Fracture Prevention in Long Term Care (LTC)

Older adults represent Ontario’s fastest growing population. Those living in Long Term Care (LTC) are at high risk of fragility fractures (broken bones from a fall from standing height or less). Fracture rate for Long Term Care residents is two to four times that of similar-aged adults in the community. Without preventative action, financial and human costs associated with osteoporotic fractures would increase dramatically. As would the risk of re-fracture!

A framework was developed in 2007 to prevent hip and other osteoporotic fractures and improve the lives and bone health of older adults residing in long term care in Ontario. Funded by the Ministry of Health & Long-Term Care, the Ontario Osteoporosis Strategy for LTC (OOS LTC) is part of the broader Ontario Osteoporosis Strategy, and aims at increasing awareness and preventing fractures among older adults residing in long term care.

The OOS LTC provides healthcare professionals, seniors and their families’ access to quality information and resources on osteoporosis prevention & management as well as an implementation framework on the guidelines. The Strategy’s goal is to provide meaningful and useful information and the latest research and best care practices to improve bone health of older adults.

In LTC, fracture prevention initiatives have included development of fracture prevention recommendations specifically for long term care and standardized risk assessment using the Fracture Risk Scale, which will be integrated into the RAI-MDS tool.

Ontario Osteoporosis Strategy would like to thank and acknowledge Dr. Alexandra Papaioannou, a geriatrician with Hamilton Health Sciences and professor, department of medicine at McMaster University in conjunction with a team of researchers and health care providers and Osteoporosis Canada’s Scientific Advisory Council (SAC) for their tremendous work and efforts in developing the 2015 Osteoporosis Long Term Care Recommendations & Guidelines which has helped increase awareness and prevent fractures among frail older adults residing in long term care.

Since 2007, the OOS LTC has engaged in outreach activities in Ontario to increase uptake of evidence-based osteoporosis/fracture prevention strategies in long-term care homes with a focus on:

• Falls Prevention - preventing unnecessary fractures from falls and handling during care
• Low-cost Interventions - providing information about the simple low-cost care interventions
• Knowledge Dissemination - educating health care providers working in LTC about fracture risk and prevention
• Knowledge Translation - developing awareness-raising resources and clinical tools to support fracture prevention
• Pain Reduction - reducing the pain and suffering from osteoporosis and fractures
• Vitamin D & Calcium intake - educating residents, their families and health care professionals working in LTC on the importance of appropriate vitamin D and calcium intake