Webinar - Fracture Prevention in LTC

This webinar has been developed and certified by the Ontario Osteoporosis Strategy for Long-Term Care. The OCFP is pleased to provide logistical support to enable its online delivery.

Program Description

Frail older adults at high risk for fracture in long-term care (LTC) face multiple challenges. Over 40% suffer from dementia, a similar percentage experience swallowing difficulties and over 20% may have renal insufficiency. It may be difficult to identify residents at high risk of fracture, as the current fracture risk assessment tools have not been validated in LTC, where residents are more dependent, frail and vulnerable requiring more complex care than community dwelling older adults. While there are many interventions intended to reduce fracture risk, such as osteoporosis therapy, calcium and vitamin D supplementation, falls prevention and exercise prescription, these are not used consistently in long-term care. Historically, clinical practice guidelines for osteoporosis have focused on the care of adults living in the community.

In 2015, fracture prevention recommendations were launched specifically for LTC. This program aims to address existing care gaps by illustrating the application of pharmacological and non-pharmacological fracture prevention recommendations with frail older adults in LTC. These treatment recommendations, which were developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, integrate falls and osteoporosis assessment, taking into consideration lifespan, renal impairment, and simultaneous risk of falls and fractures.

Case study presentations will illustrate key issues associated with implementation of the guidelines and best approaches to managing LTC residents at high risk for fracture. The program will also identify barriers and enablers to implement the recommendations (based on previous studies) and will provide examples of how to implement these based on research approaches that have been previously implemented and evaluated in the long-term care setting. This program will present a comprehensive approach to deliver non-pharmacological and pharmacological therapies to reduce immobility, pain and transfers to hospitals while improving the quality of life of residents in LTC.