Tim Joss Chief Executive and founder of AESOP:
Well-evidenced but not working – a story of older people’s falls.
Picture someone in their 80s. Someone you know. Suppose they have a bad fall. Worse – they’re on their own, they’re in pain, they can’t get up, and they can’t reach a phone.
Older people’s falls cost the NHS £2.3 billion per year. They are the most frequent and serious type of accident in people aged 65 and over. They can be traumatic, destroy confidence, increase isolation and reduce independence. After a fall, an older person is 50% likely to have seriously impaired mobility and 10% will die within a year.
The health system’s response is ‘falls prevention’ – a mix of treating medical conditions, reducing hazards in the home and – what this story is about – exercise to improve strength and balance.
There are two well-evidenced exercise programmes. One of them is called ‘Otago’. This is for frailer people who have had several, severer falls. The evidence base is strong. Otago has been the subject of over 50 randomised control trials. It reduces falls by an impressive 35%.
But there are problems. As the Royal College of Physicians’ Clinical Falls Lead commented to me, falls prevention exercise programmes are ‘dull as ditchwater’. For some older people the 50 hour exercise programme is fine. However, many don’t want to do them. If they are recruited, many don’t stick with the programme. And there are few maintenance programmes, with the result that the improvements in strength and balance disappear within a year or two. A lot of precious health funding is being wasted.
To help with this, AESOP has drawn on the artistic
and social qualities of group dancing (creative, expressive, joyous and celebratory) to offer a promising alternative called ‘Dance to Health’.
We have already demonstrated that the worlds of dance and older people’s exercise can talk to each other. The first 12 dance artists have been trained to deliver the Otago programme.
This isn’t a compromise between dance and exercise. It is high quality creative dance delivered in partnership with Arts Council England-funded dance organisations who are experienced in working with older people. All the Otago features are embedded within the dance activity and AESOP has quality assurance arrangements to ensure that Dance to Health is true to Otago.
Pilots are beginning now. There will be 10 in total across London, Cheshire and Oxfordshire. They will culminate in a celebratory dance performance by Dance to Health participants in the Royal Festival Hall on 5 February next year.
The evaluation programme will study the pilots’ processes. Outcomes for the older people will be measured: falls, GP visits, loneliness, group identification and mental health and wellbeing via the WEMWBS scale. The cost-effectiveness of Dance to Health will be assessed. The aim is for Dance to Health to be sustainable and able to grow. Market research and social enterprise modelling are planned to find the right business model.
AESOP deploys the arts’ power to deliver robust, measurable social outcomes. Its approach is to start with challenges/ unmet needs in society. It then scans all artistic options to create something of high artistic quality, suitable, evidence-based, cost-effective and sustainable