
prevent
prevent
prevent
prevent
prevent

falls: By improving your health!


falls: By having a safe home and lifestyle!
falls: By reducing the risks!
falls: By involving Your Community!
falls: By following these Tips!
falls: Its a fact!
falls: Falls Prevention Resources
falls: The Falls Prevention Initiative

These are available from the Health Canada web site (http://www.
hc-sc.gc.ca/seniors-aines/index_pages/publications_e.htm#injury),
or by contacting Health Canada directly at 1-800-O-Canada (1-800622-6232).

Canada Mortgage and Housing


Canada Mortgage and Housing has a variety of resources on
building or renovating accessible homes, and on funding for home
renovations. The home page for the web site is http://www.cmhcschl.gc.ca/en/index.cfm.
Programs that offer funding for home renovations are listed at http://
www.cmhc-schl.gc.ca/en/prfias/index.cfm.
Information on FlexHousing (planning housing that allows for easy
changes to accommodate changing abilities) is found at http://www.
cmhc-schl.gc.ca/en/imquaf/flho/index.cfm.

Tools for Living Well

Poster for
Measuring Canes
This poster was developed
by the Tools for Living Well
program as an easy display for
measuring the correct length
of cares and illustrating correct
cane use. The poster pictured
here is available on a cost
recovery basis by contacting
CAOT at 1-800-434-2268, or
through the otworks.ca website.

Inches

Appendix TWO - Other Resources That You Might Find Useful

Inches

62

60

60

59

59

58

58

57

57

56
55
54

56

WALKING WITH A CANE

WALKING UP STAIRS

Always hold the cane on your


strongest side.

1. Take the first step up with the


stronger leg.

Always move the cane and the


opposite leg together.

2. Move the cane to the same step.

54

3. Move the weaker leg to the


same step.

53

WALKING DOWN STAIRS

52

51

1. Take the first step down with the


cane and the weaker leg.

51

50

2. Lower the stronger leg


to that same step.

50

53
52

Replace worn rubber tips.


Attach an ice pick during the winter.

49

49

weaker leg

48

48

TO MEASURE YOUR CANE

47

1. Stand with your back facing the poster, arms at your sides.

47

46

2. Bend your hands upwards towards the ceiling, palms facing the floor. If you have trouble
bending your wrists, use your wrist watch as a guideline and take the measurement from
the centre of the watch face.

46

45
44

3. Your cane should measure the distance from the floor to where your hand bends at your
wrist or to the centre of the face on your watch. Ex. The person demonstrated on this poster
should have a cane that measures 39 inches long.

43

Note: You should take the reading from the hand that is on the side of your stronger leg (the
hand that you will hold your cane in).

45
44
43

42

42

41

41

40

40

39

39

38

38

37

37

36

36

35

35

34

34

33

33

32

32

31

31

30

30

29
28
27
26
25

29
Assistive Devices to Help Prevent Falls.
A joint venture between the University of Ottawa
and the Canadian Association of Occupational
Therapists (CAOT).
For more information please visit our website at
www.otworks.ca
Some information was adapted from Cherish
Your Independence, City of Ottawa,
Public Health Branch.
Funding provided by Health Canada/Veterans
Affairs Canada Falls Prevention Initiative.
The views expressed herein do not necessarily
represent the official policies of
Health Canada, Veterans Affairs Canada, the
University of Ottawa and the Canadian
Association of Occupational Therapists (CAOT).
The information in this bochure is current as of
2004.

Tools for Living Well

55

28
27

Hang 24 inches from the floor

Not medical advice: The information in this


pamphlet is intended for educational purposes
only. It is not and should not be taken as advice
or treatment from a doctor or health care
professional. Never disregard professional
medical or health care advice or delay in
seeking it because of something you have
read in this pamphlet.

26
25

63

Evaluation Tools
Contents
Evaluation Tool 1: Retailer Initial Interview ......................................................................................... 65
Evaluation Tool 2: Retail Store Environmental Scan ......................................................................... 69
Evaluation Tool 3: Retailer Follow-Up Interview...................................................................................71
Evaluation Tool 4: Hotelier Initial Interview ......................................................................................... 75
Evaluation Tool 5: Hotel/Motel Environmental Scan ........................................................................... 79
Evaluation Tool 6: Hotelier Follow-up Interview ..................................................................................81
Evaluation Tool 7: Homebuilder Initial Interview ................................................................................. 83
Evaluation Tool 8: Model Home Environmental Scan ..........................................................................87
Evaluation Tool 9: Homebuilder Follow-up Interview .......................................................................... 89

Tools for Living Well

64

Evaluation Tools

Tools for Living Well

Evaluation Tools

Evaluation Tool 1: Retailer Initial


Interview
Date:___________________
Name of interview participant: _________________________________
Name of store: ___________________________

Location/Address: ___________________

Store type (e.g. Pharmacy, home improvement, department, medical specialty) _________________
1. Approximately what percentage of your customers are older adults (over the age of 60)?
_____ % _____ Dont know
2. Most of your customers speak:
___ English
___ French
3. Is your store:

___ Other

___ Dont know

____ A franchise
____ Privately owned and managed
____ Other, please specify___________________________

4. Do you sell the following?


Assistive Device

No

Yes

If yes, are different


options/sizes available

Comments

Cane
Grab bar
Bath Bench
Non-slip bath mat
for outside the
tub/shower
Non-slip bath mat
for inside the tub/
shower
Hip protectors

Tools for Living Well

65

66

Evaluation Tools

Evaluation Tool 1

5. How much do you know about the following?


Check column that best represents stated knowledge of each assistive device.
Assistive Device

Know nothing
about it

Have heard of it
but never seen
one

Have seen one


but never used or
demonstrated use
before

Have used or
demonstrated
use before

Cane
Grab bar
Bath Bench
Non-slip mat for
outside the tub/
shower
Non-slip mat for
inside the tub/
shower
Hip protectors
6. How confident are you that you could help your customer select the right device (features, size,
etc)?
Check column that best represents stated level of confidence for each.
Assistive Device

Not at all
confident

Cane
Grab bar
Bath Bench
Non-slip mat for
outside the tub/
shower
Non-slip mat for
inside the tub/
shower
Hip protectors

Tools for Living Well

A little confident

Quite confident

Totally confident

Evaluation Tools

Evaluation Tool 1

7. Do you have brochures or information sheets that you can share with your customers on each of the
following?
Assistive Device

No

Yes

Dont
know

Comments or type of information


available

Cane
Grab bar
Bath Bench
Non-slip mat for
outside the tub
/shower
Non-slip mat for
inside the tub/
shower
Hip protectors
8. What would be most helpful to your store if you were to increase your promotion of assistive devices?
Please check all that apply.
Assistive
Device

Information
on what it is

Information on
how to help
clients select
correct one

Information
Supplier
to share with list
customers

Ideas for Other ways


displays we can
support
you?

Cane
Grab bar
Bath Bench
Non-slip
bath mat for
outside the
tub/shower
Non-slip
bath mat for
inside the
tub/shower
Hip
protectors

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Evaluation Tools

Evaluation Tool 2: Retail Store


Environmental Scan
Date:___________________

Assessment:

Initial___

Follow-up___

Name of store: _____________________________

Location/Address: ___________________

Store type (e.g. Pharmacy, home improvement, department, medical specialty) _________________

PART A
Assistive
Device

Does the
If yes, are
store sell
different
the device? options/sizes
available?

If yes, were you


able to find the
device without
asking for help?

Are
accessories
sold for
devices, such
as ice picks for
canes?

Are
information
brochures
available for
customers?

Cane
Grab bar
Bath Bench
Non-slip bath
mat for outside
the tub/shower
Non-slip bath
mat for inside
the tub/shower
Hip protectors

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Evaluation Tool 2

PART B
Please provide comments related to types of devices sold, brochures available, location of device in
store, for support, etc.:
1. Comments related to canes:

2. Comments related to grab bars:

3. Comments related to bath benches:

4. Comments related to non-slip mats for outside the tub/shower:

5. Comments related to non-slip mats for inside the tub/shower:

6. Comments related to hip protectors:

Tools for Living Well

Evaluation Tools

Evaluation Tool 3: Retailer FollowUp Interview


Date:___________________
Name of interview participant: __________________________________________
Name of store: ______________________________ Location/Address: ___________________
Store type (e.g. Pharmacy, home improvement, department, medical specialty) _________________
1. Approximately what percentage of your customers are older adults (over the age of 60)?
_____ %
___Dont know
2. Do you sell the following?
Assistive Device

No

Yes

If yes, are different


options/sizes available?

Comments

Cane
Grab bar
Bath bench or seat
Non-slip bath mat
for outside the tub/
shower
Non-slip bath mat
for inside the tub/
shower
Hip protectors

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72

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Evaluation Tool 3

3. Do you think that your knowledge about the following has changed?
Assistive Device

Yes

No

Cane
Grab bar
Bath bench or seat
Non-slip bath mat for outside the tub/shower
Non-slip bath mat for inside the tub/shower
Hip protectors
4. Has your confidence about your ability to help your customer select the right device (features, size,
etc) changed?
Assistive Device

Yes

No

Cane
Grab bar
Bath bench or seat
Non-slip bath mat for outside the tub/shower
Non-slip bath mat for inside the tub/shower
Hip protectors
5. Do you have brochures or information sheets that you can share with your customers on each of the
following?
Assistive Device

No

Cane
Grab bar
Bath bench or seat
Non-slip bath mat
for outside the tub/
shower
Non-slip bath mat
for inside the tub/
shower

Tools for Living Well

Yes

Dont
know

Comments or type of information available

Evaluation Tools

Evaluation Tool 3

6. Have you had any comments from your customers on any of the brochures that you have available?
Assistive Device

No

Yes

Dont know

Comments or type of information available

Cane
Grab bar
Bath bench or seat
Non-slip bath mat
for outside the tub/
shower
Non-slip bath mat
for inside the tub/
shower
7. Have you noticed an increase in sales in the following items?
Assistive Device

No

Yes

Dont know

Comments or type of information available

Cane
Grab bar
Bath bench or seat
Non-slip bath mat
for outside the tub/
shower
Non-slip bath mat
for inside the tub/
shower

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Evaluation Tools

Evaluation Tool 3

8. Are there any other comments that you would like to make about the Tools for Living Well program?
Assistive Device

No

Cane

Grab bar

Bath bench or seat

Non-slip bath mat


for outside the tub/
shower
Non-slip bath mat
for inside the tub/
shower

Tools for Living Well

Yes

Dont
know

Comments or type of information available

Evaluation Tools

Evaluation Tool 4: Hotelier Initial


Interview
Date:___________________
Name of interview participant: ____________________________________________________
Name of business: __________________________ Location/Address: ___________________
Business type (e.g. hotel, motel, bed and breakfast, other) _______________________________
1. Approximately what percentage of your customers that you deal with are older adults (over the age of
60)?
_____ %
___Dont know
2. Most of your customers speak:
___English
___French
3. Is your business:

___Other

___Dont know

____ A franchise
____ Privately owned and managed
____ Other, please specify___________________________

4. Are the following available in your establishment?


Assistive Device

No

Yes, in all
rooms

Yes, in certain
rooms or upon
request

Comments

Grab bars in bathtubs


Bath bench or seat
Non-slip bath mat for
outside the tub/shower
Non-slip bath mat for
inside the tub/shower

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Evaluation Tools

Evaluation Tool 4

5. How much do you know about the following?


Check the column that best represents stated knowledge of each assistive device.
Assistive Device

Know
nothing
about it

Have heard of it
but never seen
one

Have seen one but


never personally used
or demonstrated use
before

Have used or
demonstrated
use before

Grab bars
Bath bench or seat
Non-slip bath mat
for outside the tub/
shower
Non-slip bath mat
for inside the tub/
shower
6. What would be most helpful to your establishment if you were to increase your promotion of assistive
devices?
Please check all that apply.
Assistive
Device

Information
on device

Grab bar
Bath bench or
seat
Non-slip bath
mat for outside
the tub/shower
Non-slip bath
mat for inside
the tub/shower

Tools for Living Well

Information
on where
to obtain or
purchase

Information
on
installation

Information
for
customers
on proper
use

Ideas for
promoting
that we
offer these

Other
ways
we can
support
you?

Evaluation Tools

Evaluation Tool 4

7. How many rooms does your establishment have?

_____

8. Do you have any rooms designated as fully accessible?


___No

___Yesif yes, how many? ___

___Dont know

9. Have you ever received requests for rooms equipped with the following bath safety devices?
a) Bath grab bars:

___Yes

___No

___Dont know

b) Bath benches or seats:

___Yes

___No

___Dont know

c) Non-slip mats for inside the tub/shower:

___Yes

___No

___Dont know

d) Non-slip mats for outside the tub/shower:

___Yes

___No

___Dont know

10. Have you had any reported falls on your premises the past year?
___No
___Yesif yes, did any of these take place while your client was taking a bath or shower (e.g.
getting in or out of the bathtub, during a shower or bath)
___No ___Yes ___Dont know

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Evaluation Tools

Evaluation Tool 5: Hotel/Motel


Environmental Scan
Date:___________________

Assessment:

Initial___

Follow-up___

Name of business: _________________________

Location/Address: ___________________

Business type (e.g. hotel, motel, bed and breakfast, other) ________________________________

PART A
NOTE: ASK TO SEE A STANDARD ROOM
Assistive
Device

Available
in
standard
room?

Available
in fully
access
room
only?

Available
upon
request?

Advertised
in
promotional
or guest
services
material?

If available, is device
in safe, working
order? (e.g. if grab
bar, well secured,
if bench, non-slip
tips on feet, if mats,
still provide anti-slip
protection)

Are devices
inspected
on a
regular
basis?

Grab bar
(indicate
number
available per
bathtub, as
well)
Bath bench
or seat
Non-slip
bath mat for
outside the
tub/shower
Non-slip
bath mat for
inside the
tub/shower

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Evaluation Tools

Evaluation Tool 5

PART B
Please provide comments related to types of devices sold, brochures available, location of device in
store, for support, etc.:
1. Comments related to grab bars:

2. Comments related to bath benches:

3. Comments related to non-slip mats for inside the tub/shower:

4. Comments related to non-slip mats for outside the tub/shower:

Tools for Living Well

Evaluation Tools

Evaluation Tool 6: Hotelier Followup Interview


Date:___________________
Name of interview participant: __________________________________________
Name of business: __________________________

Location/Address: ___________________

Business type (e.g. hotel, motel, bed and breakfast, other) ________________________________
1. Approximately what percentage of your customers that you deal with are older adults (over the age of
60)?
_____ %
___Dont know
2. Most of your customers speak:
___English
___French

___Other

___Dont know

3. How many rooms do you have? _______


4. Do you have any rooms designated as fully accessible?
___No
___Yesif yes, how many? _______

___Dont know

5. Are the following available in your establishment?


Assistive Device

No

Yes, in all Yes, in certain


rooms
rooms or upon
request

Comments

Grab bars in bathtubs


Bath bench or seat
Non-slip bath mat for
outside the tub/shower
Non-slip bath mat for
inside the tub/shower

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Evaluation Tools

Evaluation Tool 6

6. Do you think that your knowledge about the following has changed?
Assistive Device

Yes

No

Comments

Grab bar
Bath bench or seat
Non-slip bath mat for
outside the tub /shower
Non-slip bath mat for
inside the tub / shower
7. In the past 6 months, have you received requests for rooms equipped with the following bath safety
devices?
a) Bath grab bars:

___Yes

___No

___Dont know

b) Bath benches or seats:

___Yes

___No

___Dont know

c) Non-slip mats for inside the bathtub:

___Yes

___No

___Dont know

d) Non-slip mats for outside the bathtub: ___Yes

___No

___Dont know

8. Have you had any reported falls on your premises in the past year?
___No
___Yesif yes, did any of these take place while your client was taking a bath or
shower (e.g. getting in or out of the bathtub, during a shower or bath)
___No ___Yes ___Dont know
9. Do you have any other comments about the Tools for Living Well program?

Tools for Living Well

Evaluation Tools

Evaluation Tool 7: Homebuilder


Initial Interview
Date:___________________
Name of interview participant: __________________________________________
Name of business: ____________________________ Location/Address: ___________________
Business type (e.g. townhome, single family, condo, other) ________________________________
1. Approximately what percentage of your customers that you deal with are older adults (over the age of
60)?
_____ %
___Dont know
2. Most of your customers speak:
___ English ___ French
___ Other
3. Is your business:

__Dont know

____ A franchise
____ Privately owned and managed
____ Other, please specify___________________________

4. How much do you know about the following?


Check the column that represents stated knowledge of each assistive device.
Assistive Device

Know nothing
about it

Have heard of it
but never seen
one

Have seen
one but never
personally used
or demonstrated
use before

Have used or
demonstrated
use before

Grab bar
Non-slip bath mat
for outside the tub
/shower
Non-slip bath mat
for inside the tub /
shower

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Evaluation Tools

Evaluation Tool 7

5. Do you currently display the following in model homes?


Assistive Device

No

Yes, in some

Yes, in all

Comments

Grab bars in
bathtubs and
showers (please
list how many per
bath area)
Non-slip bath mat
for outside the tub/
shower
Non-slip bath mat
for inside the tub/
shower
6. Are bathtub and shower stall areas in your new homes equipped with grab bars?
___ Nogo to number 7
___ Yes, if yes.please tell us:
a) Grab bars are:
__ Standard in all of our new homes
__ Standard in some of our new homes please specify which ones
(i.e. townhomes, single family homes) __________________________
__ Available at the customers request
b) On average, how many grab bars are there per tub/shower stall area? ________
7. Do bathtub and shower areas in new homes incorporate, as standard, wall studs or reinforcements
that are designed to accommodate future installation of grab bars?
___No
___Yes, if yes.please tell us:
__ In some but not all new homes approx. % :_____
__ In all new homes
__ Available at the customers request
Comments:

Tools for Living Well

Evaluation Tools

Evaluation Tool 7

8. What would be most helpful to your establishment if you were to increase your promotion of assistive
devices?
Please check all that apply.
Assistive
Device

Information
on device

Information
on where
to obtain or
purchase

Information
on
installation

Information
for
customers
on proper
use

Ideas for
promoting
that we offer
these

Other
ways
we can
support
you?

Grab bar

Non-slip
bath mat for
outside the
tub/shower
Non-slip
bath mat for
inside the
tub/shower

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Evaluation Tools

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Evaluation Tools

Evaluation Tool 8: Model Home


Environmental Scan
Date:___________________

Assessment:

Initial___

Follow-up___

Name of business: _____________________________ Location/Address: __________________


Business type (e.g. townhome, single family, condo, other) ________________________________

PART A
NOTE: ASK TO SEE A STANDARD MODEL HOME
Assistive Device

Available
in all
bathrooms?

Available
Advertised in If available, is device in safe,
in some?
promotional working order? (e.g. if grab bar,
bathrooms? materials?
well secured, if bench, nonslip tips on feet, if mats, still
provide anti-slip protection)

Grab bar (indicate


number available
per bathub and
shower)
Non-slip bath mat
for outside the tub/
shower
Non-slip bath mat
for inside the tub/
shower

PART B
Please provide comments related to types of devices sold, brochures available, location of device in
store, for support, etc.:
1. Comments related to grab bars:

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Evaluation Tools

2. Comments related to non-slip mats for inside the tub/shower:

3. Comments related to non-slip mats for outside the tub/shower:

Tools for Living Well

Evaluation Tool 8

Evaluation Tools

Evaluation Tool 9: Homebuilder


Follow-up Interview
Date:___________________
Name of interview participant: __________________________________________
Name of business: ____________________________ Location/Address: ___________________
Business type (e.g. townhome, single family, condo, other) ________________________________
1. Approximately what percentage of your customers that you deal with are older adults (over the age of
60)?
_____ %
___Dont know.
2. Do you think that your knowledge about the following has changed?
Assistive Device

Know nothing
about it

Have heard of it
but never seen
one

Have seen
one but never
personally used
or demonstrated
use before

Have used or
demonstrated
use before

Grab bar

Non-slip bath mat


for outside the tub
/shower
Non-slip bath mat
for inside the tub /
shower

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Evaluation Tool 9

3. Do you currently display the following in model homes?


Assistive Device

No

Yes, in some

Yes, in all

Comments

Grab bars in
bathtubs and
showers(please
list how many per
bath area)
Non-slip bath mat
for outside the tub/
shower
Non-slip bath mat
for inside the tub/
shower
4. Are bathtub and shower stall areas in your new homes equipped with grab bars?
___ Nogo to question 5
___ Yes, if yes.please tell us:
a)
Grab bars are:
__Standard in all of our new homes
__Standard in some of our new homes please specify which ones
(i.e. townhomes, single family homes) __________________________
__Available at the customers request
b) On average, how many grab bars per tub / shower stall area?__
5. Do tub and shower areas in new homes incorporate, as standard, wall studs or reinforcements that
are designed to accommodate future installation of grab-bars?
___Nogo to question 6
___Yes, if yes.please tell us:
__In some but not all new homes approx. % :_____
__In all new homes
__Available at the customers request
Comments:

Tools for Living Well

Evaluation Tool 9

Evaluation Tools

6. Have you used any of the informational brochures provided by Tools for Living Well with your
customers?
Yes___ No ___
Do you have any comments about the Tools for Living Well brochures?

7. Do you have any other comments that you would like to make about the Tools for Living Well
program?

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Evaluation Tools

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Program Tools
Contents
Program Tool 1: Community presentation (on disk)...................................................................................95
Program Tool 2: Community profile............................................................................................................99
Program Tool 3: Priority setting exercise .................................................................................................109
Program Tool 4: Strategic planning exercise ........................................................................................... 115
Program Tool 5: Sample introductory letter to businesses ...................................................................... 117
Program Tool 6: Sample script for follow-up call to businesses ............................................................. 119
Program Tool 7: Sample thank you letter for businesses ........................................................................ 121
Program Tool 8: What you should know before you approach homebuilders .........................................123
Program Tool 9: What you should know before you approach hoteliers .................................................125
Program Tool 10: What you should know before you approach retailers ................................................ 127
Program Tool 11: Staged interventions for working with businesses .......................................................129
Program Tool 12: Program Summary ........................................................................................................133

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Tools for Living Well

Program Tools

Program Tool 1: Community


presentation (on disk)
Slide 1

Slide 2

Slide 3

Slide 4

Slide 5

Slide 6

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Program Tool 1

Slide 7

Slide 8

Slide 9

Slide 10

Slide 11

Slide 12

Tools for Living Well

Program Tools

Program Tool 1

Slide 13

Slide 14

Slide 15

Slide 16

Slide 17

Slide 18

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Slide 19

Tools for Living Well

Program Tool 1

Slide 20

Program Tools

Program Tool 2: Community profile


Getting to know your community
It is useful, when beginning any community initiative, to become more familiar with your community.
Even if you already know your community well, this exercise will help you to pull the information
together so that it is available as a database from which your team can work. Completing this form may
involve working through the phone book, making phone calls or talking to people you know. Gathering
information about your community in this way will help you in several ways:
1) It will allow you to touch base with all of the organizations who provide services for seniors so that
you can:
a. Begin increasing awareness around falls prevention and assistive devices.
b. Promote Tools for Living Well and find allies.
c. Recruit volunteers for your Community Advisory Team and Program Volunteers if you plan on
including these in your program.
d. Confirm the services and programs that they are running so that you can establish partnerships
and collaborate.
2) It will give you a data base of information from which you can:
a. Plan your approach to community organizations.
b. Plan your strategy in approaching businesses.
3) It will provide you with information that you will need to tailor the program to your community.
4) If done in collaboration with your team, it can be a good way to begin the process of working together.
In order to organize information that will help you in your program, consider: WHO ARE THE PEOPLE IN
YOUR NEIGHBORHOOD? As a starting point, please consider:
Are there Fall Prevention Programs that you can link with?
Can you identify sources of Program Volunteers (if you choose to use volunteers)?
What senior service clubs or faith communities might you partner with?
Are there current events that might be opportunities for you to present your program?
Are there key media people that might be interested in this program?
What businesses might be interested?
What are some of the characteristics of your community that will help you when approaching
businesses?

Section A: Community contacts


Making contact with community groups will help you to:
increase your communitys awareness of falls prevention and the role of assistive devices;

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Program Tools

Program Tool 2

find out what falls prevention and other relevant programs are currently offered in your region;
assess current knowledge and capacity for promoting assistive devices in your community;
let potential stakeholders know about the Tools for Living Well program;
identify potential collaborations and ensure that redundancy is minimized;
identify potential members for your CAT and Program Volunteers;
obtain information on your community, e.g. number of seniors; and
identify strategies to working with your community that are mostly likely to be successful.

Community contacts:
Name of program, organization,
contact information

Falls prevention program

Falls prevention coalition

Public health unit

Local Veterans Affairs office

Local legions

Senior centers

Retired professional associations


(e.g. teachers, civil servants)
Physical activity programs for
seniors (e.g. walking clubs, Tai
Chi, city programs)
Service Clubs (e.g. Lions Club,
Rotary Club, Probus, Sororities,
Knights of Columbus, Masons,
etc.)

Tools for Living Well

Comments (e.g. relevant


program or activities,
achievements, challenges,
potential CAT members,
potential Program Volunteers)

Program Tool 2

Program Tools

Faith Communities that offer


seniors programs
Fire Department

Local police department

Local service clubs (e.g.


neighbourhood watch)
Health related professional
training programs at Universities
or Colleges in your region (e.g.
Nursing, Occupational Therapy,
Physical Therapy, Community
Health, etc.)
Equipment or relevant service
providers)
Mobility or accessibility advocacy
group
Home care services

Printed Press

Radio

Television
Other contacts

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Program Tool 2

Other potential sources of information


Most cities will have a web site, and many have some type of economic or sociological report. Try the
section of the city web site that appeals to businesses to move there. Sometimes the public health units,
local health authorities or district health councils will have reports on population and health statistics.
Check their web sites or call them. Your local Chamber of Commerce or city planning department will
probably have some of these statistics available as well. Reviewing these and other websites might be a
quick and easy way of:
obtaining information on characteristics of your community (e.g. total population);
identifying profiles of local seniors and veterans in your region (e.g. % seniors, veterans,
average income, source of income); and
identifying potentially relevant programs or activities.

Websites:
Website Address
City

Public Health

Chamber of Commerce

Other websites

Tools for Living Well

Comments (e.g. relevant


information)

Program Tool 2

Program Tools

Population statistics
This space allows you to gather statistics about your community that will be useful for:
educating the community about the need for fall prevention; and
convincing the retailers that there is a market for the assistive devices that you are
recommending.

Total population
% of population over 65 yrs

% of population 55-64 yrs

% of home ownership

Any local statistics on falls


Other
Other
Other

Section B: Contacts with retailers, hoteliers, and


homebuilders
In this program, we are interested in businesses that might promote bathtub grab bars, non-slip mats,
canes or hip protectors. They may or may not currently promote these items. If you are in a small
city, you may list all of the businesses in each category. In a larger city, you may wish to make the list
somewhat smaller by selecting particular regions of the city where there are seniors complexes, or list
only the chain and its addresses. You will be narrowing this list down when you and your team do the
exercise on Setting Priorities. Making contact with these businesses will help you to:

let local businesses know about the problem of falls and this program Tools for Living Well
identify potential businesses to target in the program
become more familiar with current availability of assistive devices in your region
get a sense of businesses current knowledge and capacity for promoting assistive devices
identify challenges or barriers that will need to be addressed when working with the businesses
in your region to promote assistive devices; and
identify potential members for your CAT.
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Program Tool 2

Retail Stores

Hardware stores
Store

Location and contact

Comments

Bathroom Supply/Plumbing Stores


Store

Tools for Living Well

Location and contact

Comments

Program Tools

Program Tool 2

Pharmacy/Drug Stores
Store

Location and contact

Comments

Location and contact

Comments

Medical Supply Stores


Store

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Program Tools

Program Tool 2

Department Stores
Store

Location and contact

Comments

Hotels/Motels (it might be useful to indicate number of rooms)


Hotel/motel

Tools for Living Well

Location and contact

Comments

Program Tools

Program Tool 2

Homebuilders
Company

Location and contact

Comments

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Tools for Living Well

Program Tools

Program Tool 3: Priority setting


exercise
Instructions:
Step 1:
List all of the potential target businesses in your region broken down into the three business types
targeted in this program.

Step 2:
Rate each business along a 3-point scale on the basis of:
Ability: Is this business in a position to make the decisions about stock necessary to participate
in the program? Is this business in the position to have an impact on the community? (e.g. In a
neighbourhood with a lot of older residents? In an area that is easy to get to?)
Inclination: Has this business shown any inclination to support seniors or community programs
in the past? Do they offer senior discounts, or special programs?
Connection: Do we have a personal connection with anyone at this business? Have any
of your Program Volunteers worked with them, or know them personally? Does anyone on
the Community Advisory team work with them, and can they introduce the program to them
personally before sending in the Program Volunteer?

Rating guide:
Ability: Is this
business in a position
to make the decisions
about stock necessary
to participate in the
program? Is this
business in the position
to have an impact on
the community (e.g. in
a neighbourhood with
a lot of older residents?
In an area that is easy
to get to?)

This business is a
franchise that gives
its local managers no
control over advertising,
or probably unable to
participate for other
reasons.

There may be some


The local store has
leeway in the decision- good control over their
making process. This
stock and advertising.
business could have an They already sell to
impact on seniors.
seniors so could have
an impact. They are
situated close to a
seniors complex.

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Program Tool 3

Inclination: Has this


business shown any
inclination to support
seniors or community
programs in the past?
Do they offer senior
discounts, or special
programs?

The business has not


shown any inclination
to be involved in
community events in
the past.

The business has


shown some inclination
to be community
minded, but not in the
area of seniors.

The business has run


programs aimed at
seniors, and supported
senior related causes in
the past.

Connection: Do we
have a connection
with anyone at this
business?

Nobody on the
committee has any
connection with anyone
in this business.

Someone on the
committee knows the
people who work there
on a casual basis, or
knows people not in
power positions who
could at least introduce
us or help identify
the correct person to
approach.

One of the committee


members has worked
here in the past, is
related to or close
friends with the
manager.

Step 3:
Sum the scores for each business that you rated. The 5 businesses within each business type with the
highest total scores are those that you likely want to target in this program.

Example of priority setting exercise with retailers


There is an Old Time Hardware Store downtown that has been in business for several years. It remains
a family run business, owned and operated by a family who happens to be well known around town.
Many of the older people in town prefer to shop there rather than the huge box store outside of town
because it is smaller, making it easier to find what they are looking for and offering better service. They
give a 15% discount to seniors every Tuesday. It is downtown, on the bus route, and close to several
apartment buildings that house seniors. One of your Program Volunteers, Joe, went through school with
the present manager, Mr. Family, many years ago, and goes to the same church with his family, although
they are not close friends.
Another business is the Standard Plumbing Supplies Store. They are part of a franchise and head
office controls all of their advertising and most of their stock choices. Store management changes every
three years, and is often sent in from other cities. They have not been known to be supporters of city
events in the past. Nobody on your CAT knows the manager.
A third business is the Average Mall Pharmacy. They already sell canes and other assistive devices,
though most of these are not related to fall prevention. They give a seniors discount on a regular basis.
Although several of your CAT members are customers, there is no specific connection.

Tools for Living Well

Program Tools

Program Tool 3

Priority Setting Table


Business
Name

Ability

Inclination

Connection

TotalScore

Comments

Tuesday

Retailers
The Old Time
Hardware

Seniors
Some contact
Standard
Plumbing
Supplies

Average Mall
Pharmacy

No contacts
No known
support of local
events

Seniors
discounts
Carry assistive
devices
No contacts

etc
etc

Decision:

It would appear, from this exercise, that your best bet would be to target the Old Time Hardware Store.
Targeting Average Mall Pharmacy would also seem to be worth your efforts. You would likely want to
delay approaching Standard Plumbing Supplies until you have successfully created momentum in your
region for this program.

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Program Tool 3

Priority setting table


Retailers
Business Name

Ability

Inclination

Connection

Total

Comments

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

Mark a check next to the top 5 businesses to be targeted in this program.


Comments that you may want to add include specific contact information or ways in which the business
has successfully supported seniors.

Tools for Living Well

Program Tools

Program Tool 3

Hotels/motels
Business Name

Ability

Inclination

Connection

Total

Comments

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

Mark a check next to the top 5 businesses to be targeted in this program.


Comments that you may want to add include specific contact information or ways in which the business
has successfully supported seniors.

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Program Tools

Homebuilders
Business Name

Ability

Inclination

Connection

Total

Comments

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

Mark a check next to the top 5 businesses to be targeted in this program.


Comments that you may want to add include specific contact information or ways in which the business
has successfully supported seniors.

Tools for Living Well

Program Tools

Program Tool 4: Strategic planning


exercise
Instructions
Step 1: List the 5 top rated businesses in each category.
Step 2: For each business, note the strengths from the Setting Priorities exercise and other information
that the team knows about the business.
Step 3: Plan on a strategy for each approach. The strategy should outline not only who might be best
suited to approach the business, but also the business case that is most likely to be successful in the
approach.

Example of strategic planning exercise with retailers


The Old Time Hardware Store, as we saw earlier, has been identified as a business to target in your
community. They offer senior discounts every Tuesday, are situated close to seniors residences, and
one of your volunteers, Joe, knows the owners, at least casually. In addition, Joe used to work in retail,
so appreciates how busy and unpredictable the retail industry can be.
The Average Mall Pharmacy is also a priority rated store. They already handle canes and a small
number of other assistive devices not related to fall prevention. None of your team knows the owners,
but they routinely offer senior discounts.
Business

Relevant information

Strategic Approach

The Old Time


Hardware
Store

Senior Friendly Tuesdays

Emphasis will be on the large market that they


service and the impact it could have on the well-being
of many seniors.

Closely situated to seniors


housing

Offer some displays and suggest that you may be


able to staff a display on one of the Senior Tuesdays.
Average Mall
Pharmacy

Offer seniors discounts


Carry canes but not bathtub
bars, benches and mats or
hip protectors

Someone in your group knows the manager, and will


make a phone call introducing you.
The approach will emphasize that there are many
other types of assistive devices that they could carry
to increase their market share.

No contacts

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Program Tools

Program Tool 4

Strategic Planning Table


Business
Retailers
1.
2.
3.
4.
5.
Hotels/motels
1.
2.
3.
4.
5.
Homebuilders
1.
2.
3.
4.
5.

Tools for Living Well

Relevant information

Strategic Approach

Program Tools

Program Tool 5: Sample


introductory letter to businesses
Your Name & Title,
Tools for Living Well
Your Street Address,
Town or City, Province
Postal Code
Contact person
Hotel name
Street Address
Town or City, Province,
Postal Code
Date
Dear Mr./Ms./Mrs. ____________,
I would like to introduce you to a program that could offer you the prospect of expanding your market by offering
an additional products and/or safety feature to your clients while making a contribution to your community.
______________(sponsoring agency) is operating a new program called Tools
Tools for Living Well
Well, which
aims to create awareness that assistive devices such as bathtub grab bars, non-slip mats and bath
seats and hip protectors are simple and inexpensive tools that can vastly improve the quality of life for
seniors and others by preventing falls or reducing injuries in the event of a fall. Our goal is to support
local businesses to better promote these devices.
We believe that _______________(business type) such as yours could, with minimal effort and cost,
play a significant role in helping to make at least some of the assistive devices identified above more
accessible in your community. We would like to discuss how we can support you in achieving this goal.
A representative of this program will be in touch with you in the next week to set up a brief meeting. This
meeting should take no more than 15 minutes. During this meeting, our representative will explain how
this program can help you and your business. We are not trying to sell you anything! We simply want to
provide you with some information about why these products are important to seniors in our community
and help you where we can to make these more available in your community.
Yours sincerely,
Site Coordinator Signature
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Tools for Living Well

Program Tool 5

Program Tools

Program Tool 6: Sample script for


follow-up call to businesses
Hello. May I speak with the manager please? (If you know the name, ask for them).
My name is _____________, and I am part of the Tools for Living Well program in ___________ (name
of town or city). The program, sponsored by ______________ (sponsoring agency) aims to increase the
availability of grab bars in hotels, motels and resorts in our community.
Did you receive our introductory letter that was sent to your by our local coordinator
___________________? (name local coordinator).
(Note: If they did not receive the letter, fax or deliver it to them as soon as possible.)
I was wondering if I might make an appointment to see you at your office so that I can explain a little bit
more about the program? Im not trying to sell you anything, Id like to provide you with some information
about why these products are important to seniors in our community. I just need about 15-30 minutes of
your time, when its convenient for you.
Would next ______(day and date) be suitable? Or if not, how about ______________ (alternate day and
date)? What time would be best for you?
Thanks for your interest in the program. I look forward to seeing you on _____________ (day, date and
time). Goodbye.

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Program Tools

Tools for Living Well

Program Tools

Program Tool 7: Sample thank you


letter for businesses
Your Name & Title,
Tools for Living Well
Your Street Address,
Town or City, Province
Postal Code
Business name
Street Address
Town or City, Province,
Postal Code
August 13, 2002
Dear Mr./Ms./Mrs. ____________,
Thank you for taking the time to meet with our representative _____________(name) for the Tools for
Living Well program. We truly appreciate your time and hope that you felt the meeting was mutually
beneficial. We hope that you will appreciate the potential benefits that being part of this program can
bring to your business, your customers, and your community. We truly believe that projects such as this
one can help prevent falls and vastly improve the quality of life for seniors.
If you have any questions at all about this program, please feel free to contact me at any time. We look
forward to supporting your business in helping to reduce falls among seniors in our community.
Yours sincerely,

Site Coordinator Signature

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Tools for Living Well

Program Tools

Program Tool 8: What you should


know before you approach
homebuilders
Key message
Assistive devices such as bath and shower grab bars and non-slip mats are important for preventing
falls. Having grab bars and non-slip mats displayed in model homes is a priority. Building supports in
bath and shower walls to accommodate future installation of grab bars and offering grab bars as a
standard amenity for all new homes is helpful.

What might we expect a homebuilder to do?


Homebuilders have the capacity to promote:
Bath and shower grab bars:
o as a standard fixture in the bathrooms of new homes;
o as a standard display in all model homes; and
o as a feature for future consideration, by ensuring that new homes are built with supports
that will accommodate future installation of grab bars.
Non-slip bath mats for inside and outside of the bathtub and shower:
o as standard displays in all model homes.

Why should a homebuilder be interested?

Seniors are a growing segment of the homebuyer market.


Grab bars and non-slip mats are a relatively small investment:
o grab bars cost between $20 and $80 each (CDN, as of 2004);
o non-slip mats cost between $10 and $40 each (CDN, as of 2004);
o grab bars dont have to look institutional. They are becoming available in styles and colours
that complement bathroom dcor.
Grab bars are less expensive if built into the home at the time of construction.
Grab bars can be added at a later date if the wall surrounding the bathtub and shower has been
strengthened or has studs that will support the bar.
By promoting grab bars and other bath safety devices, homebuilders may:
o expand the market for new homes;
o help to reduced health care costs for the community;
o help to ensure ongoing independence and quality of life for seniors in your community (we
will ALL be seniors one day); and
o become a trend setter among peers.

How can this program help homebuilders?


This program can support homebuilders in their efforts to display bath safety devices and increase
availability of grab bars by:
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Program Tools

providing information on bathroom safety devices to pass on to staff, prospective homebuyers


and head office;
possible assistance in staffing a display of a bathtub with grab bars set up in a home show;
offering in-services to staff;
providing ideas of how they can make small changes to increase customer access to assistive
devices for their homebuyers;
informing them of community events or public displays where we will be promoting the assistive
devices;
providing information on manufacturers/wholesalers of assistive devices; and
listing their business when we publicize those who are participating in our program.

Brochures you may want to share with homebuilders:

Program Tool 8

Brochure
Brochure
Brochure
Brochure
Brochure
Brochure

1: Seniors are Good for Business!


4: Use grab bars!
6: Non-slip mats in your bathroom!
7: Invest in your independence!
9: Have a safe home and lifestyle!
10: Protect yourself from falls!

Tools for Living Well

Program Tools

Program Tool 9: What you should


know before you approach
hoteliers
Key message
Assistive devices such as bathroom grab bars, non-slip mats and bath seats are important in preventing
falls. Having grab bars and non-slip mats in every bathroom in hotels, motels and resorts is a priority.
Letting hotel guests know that they can request the use of a bath seat can also be helpful.

What might we expect a hotelier to do?


Hoteliers have the capacity to promote:
bath and shower grab bars in all guestrooms;
non-slip mats inside and outside of every bath and shower in all guest rooms; and
bath seats/benches available for use that are in good repair and well publicized to guests.

Why should a hotelier be interested?

Seniors are a growing segment of the travelling market.


Bath safety devices are a relatively small investment and can be attractive:
o grab bars cost between $20 and $80 each (CDN, as of 2004);
o bath mats cost between $10 and $40 each (CDN, as of 2004) ;
o bath seats/benches cost between $40 to $120 each (CDN, as of 2004); and
o grab bars dont have to look institutional. They are becoming available in styles and colours
that complement bathroom dcor.
By promoting grab bars and other bathroom safety devices, they may:
o expand the market for hotel clientele;
o reduce their customers risk of falling in the bathtub or shower; therefore less chance of
lawsuits arising from falls; and
o increase the chance of attracting senior bus tours and others by advertising safety features
in every bathroom. For example: We care for your safety. Bathroom grab bars are included
in every room and bath seats are available on request, can be a key advertising message.
Help reduced health care costs for the community.
Help to ensure ongoing independence and quality of life for seniors in your community (we will
ALL grow older!).
Become a trend setter among peers.

How can this program help hoteliers?


This program can support hoteliers in their efforts to increase availability of safety devices by:
providing information on bathroom safety devices for customers, staff, head office;
providing in-services to staff;
inform them of special events related to assistive devices that might be relevant to their
business;
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Program Tools

listing their business when we publicize those who are participating in our program;
providing ideas of how they can make small changes to increase customer access to assistive
devices in their hotel/motel;
informing them of community events or public displays where we will be promoting the assistive
devices;
provide information on suppliers of assistive devices; and
providing brochures on falls safety for travellers that can be shared with guests.

Brochures you may want to share with hoteliers

Program Tool 9

Brochure
Brochure
Brochure
Brochure
Brochure
Brochure
Brochure

1: Seniors are Good for Business!


4: Use grab bars!
5: Use a bath seat!
6: Use non-slip mats in your bathroom!
8: Avoid falls while travelling!
9: Have a safe home and lifestyle!
10: Protect yourself from falls!

Tools for Living Well

Program Tools

Program Tool 10: What you


should know before you approach
retailers
Key message
Assistive devices can reduce older peoples risk of falling and injuries. Devices such as bath and shower
grab bars, non-slip mats, and bath benches, are important in preventing falls. Hip protectors are effective
in preventing hip fractures in the event of a fall. Increasing the availability and promotion of these
devices in mainstream stores is a priority.

What might we expect a retailer to do?

Retailers have the capacity to sell and promote:


o bath or shower grab bars (range from $20-$80 retail CDN, as of 2004);
o non-slip mats for inside and outside of the bathtub or shower (range from $10-$40 retail
CDN, as of 2004);
o canes (range from $10-$80 retail CDN, as of 2004);
o hip protectors (range from $50-$200 retail CDN, as of 2004);
o bath seats/benches or shower stools (range from $40-$120 retail CDN, as of 2004).
Retailers have the capacity to educate their customers on:
o selecting the right assistive device for their needs;
o sizing the assistive devices; and
o the proper use of assistive devices.

Why should a retailer be interested?

Seniors are a growing segment of the consumer market.


o Older customers tend to prefer stores that are close to them because of the convenience, ease
of transportation, or physical limitations that affect their ability to travel.
o Older customers prefer to shop at fewer stores.
o Older customers prefer to shop at general or department stores rather than specialty stores
because of the convenience of one-stop shopping.
o Seniors find it difficult to shop at specialty stores (medical supply outlets) for assistive
devices for two reasons: 1) limited hours and 2) remote store locations.
The targeted devices in this program do not require much space to display and may not require
the retailer to carry much inventory. In some cases, they may be able to have a model on
display, and arrange for delivery from their wholesaler in a day or two.
By promoting grab bars and other bath safety devices, canes, and hip protectors, a store may:
o expand the market for their business;
o help to reduced health care costs for the community;

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Program Tools

o
o

Program Tool 10

help to ensure ongoing independence and quality of life for seniors in your community (we
will ALL grow older!); and
become a trend setter among your peers.

How can this program help retailers?


This program can support retailers in their efforts to increase the availability and promotion of bathroom
safety devices, canes, and hip protectors by:
providing information on assistive devices for their use, for customers, staff and head office;
informing them of community events or public displays where we will be promoting the assistive
devices;
providing posters and help with setting up displays for the promotion of assistive devices;
offering in-services to staff;
providing ideas of how they can make small changes to increase customer access to assistive
devices in their stores;
listing their business when we publicize those who are participating in our program.

Brochures you may want to share with retailers:

Brochure
Brochure
Brochure
Brochure
Brochure
Brochure
Brochure
Brochure
Brochure
Brochure

1: Seniors are Good for Business!


2: Use a cane!
3: Wear hip protectors!
4: Use grab bars!
5: Use a bath seat!
6: Use non-slip mats in your bathroom!
7: Invest in your independence!
9: Have a safe home and lifestyle!
10: Protect yourself from falls!
11: Hip protectors suppliers list

Tools for Living Well

Program Tools

Program Tool 11: Staged


interventions for working with
businesses
Staged interventions for: hotels
Assistive devices: Grab bars, non-slip surfaces in and out of bathtubs and shower stalls, bathseats.
Goals: Universal access to grab bars and non-slip surfaces in all rooms; promotion of bath benches for
all guests.
Stage

Discussion points and intervention strategies

Precontemplation or
contemplation

The hotel has none available as


standard equipment in any rooms
and has not considered this as an
option.

Discuss whether they have had requests or comments from


guests for this type of equipment?
Discuss whether there have been any recent incidents (past
year) of guests falling in the bathroom?
Discuss, from a business point of view, what are the
advantages and disadvantages of making bathroom assistive
devices available for clients?
Discuss, from a business point of view, what are the
advantages and disadvantages of NOT making bathroom
assistive devices available for clients?
Build awareness of the availability of bathroom assistive
devices, and expectations of the public regarding safety.
Discuss who would have to make a decision to purchase and
install the equipment for the hotel.

Early action

The hotel has some available


on request or available in a
limited number of rooms. Limited
marketing of the devices to clients
in hotel.

Suggest that hotel management place reminder in bathrooms


with instructions on how to use grab bars and bathmats safely.

Suggest providing information for all guests indicating that


bath seats are available on request.

Offer education to staff on what is available and how they


might suggest it or have to clean it.

Advertise all safety devices offered and benefits of these for


travelers.

Suggest that they request feedback from clients on availability


of the bathroom devices.

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Program Tool 11

Action to maintenance

The hotel has universal access


but needs to be supported to
maintain their participation, or
expand the devices available or
ensure appropriate maintenance
of devices.

Offer updates on community events upcoming & encourage


media releases.

Continue to distribute brochures.

Encourage using the availability of devices as a means of


gaining market niche.

Include in advertising on web sites or in brochure.

Encourage regular maintenance checks (e.g. on list for room


maids to check bathmats).

Encourage advertising features in their web sites and


brochures.

Reinforce that they are leaders in their field.

Discuss whether they have considered trying to influence head


office to advertise, promote and expand this innovation.

Offer information that can be sent to head office.

Diffusion of innovation
The business would promote
the use beyond its own site with
support.

Suggest that they request feedback from clients on the


bathroom devices.

Encourage bathtub access seal of approval award from local


business association.

Offer information that can be sent to the local hotel/motel


association.

Staged interventions for: homebuilders and developers


Assistive devices: Grab bars, non-slip surfaces in and out of bathtub and shower stalls.
Goals: Grab bars and non-slip surfaces in model homes; reinforced walls around baths in newly
constructed homes, grab bars as standard optional features in newly constructed homes.
Stage

Discussion Points and Intervention Strategies

Precontemplation or
contemplation

The business has none available.

Discuss whether they have had requests or comments from


potential buyers for this type of equipment.
Build awareness of the availability of bathroom assistive
devices and expectations of the public regarding safety.
Discuss the pros and cons of:

o having devices displayed in model homes.


o having walls in newly constructed homes to support
future installation of grab bars.

o including grab bars as standard options for new homes.

Tools for Living Well

Program Tools

Program Tool 11

Early action

The business has some


available but could use support
in better marketing and
promoting safe use.

Action to maintenance

The business needs to be


supported to maintain its
participation and to expand their
market and range of devices
offered.

Diffusion of innovation

The business would promote


the use beyond its own site with
support.

Suggest that they distribute brochures on grab bars to


customers.
Offer education to staff on the importance of assistive devices.
Suggest that they advertise the ways in which they support
grab bars (e.g. advertise that grab bars are a standard option in
new home amenities and that new homes are constructed with
bathroom walls to support future installation of grab bars).
Offer updates on community events upcoming and give regular
media releases.
Continue to distribute brochures.
Encourage using the availability of devices as a means of
gaining market niche.
Include in advertising on web sites or in brochures.
Reinforce that they are leaders in their field.
Offer information that can be sent to the local construction
association.
Discuss whether they have considered trying to influence head
office to advertise, promote and expand this innovation.
Offer information that can be sent to head office.

Staged Interventions for: retailers


Assistive devices: Bathtub grab bars, non-slip bath mats, bath benches, canes, hip protectors.
Goals: Greater availability, selection, and promotion of assistive devices.
Stage

Discussion Points and Intervention Strategies

Precontemplation or
contemplation

The business has none available.


Early action
The business has some available,
but could use support in better
marketing them and promoting
safe use.

Discuss whether they have had requests or comments from


customers for any of the assistive devices.
Build awareness of the availability of different assistive devices
and expectations of the public regarding safety.
Discuss the pros and cons of selling various assitive devices.
Suggest that they distribute brochures and display posters on
assistive devices to potential customers.
Offer education to staff on the importance of assistive devices.
Offer education to staff on how they can help customers to
select the proper device at point of purchase and on proper use.
Suggest that they advertise the assistive devices that they carry.
Suggest that they increase the profile of assistive devices that
they carry in their store by displaying them more prominently.
Suggest that they increase the variability of the devices that
they carry to better meet the needs of different consumers.
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Program Tool 11

Action to maintenance

The business needs to be


supported to maintain their
participation and to expand their
market and range of devices
offered.

Diffusion of innovation

The business would promote


the use beyond its own site with
support.

Tools for Living Well

Offer updates on community events upcoming and give regular


media releases.
Continue to distribute brochures for customers.
Encourage using the availability of devices as a means of
gaining market niche include in advertising on web sites or in
brochures.
Encourage ongoing in-services to staff on proper selection and
use of assistive devices.
Reinforce that they are leaders in their field.
Offer information that can be sent to the local retail associations
(e.g. pharmacists association).
Discuss whether they have considered trying to influence head
office to advertise, promote and expand this innovation.
Offer information that can be sent to head office.

Program Tools

Program Tool 12: Program Summary


Tools for Living Well: Promoting
the use of assistive devices to
help prevent falls among seniors
and veterans
Background:
Falls are a leading threat to loss of independence among older adults. One in three seniors and
veterans in Canada will experience a fall in a year. Many of these falls will result in injury, hospitalization,
institutionalization, and even death. Assistive devices such as canes and bath safety devices may
reduce an older persons risk of falling. In the event of a fall, other devices, such as hip protectors, may
reduce a seniors risk of injury. Despite the potential benefits of assistive devices they are underused.
This may be because they are associated with disability rather than independence, hard to access/
purchase, and/or in some cases difficult to install.

Why are we promoting bathtub/shower grab bars, bath seats & nonslip mats?

The 1997 Canadian Hospital Injury Reporting and Prevention Program statistics showed that
almost 50% of falls among seniors and veterans occur in the home. Among falls in bathrooms,
half occur while bathing and over 70% result in an injury.

Why are we promoting canes?

Canes are often purchased without knowledge of correct size or use.

Why are we promoting hip protectors?

Hip protectors are a relatively new assistive device and less commonly known by the general
population. Research indicates that they reduce the injury if a fall does occur.

The Tools for Living Well program is designed to:

increase awareness of, and access to, assistive devices in your community;
encourage retailers, hoteliers and homebuilders to promote assistive devices in stores, hotels/
motels, and new homes;
educate seniors and their caregivers to make informed choices about assistive device and to
use them correctly; and
support a shift in social norms from assistive devices as tools for persons with disabilities to
assistive devices as tools for independent living.

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Program Tools

Program Tool 12

Locally, Tools for Living Well is supported by

For more information, contact:

Visit the web site at www.otworks.ca and follow the links to Tools for Living Well.
This program was developed with funding provided by the HC/VAC Falls Prevention Initiative, and cosponsored by the University of Ottawa and Canadian Association of Occupational Therapists.

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Brochures
Contents
Brochure 1: Seniors are Good for Business! .....................................................................................137
Brochure 2: Use a cane! ................................................................................................................... 139
Brochure 3: Wear hip protectors! ......................................................................................................141
Brochure 4: Use grab bars! ............................................................................................................... 143
Brochure 5: Use a bath seat! ........................................................................................................... 145
Brochure 6: Use non-slip mats in your bathroom! ............................................................................147
Brochure 7: Invest in your Independence! ........................................................................................ 149
Brochure 8: Avoid falls while travelling! .............................................................................................151
Brochure 9: Have a safe home and lifestyle! .................................................................................... 153
Brochure 10: Protect yourself from falls! ........................................................................................... 155
Brochure 11: Hip Protector Supplier List ............................................................................................157

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Brochures

Tools for Living Well

Brochures

1: Seniors are Good for Business!

Seniors Are
Good for Business!

HOMEBUILDERS: Seniors want to live


independently!
Most seniors live at home as opposed to in an
institution. The latest figures indicate that 92%
of Canadians aged 65 and over live in a
private household.9
As they age, many baby boomers are buying their
second and third homes.10
OPPORTUNITY FOR ALL: The Baby
Boomers are aging!

Seniors are a large and growing market!


Seniors are one of the fastest growing
population groups in Canada. In 2000, one out
of every eight people in Canada was 65 or
older. By 2026, it is estimated that one out of
every five people will be a senior.1
By 2016 at the latest, Canada will have far
more seniors than children aged 14 and under,
a phenomenon never before recorded.2
Seniors have disposable income and can
impact on your business!
Todays seniors generally have more leisure time
and disposable income than members of other
age groups.3

There are 9.9 million baby-boomers that account


for almost 1/3 of the Canadian population.11
Baby-boomers exert a dramatic impact on markets.
The reason is simple: people of the same age tend
to have the same needs at about the same time. You
can benefit from anticipating their needs.12
Endnotes
1 Statistics Canada (2001, March 13). Population Projections 2000 to 2026.
http://www.statcan.ca/Daily/English/010313/d010313a.htm
2 Statistics Canada (2001, March 13). Population Projections 2000 to 2026.
http://www.statcan.ca/Daily/English/010313/d010313a.htm
3 Moschis, G. (1992). Marketing to older consumers. Westport, Connecticut: Quorum Books.
4 Health Canada. Division of Aging and Seniors. (1999). Canada's Seniors at a Glance.
Poster prepared by the Canadian Council on Social Development. Ottawa.
http://www.hc-sc.gc.ca/seniors-aines/pubs/communicating/audience_e.htm#4.
5 American Association of Retired Persons (AARP) (May 2000). Fixing to Stay: A national
survey of housing and home modification issues. Washington, D.C.: Bayer, A. & Harper, L.
http://research.aarp.org/il/home_mod_1.html.
6 Foot, D. K. & Stoffman, D. (1998). Boom, Bust & Echo 2000. Toronto: Macfarlane,
Walter and Ross.
7 Foot, D. K. & Stoffman, D.(1998). Boom, Bust & Echo 2000. Toronto: Macfarlane,
Walter and Ross.

Seniors households in Canada spent a total of


$69 billion in 1996.4

8 Statistics Canada (1999). A portrait of seniors in Canada (3rd edition). 89-519-XPE.


http://www.statcan.ca/english/ads/89-519-XPE/link.htm

RETAILERS: Seniors are modifying their


homes!

10 North County Times (2002, Nov 20). Boomers buying second and third homes.
Baldwin, A. http://www.nctimes.net/news/2002/20021120/51416.html

89% of seniors want to age in place. Many


seniors are modifying their homes to help them
"age in place".5

12 Foot, D. K. & Stoffman, D.(1996). Boom, Bust & Echo. Toronto: Macfarlane,
Walter & Ross.

Important opportunities exist for retailers whose


products can help seniors remain in their homes
despite the increasing frailty that develops with age.6
HOTELIERS: Seniors are traveling more
than ever!
Tourism is a big winner in an aging population
because older people have the time, money and
desire to travel.7
In 1999, seniors made an average of more
than 3 trips per person in Canada.8

9 Statistics Canada (1999). A portrait of seniors in Canada (3rd edition). 89-519-XPE.


http://www.statcan.ca/english/ads/89-519-XPE/link.htm

11 Foot, D. K. & Stoffman, D.(1998). Boom, Bust & Echo 2000. Toronto: Macfarlane,
Walter & Ross.

Assistive Devices to Help Prevent Falls.


A joint venture between the University of Ottawa and the
Canadian Association of Occupational Therapists (CAOT).
For more information please visit our website at
www.otworks.ca
Funding provided by Health Canada/Veterans Affairs
Canada Falls Prevention Initiative.
The views expressed herein do not necessarily represent
the official policies of Health Canada, Veterans Affairs
Canada, the University of Ottawa and the Canadian
Association of Occupational Therapists (CAOT).
The information in this brochure is current as of 2004.

Tools for Living Well

137

138

Brochures

Tools for Living Well

For your convenience, phone ahead to be


certain that the cane you are looking for is
available.

select department stores

your local medical supply store

your local pharmacy

Different styles of canes may be found at:

WHERE CAN I PURCHASE A CANE?

Cane hand loop: A cane hand loop


wraps around the cane and your hand so
that the cane will not drop to the ground if
your hand lets go.

Cane holder: A cane holder clips onto the


cane so it can hang from the edge of any
table, counter or desk, when not in use.

OTHER HELPFUL CANE ACCESSORIES

Ice picks should always be used outdoors


during the winter season.

Ice pick for canes: An ice pick clamps onto


the bottom of the cane to help prevent the
cane from slipping on snow-covered, slushy
or icy surfaces.

Rubber tips should be replaced when worn.

Rubber tip: A rubber tip fits onto the bottom


of the cane to help prevent the cane from
slipping on wet surfaces.

RECOMMENDED CANE ACCESSORIES

something you have read in this brochure.

health care advice or delay in seeking it because of

care professional. Never disregard professional medical or

not be taken as advice or treatment from a doctor or health

is intended for educational purposes only. It is not and should

Not medical advice: The information provided in this brochure

The information in this bochure is current as of 2004.

Funding provided by Health Canada/Veterans


Affairs Canada Falls Prevention Initiative.
The views expressed herein do not necessarily
represent the official policies of
Health Canada, Veterans Affairs Canada, the
University of Ottawa and the Canadian Association
of Occupational Therapists (CAOT).

Assistive Devices to Help Prevent Falls.


A joint venture between the University of Ottawa
and the Canadian Association of Occupational
Therapists (CAOT).
For more information please visit our website at
www.otworks.ca
Some information was adapted from Cherish Your
Independence, City of Ottawa,
Public Health Branch.

1 in 3 seniors fall each year.


It could happen to you or
someone you love.

Protecting yourself from a fall is


important to maintain a healthy
and independent lifestyle. The
following information will help
you learn more about the benefits
of using a cane, and what to
look for when buying one.

Use a cane!

Prevent falls and


maintain your independence:

Brochures

2: Use a cane!

Tools for Living Well

139

1. Most canes can be easily adjusted


within 2.50 cm (1.0 inch) of the
desired height. To correctly adjust the
height, follow the instructions on how
to measure your cane (see figure 1).

For aluminum canes:

4. Replace the rubber tip.

3. Cut the cane 1.25 cm (1/2 inch) shorter


than where you marked it (to allow for
extra height the rubber tip adds).

2. Remove the rubber tip.

1. When your cane is upside down,


mark the cane at the level of your wrist
(see figure 1).

For wooden canes:

TO ADJUST YOUR CANE

Because individual needs vary, you may


want to speak to a health care professional
about choosing the best cane for you.

Canes come in different handles, lengths


and colours. A comfortable handle will
make the cane more stable in your hand.

CHOOSING A CANE

If you feel unsteady on your feet and/or


have a bad leg, a cane can provide you
with balance and support. Using a cane
while walking can also give you more
confidence in your abilities, helping you to
enjoy your life and your independence.

WHAT CAN A CANE DO FOR YOU?

3. The rubber tip of the cane should


be at the level of your wrist.

2. Stand with your arms at your sides.

1. Turn the cane upside down and put


the handle on the floor.

TO MEASURE YOUR CANE

Figure 1

Tools for Living Well


weaker leg

2. Then, lower the stronger leg to that


same step.

1. Take the first step down with the cane


and the weaker leg.

GOING DOWN THE STAIRS

3. Move the weaker leg to the same step.

2. Move the cane to the same step.

1. Take the first step up with your


stronger leg.

GOING UP THE STAIRS

Attach an ice pick during the winter.

Replace worn rubber tips.

Always move the cane and the


opposite leg together (see figure 2).

WALKING WITH A CANE


Always hold the cane on your
strongest side.

Figure 2

140
Brochures

Brochures

3: Wear hip protectors!


WHERE CAN I PURCHASE HIP
PROTECTORS?
Hip protectors may be found:
at medical supply stores
at pharmacies
on the internet (search: hip protectors)
For your convenience, phone ahead to be
certain that hip protectors are available.

Prevent falls and


maintain your independence:
Assistive Devices to Help Prevent Falls.
A joint venture between the University of
Ottawa and the Canadian Association of
Occupational Therapists (CAOT).
For more information about this project please
visit our website at www.otworks.ca.
Funding provided by Health Canada/Veterans
Affairs Canada Falls Prevention Initiative.
The views expressed herein do not necessarily
represent the official policies of
Health Canada, Veterans Affairs Canada, the
University of Ottawa and the Canadian
Association of Occupational Therapists (CAOT).
The information in this brochure is current
as of 2004.

Not medical advice: The information provided in this


brochure is intended for educational purposes only.
It is not and should not be taken as advice or
treatment from a doctor or health care professional.
Never disregard professional medical or health care
advice or delay in seeking it because of something
you have read in this brochure.

Wear hip protectors!


Protecting yourself from a hip
fracture is important to maintain a
healthy and independent lifestyle.
The following information will
help you learn more about the
benefits of using hip protectors,
and what to look for when
buying a pair.
Think of hip protectors as
hockey pads for the "sport" of life.

1 in 3 seniors fall each year.


Many of these falls will result in hip
fracture. It could happen to you or
someone you love.
Tools for Living Well

141

142

Brochures

WHAT ARE HIP PROTECTORS?


Hip protectors are protective equipment
specifically designed to protect your hips
during a fall. Hip protectors are easy to wear
and are available in the form of a belt or
brief (underwear).

WHEN SHOULD I WEAR HIP


PROTECTORS?
Hip protectors can only help when you are
wearing them. Hip protectors should be worn
whenever possible, indoors and outdoors, as
falls can happen anywhere, any time.
THINGS TO CONSIDER WHEN
CHOOSING A PAIR OF HIP
PROTECTORS:
1) Choose hip protectors that fit comfortably.

Belt

Hip protectors are available in various


sizes. Follow the sizing instructions
provided by the manufacturer. If you
are unsure, ask for assistance.
Belt: A hip protector belt can be worn
over or under your clothing. Be sure that it
fits comfortably, whichever way you
choose to wear it.

Hip Protector
Warning: Hip protectors are effective only if
worn properly. Carefully follow the wearing
instructions provided by the manufacturer.

Brief: Hip protector briefs should fit


comfortably under your clothing.
2) Choose hip protectors that are washable.
Whether a belt or brief style of hip protectors, the
one you choose should be washable. Check the
manufacturers instructions before purchase.
VETERANS

Hip Protector

Brief

Research shows that wearing hip protectors


can reduce the risk of hip fracture when
you fall. Wearing hip protectors may
prevent an injury that could lead to the loss
of your independence.

Tools for Living Well

Veterans Affairs Canada will help pay for hip


protectors for eligible veterans. A prescription
from your health care provider is necessary (i.e.
occupational therapist, family doctor, etc.). Ask
your health care professional or hip protector
retailer for details.

Assistive Devices to Help Prevent Falls.

Not medical advice: The information provided in


this brochure is intended for educational purposes
only. It is not and should not be taken as advice or
treatment from a doctor or health care professional.
Never disregard professional medical or health
care advice or delay in seeking it because of
something you have read in this brochure.

The information in this brochure is current


as of 2004.

The views expressed herein do not necessarily


represent the official policies of Health
Canada, Veterans Affairs Canada, the
University of Ottawa, and the Canadian
Association of Occupational Therapists (CAOT).

All graphics were adapted with permission


from the MU Extension, University of Missouri.

Funding provided by Health Canada/Veterans


Affairs Canada Falls Prevention Initiative.

A joint venture between the University of


Ottawa and the Canadian Association of
Occupational Therapists (CAOT).
For more information about this project please
visit our website at www.otworks.ca

Note: Wall stud spacing may vary.

Faucet wall: Vertical and/or horizontal bar

Figure 3

Back wall: Full or partial


length of the bathtub

Thick lines represent wall


studs that are located behind
your bathroom wall

If you are qualified to install the grab


bar(s) yourself, you should carefully
follow the instructions provided by
the manufacturer.

We recommend that you hire a


professional to install your wall
mounted grab bar(s).

Wall mounted grab bar:

Regularly check your portable grab bar


to ensure that it is secure and tightly
screwed on to the bathtub rim.

A portable grab bar can be installed by


carefully following the instructions
provided by the manufacturer.

Portable grab bar:

IMPORTANT: Grab bars are safety


supports only when installed properly
and securely.

INSTALLATION

For your convenience, phone ahead to be


certain that the grab bar you are looking for
is available.

Grab bars can be found at:


hardware stores
home improvement stores
medical supply stores
department stores
select pharmacies

WHERE CAN I PURCHASE A


GRAB BAR?

3) Ceramic: Ceramic tiles may be a concern


when installing grab bars as they can crack
very easily. A professional should be able to
install grab bars in your ceramic tiles without
damaging them.

2) FOR YOUR SAFETY: If a grab bar is


horizontally mounted, it should have a wall
clearance of approximately 4.5 cm (13/4
inches) from the wall where the grab bar is
mounted. This precaution will ensure that
you wont catch your arm in the gap
between the wall and the bar.

1) Installation height: The Canadian Standards


Association (CSA) recommends that a wall
mounted grab bar be installed at a height
of 18 to 28cm (7 to11 inches) above the
rim of the bathtub.

INSTALLATION TIPS FOR WALL


MOUNTED GRAB BARS:

To be safe, your grab bar needs to be


securely anchored into the wall studs.

Shower stall: Measure the distance


between the studs where you are
planning to install your grab bar.

Vertical bar: Vertical bars are


installed along a single stud.

Horizontal bar: Measure the full


length of the faucet wall; outside stud
to outside stud.

2) Faucet wall:

1) Back wall: Depending on your needs,


you will require a grab bar that extends
the full or partial length of your bathtub.
Measure accordingly.

Bathtub (see figure 3):

HOW TO MEASURE FOR YOUR


WALL MOUNTED GRAB BAR(S):
Tip: Before going to the store, use a stud
locator to measure the distance between
the wall studs.

Brochures

4: Use grab bars!

Tools for Living Well

143

Tools for Living Well

1 in 3 seniors fall each year.


Up to 15% of these falls occur in
the bathroom. It could happen to
you or someone you love.

Protecting yourself from a fall is


important to maintain a healthy
and independent lifestyle. The
following information will help
you learn more about the
benefits of using bath and
shower grab bars, and what
to look for when buying and
installing them.

Use grab bars!

Prevent falls and


maintain your independence:

help you safely lower and raise yourself


into and up from the bottom of the
bathtub.

help you steady yourself while stepping


into and out of the bathtub or
shower stall;

A wall mounted grab bar can:

There are two types of grab bars to


choose from: wall mounted and portable.

Using a grab bar can reduce your risk of


falling in the bathtub and shower.

WHAT CAN A GRAB BAR


DO FOR YOU?

Everyone! People of all ages and abilities can


benefit from using grab bars.

WHO SHOULD USE GRAB BARS?

A grab bar is an accessory that can be


used in bathtubs and shower stalls to
reduce the risk of falling and injuring
yourself when taking a bath or shower. A
grab bar can be made of stainless steel,
aluminum or plastic, and is available in a
variety of shapes, sizes and colours.

WHAT IS A GRAB BAR?

(see figure 1)

one along the back wall

at least one along the faucet wall

Research suggests that two grab bars in a


bathtub are useful for most older adults:

Because individual needs vary, you should


talk to an occupational therapist to
determine specifically where your grab bars
would be most useful. A health care
professional should be able to refer you to
an occupational therapist.

HOW MANY GRAB BARS DO I


NEED AND WHERE SHOULD THEY
BE INSTALLED?

FOR YOUR SAFETY: Portable grab bars are


not designed to support your weight when
sitting into or getting up from the bottom of
the bathtub.

A portable grab bar can be installed on


the bathtub rim with minimal effort and is
removable so you may take it with you
when you travel or move.

A portable grab bar can help you steady


yourself while stepping into and out of the
bathtub.

Faucet wall

Figure 2

If you have a shower stall, one grab bar


installed near the entrance may be sufficient.
(see figure 2)

Figure 1

Back wall

We recommend that you choose a grab


bar that has a textured non-slip surface
that is, a surface that has a rough finish
where you are most likely to grab the bar.
A rough finish will provide a better grip
when the bar is wet.

4) Choose a grab bar with a textured surface.

For adults, the recommended diameter of


a grab bar is between 3 and 4.5 cm
(11/4 and13/4 inches). We recommend that
you wrap your hand around the different
sizes to find the one that fits in your hand
most comfortably.

3) Choose a grab bar that feels comfortable


in your hand.

The distance between the studs in your


bathtub or shower stall wall will determine
the length of grab bar you require. (See
other side for measuring instructions).

2) Choose a grab bar that is the correct


length for your bath or shower area.

Most grab bars will support the weight


of a person up to 113 kg (250 lbs).
Manufacturers will often list a specific
weight limit on the grab bar packaging.
If your weight exceeds this limit, you
should be able to special order from
your grab bar retailer.

1) Choose a grab bar that will be safe


for your weight.

THINGS TO CONSIDER WHEN


SELECTING YOUR GRAB BAR(S)

144
Brochures

Brochures

5: Use a bath seat!


WHERE CAN I PURCHASE BATHTUB
AND SHOWER SEATS?

Bathtub and shower seats may be found at:


medical supply stores
home improvement stores
select department stores
select pharmacies
For your convenience, phone ahead to be
certain that the seat you are looking for is
available.

Prevent falls and


maintain your independence:

Use a bath seat!


Assistive Devices to Help Prevent Falls.
A joint venture between the University of Ottawa
and the Canadian Association of Occupational
Therapists (CAOT).
For more information please visit our website at
www.otworks.ca
Funding provided by Health Canada/Veterans
Affairs Canada Falls Prevention Initiative.
The views expressed herein do not necessarily
represent the official policies of
Health Canada, Veterans Affairs Canada, the
University of Ottawa and the Canadian Association
of Occupational Therapists (CAOT).

Preventing falls is important to


help maintain a healthy and
independent lifestyle. The
following information will help
you learn more about the
benefits of using a bath seat,
and what to look for when
buying one.

The information in this bochure is current as of 2004.

Not medical advice: The information provided in this


brochure is intended for educational purposes only. It
is not and should not be taken as advice or treatment
from a doctor or health care professional. Never

1 in 3 seniors fall each year.


Up to 15% of these falls occur in the
bathroom. It could happen to you or
someone you love.

disregard professional medical or health care advice

WHAT CAN A BATH SEAT DO FOR YOU?

or delay in seeking it because of something you have

A bath seat can help make you more comfortable


and safe while bathing and showering.

read in this brochure.

Tools for Living Well

145

146

Brochures

WHO SHOULD USE A BATH SEAT?


We recommend that you use a bath seat if sitting
in the bathtub or standing in the shower is
difficult for you.

THINGS TO CONSIDER WHEN MAKING


YOUR SELECTION:

1) Choose a seat that is height adjustable.


Adjustable legs will allow you to
customize your seat to a height that is
comfortable and safe. An adjustable
seat will also allow for safe and
comfortable use by others.
2) Choose a seat that will be safe for
your weight.

Example of a bath/shower seat

Most bathtub and shower seats will


support the weight of a person up to
113 kg (250 lbs). Seat manufacturers
will often list a weight limitation on their
packaging. If your weight exceeds this
limit, ask your retailer whether the
manufacturer offers a seat with a higher
limit, as there is usually an alternative
available.
3) Choose a seat with non-skid rubber tips.
Non-skid rubber tips on the feet of the
seat will stick to the bottom of the tub
or shower to keep the seat from sliding.
4) A seat with a backrest may be preferable.
A chair or bench with a backrest will
provide extra support for your back.
5) A seat with a "built-in" holder for
a shower spray may be preferable.
When using a bathtub or shower seat,
a hand-held shower spray is almost a
necessity to direct the water where
needed.

Example of a transfer bench with a backrest


(extends over the side of the tub for easier
access into and out of the bathtub)
Note: Bathtub and shower seats may also
be referred to as chairs, benches or stools.

Tools for Living Well

Brochures

6: Use non-slip mats in your bathroom!


WHERE CAN I PURCHASE A
NON-SLIP BATHROOM MAT?
Non-slip mats for the inside and
outside of bathtubs and shower stalls
may be found at:
department stores
hardware stores
home improvement stores
medical supply stores
select pharmacies
For your convenience, phone ahead to
be certain that the non-slip mat you are
looking for is available.

Prevent falls and


maintain your independence:

Use non-slip mats

in your bathroom!

Assistive Devices to Help Prevent Falls.


A joint venture between the University of Ottawa
and the Canadian Association of Occupational
Therapists (CAOT).
For more information please visit our website at
www.otworks.ca
Funding provided by Health Canada/Veterans
Affairs Canada Falls Prevention Initiative.
The views expressed herein do not necessarily
represent the official policies of
Health Canada, Veterans Affairs Canada, the
University of Ottawa and the Canadian Association
of Occupational Therapists (CAOT).

Protecting yourself from a


fall is important to maintain
a healthy and independent
lifestyle. The following
information will help you
learn more about the
benefits of using non-slip
mats, and what to look for
when buying them.

The information in this bochure is current as of 2004.

Not medical advice: The information provided in this


brochure is intended for educational purposes only. It
is not and should not be taken as advice or treatment
from a doctor or health care professional. Never
disregard professional medical or health care advice
or delay in seeking it because of something you have
read in this brochure.

1 in 3 seniors fall each year.


Up to 15% of these falls occur in the
bathroom. It could happen to you or
someone you love.
Tools for Living Well

147

148

Brochures

WHO SHOULD USE NON-SLIP


BATHROOM MATS?
Everyone! People of all ages and abilities can
benefit from using non-slip mats on the inside
and outside of bathtubs and shower stalls.
WHAT CAN A NON-SLIP BATHROOM
MAT DO FOR YOU?
Non-slip mats placed on the inside and outside of
bathtubs and shower stalls can help prevent slips
and falls by providing traction for your feet when
they are wet.
We recommend that you place a non-slip
mat on the inside and outside of all bathtubs
and shower stalls.

PRIOR TO USING THE BATHTUB OR


SHOWER, ENSURE THAT YOUR
INSIDE NON-SLIP MAT IS IN PLACE:

Note: Non-slip mats should be placed on the


inside of bathtubs and shower stalls even if antislip treads are present.

Step 1: Run water to moisten the bottom of


the bathtub or shower floor, pressing down to
anchor suction cups.

THINGS TO CONSIDER WHEN MAKING


YOUR SELECTION:

Step 3: Step carefully onto mat, using grab


bar or bathtub edge.

1. Choose a mat for the inside of bathtubs and


shower stalls that:

Step 4: Firmly step in 56 places on mat to


ensure it is anchored.

has a textured non-slip surface (top side). A


textured non-slip surface will help keep your feet
from slipping when they are wet.
has a suction cup backing (underneath side).
Suction cups will stick to the bottom of
bathtubs and shower stalls, preventing the
mat from sliding.
covers the length (or most of the length) of the
surface on the inside of your bathtubs and
shower stalls. Before going to the store,
measure the length of the inside of your
bathtubs and shower stalls.
2. Choose a mat for the outside of bathtubs
and shower stalls that:
has a non-slip latex/rubber backing
(underneath side). A non-slip backing will
stick to the bathroom floor, preventing the
mat from sliding.

Tools for Living Well

Step 2: Continue to fill the bathtub or shower.

WARNING: A non-slip bathroom mat can


help prevent a fall only if it is properly cared
for. Please follow the instructions we have
provided.
CARING FOR YOUR NON-SLIP
BATHROOM MAT:
Most inside and outside non-slip mats are
machine washable. Check the
manufacturers packaging for washing instructions.
Mildew build-up is slippery and dangerous.
To avoid mildew on your inside mat, make
sure that you remove it after every use,
hanging it to dry.
Replace your non-slip mats when the adhesive
backing no longer sticks firmly to the bottom of
the bathtub or shower stall.

Brochures

7: Invest in your Independence!


(Endnotes)
1. CHIRPP Injury Reports. Injuries associated with falls in seniors. Summary Data for
1997. Computations by Injury Section, Health Surveillance & Epidemiology Division,
CHHD, PPHB, Health Canada.) (Identification of consumer products causing injury
and death to seniors. Final Report Submitted to the Product Safety Bureau, Health
Canada by Valerie Howe, Prospect Consulting, March 1996.

Invest in your
independence!
Assistive Devices to Help Prevent Falls.
A joint venture between the University of
Ottawa and the Canadian Association of
Occupational Therapists (CAOT).
For more information please visit our
website at www.otworks.ca
Funding provided by Health Canada/Veterans
Affairs Canada Falls Prevention Initiative.

Funding for Home Modifications


for Seniors and Veterans
Investing in equipment and
modifications for your home to make it
safer may help you to remain living
independently in your home.

The views expressed herein do not necessarily


represent the official policies of
Health Canada, Veterans Affairs Canada, the
University of Ottawa and the Canadian
Association of Occupational Therapists (CAOT).
The information in this bochure is current
as of 2004.

Not medical advice: The information provided in this


brochure is intended for educational purposes only. It
is not and should not be taken as advice or treatment
from a doctor or health care professional. Never
disregard professional medical or health care advice
or delay in seeking it because of something you have
read in this brochure.

1 in 3 seniors fall each year.


It could happen to you or
someone you love.
Tools for Living Well

149

150

Brochures

Nearly half of all injuries among seniors take


place at home. Constructional features of a house
or building such as floors, stairs and steps are
identified more often in an injury than any
household product.1

If you qualify, the following programs may be of


assistance to you:
CANADA MORTGAGE AND HOUSING
CORPORATION (CMHC)
Home Adaptations for Seniors' Independence (HASI)

HASI is a financial assistance program for seniors


to help extend the time they can remain living
independently in their homes. As of 2004, for
minor home modifications such as grab bars and
hand rails, the program offers a forgivable loan
up to $3,500.
To find out more information about this program as
well as other financial assistance programs that are
available through CMHC, contact your regional
CMHC office or visit their website at:
http://www.cmhc.ca/en/prfias/index.cfm
VETERANS AFFAIRS CANADA
Aids for Daily Living

Veterans Affairs Canada offers a wide variety of


programs and services to veterans. Aids for
Daily Living is a program that can assist with the
purchase of assistive devices such as canes,
walkers and wheelchairs.
To find out more information about this program as
well as other financial assistance programs that are
available through Veterans Affairs Canada, contact
your local office or visit the VAC website at:
www.vac-acc.gc.ca

Tools for Living Well

SOCIAL CLUBS AND COMMUNITY


ORGANIZATIONS
Financial Aid
Kiwanis, Rotary, Lions Club and the Royal
Canadian Legion are all examples of
social clubs and community organizations
that may offer financial assistance for
purchasing assistive devices.
Equipment Loan Cupboards
Social clubs and community organizations
may run Equipment Loan Cupboards in
your community. Loan Cupboards offer
equipment such as bath seats,
wheelchairs and other items that have
been donated to them.

BANK LOANS
Home improvement loans are available at
most banks. If you do not qualify for funding
under any other program you may qualify for
a loan at your local bank.

Brochures

8: Avoid falls while travelling!

Assistive Devices to Help Prevent Falls.


A joint venture between the University of Ottawa
and the Canadian Association of Occupational
Therapists (CAOT).
For more information please visit our website at
www.otworks.ca
Thank you to the Prince Edward Island Falls
Prevention Initiative for giving us permission to
use their bus tips.

Prevent falls and


maintain your independence:

Avoid falls
while travelling!

Funding provided by Health Canada/Veterans


Affairs Canada Falls Prevention Initiative.
The views expressed herein do not necessarily
represent the official policies of
Health Canada, Veterans Affairs Canada, the
University of Ottawa and the Canadian Association
of Occupational Therapists (CAOT).
The information in this bochure is current as of 2004.

Not medical advice: The information provided in this


brochure is intended for educational purposes only.
It is not and should not be taken as advice or
treatment from a doctor or health care professional.
Never disregard professional medical or health care
advice or delay in seeking it because of something
you have read in this brochure.

1 in 3 seniors fall each year.


It could happen to you or someone
you love.

Tools for Living Well

151

152

Brochures

ACCOMMODATIONS

TOURING

Use luggage on wheels and avoid carrying


heavy luggage. Use the services of bellhops
or porters, if available.

Clothing and carry bags

Ask for a room with a bathroom that is


equipped with grab bars and non-slip
bath mats.

Wear sturdy, comfortable walking shoes.


Avoid slip-on shoes and strapless sandals.
If you buy new shoes, wear them in
before you leave. Blisters and sore feet will
affect your balance.

Bring a nightlight with you; moving around in


the dark in an unfamiliar place may result in a
fall. If you do not have a nightlight, leave a
small light on in the room.
If you have to use stairs,
use the handrail.
Report any hazards to
building management.

Wear sunglasses to reduce glare on


sunny days.

Avoid carrying a purse or shoulder bag to


keep your hands free. Free hands will help
you to maintain your balance. Instead,
consider using a:
~ waist bag for your wallet and valuables.
~ knapsack for carrying your extra sweater,
hat, and purchases. Be sure to wear your
knapsack properly, over both shoulders,
so that the weight you are carrying is
close to your body and better balanced.

TRAVELING BY BUS

BE AWARE AND PREPARED

Make sure you plant your foot firmly in the


centre of the stair and use the handrail for
support. Take the hand offered by the driver or
tour director; they are offering safety!

Look for uneven ground, rocks or other


obstructions that could cause you to trip
when you are walking.

If you feel unsafe getting off the bus,


ask for help.
Remain in your seat while the bus is moving.
If you have to move, ask for assistance.
In the washroom, make sure you have your
feet firmly planted on the floor when sitting or
standing. Use the grab bar while moving
between sitting and standing position.

If you have problems keeping your


balance, use assistive devices like canes,
walking sticks or walkers. For your safety,
be sure that your assistive devices fit properly.
If you are unable to walk long distances, it
may be possible to rent a wheelchair or
power scooter at your destination.
Call ahead or ask your travel agent
to check for you.
Try not to let yourself
get too tired. Physical
exhaustion can lead
to slips and falls.

Enjoy your trip!

Tools for Living Well

Finally, know that you have the right


to be safe. If you notice any hazards
or unsafe conditions, let the proper
authorities know (municipality,
apartment owner, seniors' centre,
store staff). Cracks can be repaired;
public ramps can be installed; traffic
lights can have their timing changed...
Reporting unsafe conditions benefits
you and the entire community!

Don't rush to the phone: if you have


an answering service, your callers
will leave a message; if not, they
will call back.

Use your cane or walking aid inside


the house if necessary.

Take off your reading glasses when


you're not reading.

Turn the lights on ahead of you


while moving through the house.

Take care not to trip on your pet


(or your grandchild's toys!) always
check the floor, the stairs, the
hallway...

Don't try to do tasks that are too


strenuous or potentially dangerous.
Find a volunteer a friend, a
neighbour, a relative, building
maintenance staff to help you
with the heavy work.

OTHER PRECAUTIONS

Assistive Devices to Help Prevent Falls.

Not medical advice: The information provided in


this brochure is intended for educational purposes
only. It is not and should not be taken as advice or
treatment from a doctor or health care professional.
Never disregard professional medical or health
care advice or delay in seeking it because of
something you have read in this brochure.

The information in this brochure is current


as of 2004.

The views expressed herein do not necessarily


represent the official policies of
Health Canada, Veterans Affairs Canada, the
University of Ottawa, and the Canadian
Association of Occupational Therapists (CAOT).

Funding provided by Health Canada/Veterans


Affairs Canada Falls Prevention Initiative.

This brochure was adapted from You Can


Prevent Falls!, a Health Canada/Veterans
Affairs Canada Falls Prevention Initiative.

A joint venture between the University of


Ottawa and the Canadian Association of
Occupational Therapists (CAOT).
For more information about this project please
visit our website at www.otworks.ca.

1 in 3 seniors fall each year.


It could happen to you or
someone you love.

Here are some ideas to make


the inside and the outside of
your home a safer place for you.

Most falls occur at home


especially in the kitchen, on
the stairs and in the bathroom.

Have a safe home


lifestyle!

Prevent falls and


maintain your independence:

Brochures

9: Have a safe home and lifestyle!

Tools for Living Well

153

Tools for Living Well

Take your reading glasses off before


going up and down stairs. If you
wear bifocals, be very careful when
using stairs.

Don't carry heavy objects up and


down stairs.

Don't put things on the stairs.

Make sure stairs are properly lit with


the maximum wattage recommended
for the outlet.

Have handrails on both sides of the


stairs and use them.

STAIRS

Wipe up any spills immediately to


prevent slipping.

Have everything within reach so


that you don't need to climb; if you
must climb, use a stable stepping
stool with a safety rail.

KITCHEN

Eliminate throw rugs throughout your


house, or make sure they are secured
to the floor and do not move underfoot.

Be a defensive walker watch for


traffic, bicycles and in-line skaters.

Don't load yourself down with


packages; take advantage of
home delivery or use a pushcart
(which can also act as a walking aid).

Walk slowly and carefully watch


for sidewalk cracks, obstacles,
slopes, slippery surfaces and other
hazards.

Use your walking aid.

Wear footwear to prevent slipping


and avoid using laces that may
come undone.

Take all the time you need plan


ahead, don't rush.

WHEN GOING OUT

installed along your front walkway.

If necessary, have a handrail

Keep your steps and walkways


free of ice, snow, newspapers and
wet leaves.

Have a sturdy chair in your


entryway to help you put on and
remove your shoes and boots.

WALKWAYS AND ENTRYWAYS

Ensure furniture and lamps are


steady and stable.

Make sure electrical cords are out


of the way.

Leave generous space to move


safely around furniture.

LIVING ROOM

Wipe up moisture or spills immediately.

Install a night-light in the hallway


and bathroom.

Use non-slip mats inside and outside


of your bathtub and shower stall.

Install grab bars in bathtubs


and shower stalls.

BATHROOM

154
Brochures

Brochures

10: Protect yourself from falls!


(Endnotes)
1. Health Canada/Veterans Affairs Canada Falls Prevention Initiative. (2002). Help
yourself to assistive devices! http://www.hc-sc.gc.ca/seniorsaines/pubs/assistive/assistive4_e.htm
2. O'Loughlin, J.L. et al. 1993. Incidence of and risk factors for falls and injurious falls
among the community-dwelling elderly. American Journal of Epidemiology, 137(3),
342-354.
3. National Osteoporosis foundation. (2001). Disease Statistics.
http://www.nof.org/osteoporosis/stats.htm
4. Statistics and trends. Prepared for the Canadian Conference on Injury Prevention
and Control by the Alberta Centre for Injury Control and Research, 2000.
5. Computations by Micheline Charest, Planning and Negotiations Coordinator,
Veterans Affairs Canada. From Table HS7A, Veterans care needs survey, Statistics
Canada, 1997. Cat. no 89-554-XPE.
6. The Hygeia Group. The economic burden of unintentional injury in Canada.
Smartrisk, 1998.

Prevent falls and


maintain your independence:

Assistive Devices to Help Prevent Falls.


A joint venture between the University of Ottawa
and the Canadian Association of Occupational
Therapists (CAOT).
For more information please visit our website at
www.otworks.ca
This pamphlet was adapted from You Can Prevent
Falls!, a Health Canada/Veterans Affairs Canada
Falls Prevention Initiative.
Funding provided by Health Canada/Veterans Affairs
Canada Falls Prevention Initiative.
The views expressed herein do not necessarily
represent the official policies of
Health Canada, Veterans Affairs Canada, the
University of Ottawa and the Canadian Association
of Occupational Therapists (CAOT).

Protect yourself
from falls!
Falls are the leading cause of fatal injuries
among Canadian seniors.
Nothing to lose, everything to gain!

Assistive devices can have a positive


impact on your mental and physical
health. By living the active, social life
you desire, you remain independent, selfconfident and positive. Use assistive
devices such as canes and grab bars
with confidence. Youll become a model
initiative and good sense for others who
are reluctant to enjoy their benefits!1

The information in this bochure is current as of 2004.


Not medical advice: The information provided in this
brochure is intended for educational purposes only.
It is not and should not be taken as advice or treatment
from a doctor or health care professional. Never
disregard professional medical or health care advice
or delay in seeking it because of something you have
read in this brochure.

1 in 3 seniors fall each year.


It could happen to you or
someone you love.
Tools for Living Well

155

156

Brochures

TIPS TO HELP YOU PREVENT FALLS


To improve your chances of keeping safe and not
falling, use the following list and post in a convenient
spot for frequent checking.
Your Health
Diet: Eat regular, well-balanced meals.

FACTS ON FALLS
Seniors' falls result in a loss of
independence. Seniors are more likely to be
admitted to hospital from an injury as a result
of a fall than any other age group. In fact,
over half (56%) of all admissions due to falls
occurred in persons 65 years of age or over.2
One in 5 older adults will die within
12 months of suffering a hip fracture.
Most of those who survive will end up in a
nursing home, using a walking aid, and/or
with restricted abilities.4
Seniors who fall are 3 times as likely of
being admitted to a long-term facility
such as a nursing home, than those
who do not fall.6
20% of deaths among seniors related to
injury can be traced back to a fall.7
NOTE:
With a restricted budget, it can be hard to find the
money for exercise classes or home improvements
such as grab bars or assistive devices. Veterans
should contact their nearest Veterans Affairs
Canada District Office to find out about programs
and services they may be eligible to receive that
can improve their well-being and help them to stay
in their home and community. Seniors can contact
the municipality, the local health centre or their local
Seniors' organization to obtain information on
services available at reduced cost or free of charge.
*You can obtain these publications free of charge
by calling 1-800-O-Canada (1-800-622-6232)

Tools for Living Well

Exercise: Be physically active every day - exercise


for strength and balance. Balance exercises,
such as Tai Chi, are very good.
Medication: Take your medications properly and
look after your health. Consult your pharmacist or
doctor to find out what your medication side
effects are. Review your medications with
your doctor at every visit.
Vision: Take your reading glasses off when not
reading. If you wear bifocals, be particularly
careful when using stairs. Have your eyes
checked regularly.
Your Home
Install assistive devices around your home such as
grab bars, non-slip surfaces and railings.
Keep your home and yard free of hazards;
pathways and steps should be free of ice, snow,
newspapers and leaves.
Get rid of any throw rugs or make sure they are
secured to the ground with a solid rubber backing.
Your Independence
Use assistive devices for walking. If you have
hearing aids or glasses, remember to wear them.
Don't forget you need all of your senses for
your balance!
Plan your outings to allow plenty of time never rush.
Your Community
Keep an eye out for dangers and hazards;
inform the proper officials of any unsafe condition.
TAKE CARE!

HIP PROTECTOR SUPPLIER LIST

Safe Hip
underwear

Hip Saver
underwear

Energy
Shunting
&
Energy
Absorbing

SEWN IN

SOFT Shell

(Does not
sell to
retailers)

$59.99

$110

$75

$59

Approx.
Purchase
Price

Information accurate as of October 1, 2003

Energy Shunting

SEWN IN

Energy Shunting

SEWN IN

Energy Shunting

HARD Shell

Belt

N/A

Not
Available

$115

$105

Suggested
Retail Price

Help Mates
Karen Brown, President
Phone: 1-888-771-0977
www.hipsaver.ca
kbrown@helpmates.on.ca

Regency Medical Supplies


(Burnaby, BC)
Allaster Campbell
1-604-434-1383
www.regencymed.com

Hip Guard
Anne Kovin, President
Phone: 1-800-299-8892
www.hipguard.net
info@hipguard.net

Hip Guard
Anne Kovin, President
Phone: 1-800-299-8892
www.hipguard.net
info@hipguard.net

Contact Information

Product and company names are listed in no particular order.


Prices listed are for base models. Please note that many companies offer more than one stylebe sure to ask for details!

Brief

Safe Hip
underwear

Hip Guard Belt

Hip Protector

Characteristics of hip protectors were drawn from supplier information and have not been objectively evaluated by our team.

Brochures

11: Hip Protector Supplier List

Tools for Living Well

157

Tools for Living Well

HIPS

Belt

Energy
Shunting
&
Energy
Absorbing

REMOVABLE

SOFT Shell

$55.65

$110

$110
(Discount
may
apply)

$65

Approx.
Purchase
Price

Information accurate as of October 1, 2003

Energy Shunting
&
Energy Absorbing

REMOVABLE

Energy Shunting

REMOVABLE

Energy Shunting

REMOVABLE

HARD Shell

$79.50

Not
Available

Not
Available

$95

Suggested
Retail Price

Briefs come in four colours:


white, black, grey & beige

D.R. Mdical
1-888-268-0778
www.dr-medical.com

Regency Medical Supplies


(Burnaby, BC)
Allaster Campbell
1-604-434-1383
www.regencymed.com

Ladies Item# ERP6672-12 (size small)


-13/14/15 (other sizes)
Mens Item# ERP6672-02 (size small)
-03/04/05 (other sizes)

ERP Group
Maria Di Pasquo
Phone: 1-800-361-3537
www.erp.ca

Professional Orthopedic Products


Martin Paul Onrot
Phone: 514-484-4441
martinonrot@sympatico.ca

Contact Information

Product and company names are listed in no particular order.


Prices listed are for base models. Please note that many companies offer more than one stylebe sure to ask for details!

Pro-Hips

Hip Protection
System

HIPS

Hip Shield

Hip Protection
System

Brief

Hip Protector

HIP PROTECTOR SUPPLIER LIST

Characteristics of hip protectors were drawn from supplier information and have not been objectively evaluated by our team.

158
Brochures

HIP PROTECTOR SUPPLIER LIST

Belt

Energy
Absorbing

SEWN IN

Energy
Absorbing

REMOVABLE

SOFT Shell

$86.75

$48.00

$54.20

$55.00

Approx.
Purchase
Price

Information accurate as of October 1, 2003

Energy Shunting

REMOVABLE

Energy Shunting
&
Energy Absorbing

SEWN IN

HARD Shell

$115

Not
Available

$93.50

Not
Available

Suggested
Retail Price

Impact Body Wear Ltd.


Ellaine Gallagher, President
1-250-474-5535
www.impactbodywear.com
impactbodywear@shaw.ca

(Item #00979)

Invacare Supply Group


1-800-225-4792
www.invacaresg.com

Catalogue #6016 Standard Brief


Catalogue #6017 Incontinent Brief
Catalogue #6018 Male Fly Brief

Canadian Hospital Specialties


1-905-825-9300
www.chsltd.com

Geriatric Protection Products


Jeff Elstad
1-800-234-8291
www.preventproducts.com
jeffe@preventproducts.com

Contact Information

Product and company names are listed in no particular order.


Prices listed are for base models. Please note that many companies offer more than one stylebe sure to ask for details!

Impactwear
Hip Protectors

Rite- Fit Hip


Protection
Garment

Gerihip brief

Posey Hipsters

Brief

Hip Protector

Characteristics of hip protectors were drawn from supplier information and have not been objectively evaluated by our team.

Brochures

Tools for Living Well

159

Tools for Living Well

Briefs

Belt

Energy
Shunting

SEWN IN
OR
REMOVABLE

Energy
Shunting

REMOVABLE

HARD Shell

Energy
Absorbing

SEWN IN
OR
REMOVABLE

SOFT Shell

$118

Suggested
Retail Price

Phone: +61 2 9477 9768


Fax: +61 2 9477 9105
klockwoo@doh.health.nsw.gov.au

Cannot be sold in Canada

HIProtector
1-800-930-9255
www.hipprotector.com

Does not sell to Canada

Impact Body Wear Ltd.


Ellaine Gallagher, President
250-474-5535
www.impactbodywear.com
impactbodywear@shaw.ca

Contact Information

Canada offers reimbursement, to eligible veterans, up to 2 pairs of hip


Blue Cross and ask for details.

$79.00

Approx.
Purchase
Price

Product and company names are listed in no particular order.


Prices listed are for base models. Please note that many companies offer more than one stylebe sure to ask for details!

Information accurate as of October 1, 2003

Assistive Devices to Help Prevent Falls.


A joint venture between the University of Ottawa and the Canadian Association of Occupational Therapists (CAOT).
For more information about this project please contact the CAOT at 613-523-2268 or www.caot.ca

Retailer information: Under the Blue Cross Program, Veterans Affairs


protectors per calendar year. To find out if your customer qualifies, call

Hornsby
Healthy Hips

KPH Hip
Protector

http://www.raunomo
.fi/index.htm

Safety Pants

Hip Protector

HIP PROTECTOR SUPPLIER LIST

Characteristics of hip protectors were drawn from supplier information and have not been objectively evaluated by our team.

160
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Related Interests