This document discusses bone health and falls prevention for people with intellectual disabilities. It summarizes research finding higher rates of osteoporosis and falls among this group compared to the general population. It then outlines an osteoporosis awareness campaign at St. Michael's House including staff education, patient referrals for bone density scans, and lifestyle improvements. It also describes the development of educational resources called "Happy Bones" and "Best Foot Forward" to promote bone health and falls prevention among people with intellectual disabilities.

1. Happy Bones
are Healthy
Bones
Anne Spencer,
Educational Technologist,
Partners in Education, Teaching
And Learning (PETAL)
Daragh Rodger,
ANP, Older Adult Community
St Mary’s Campus
Lorraine Ledger
CNM3,
St Michael’s House
RNID Section Conference - 22nd November 2016

2. Background
• St Michael’s House, Osteoporosis
Awareness Campaign 2011
• MDT input
• Doctor
• Nurse
• Physiotherapist
• Dietician
• Education sessions for all staff
• Leaflet and mail shot to families
• Generic referral letter for DXA Scan

3. Why Is It Important?
Greater risk factors for
people with an ID from a
young age due to :
• Specific Syndromes
• Co Morbidities
• Immobility
• Adverse effects of
medications
• Vitamin D deficiency
• Protected lifestyles

4. Advancing Years Differing Challenges – Wave 2
IDS-TILDA
Prevalence of Osteoporosis
http://www.idstilda.tcd.ie/assets/pdf/Wave_2_Report_October_2014.pdf
People with
Intellectual
Disability
General
Population
Age 35% 28%
Age 50-64 36.8% 8%
Prevalence of Osteopenia
37% 14%
7 out of 10 people with an intellectual disability have
either osteopenia or osteoporosis
Osteoporosis is the most common non-cardiovascular chronic disease in the Intellectual Disability
population

5. Advancing Years Differing Challenges – Wave 2
IDS-TILDA
Prevalence of Falls
http://www.idstilda.tcd.ie/assets/pdf/Wave_2_Report_October_2014.pdf
People with
Intellectual
Disability
General
Population
Age 40-49 22.7%
Age 50-59 33% 17.6%
Age 75+ 24.6%
Recurrent Falls 15.3% 8.8%
Injurious Falls 13.7% 9.9%

6. St Michael’s House DXA Results
70% demonstrate some degree of
bone thinning

7. • Supplements and
treatments prescribed
• Dietary improvements
• Exercise programmes
• Carer’s are generally more
bone health aware
• Follow up Dexa scans –
this year 2015
Actions

8. Gap in Service Delivery
• Recognised need for education
for all regarding bone health and
falls prevention in those with an
intellectual disability – “Bone
Health is a lifelong process”
• Blinkered vision – some units in
St Michael’s House
• Linked with ANP in St Mary’s
Healthy Ageing Clinic who had
developed bone health in the
park www.bonehealth.co

9. Forever Autumn COP
• Areas represented:
① Acute
② Community
③ Residential
④ Palliative Care
⑤ Intellectual Disability
• Expressed interest from Intellectual
Disability sector
• No education available nationally
• PhD work by Sinead Foran (WIT) &
Eilish Bourke (TCD)
• Facts from TILDA Report

10. Bone Health in Intellectual Disability
• Commenced work with St Michael’s House Aug 2014 to develop
educational resource on bone health for service users, carer’s, key
workers and health care professionals
• Built on existing work and created ‘Happy Bones’
• Collaborated with MDT in St Michael’s House with representation from
Nursing, Medicine, Dietetics and Physiotherapy

11. Falls Awareness in Intellectual Disability
• Worked with staff and service users from Daughters of Charity Disability
Support Services, in 2015, to develop educational resource on falls awareness
for service users, carer’s, key workers and health care professionals
• Built on existing work and created “Best Foot Forward”
• Collaborated with MDT in St Joseph’s Care Centre, Clonsilla & St Vincent’s
Care Centre, Navan Road with representation from Nursing, Pharmacy and
Physiotherapy

12. Bone Health in the Park
www.bonehealth.co/ebonehealthOver 40,000 visits

13. • Collaborative exercise
• Pragmatic approach to design & delivery
• Online - accessibility & equitability key considerations
• Open access – staff, families, carers and the public
• Suitable for mobile devices and differing platforms
• Bite size ‘nuggets’ of learning
Design & Delivery
• Happy Bones – Exercise and Healthy Eating Booklet
• 3 short films - Paula’s Story, Having a DXA Scan, Chrissie’s
Story
• Easy Read Information Leaflet
• Best Foot Forward – Falls Awareness Booklet

14. Happy Bones
Paula’s Story (& Una!) Chrissie’s Story –
Best Foot Forward
www.happybones.ie

15. www.happybones.ie

16. A special thanks to the ‘stars’ of Happy Bones

17. Whoislookingatus?
Web Site - 4,500 page views in 1 year
International audience
YouTube
Paula’s Story over 225 views
Chrissie’s Story over 100 views
SlideShare
Best Foot Forward over 360 views &
downloads

18. NextSteps?
Falls Prevention Programme
• Screening / Falls Risk
• Multifactorial assessment
• Falls Prevention & Management Policy
Aim would be that “ Happy Bones”
will be adopted nationally and
become synonymous with healthy
bones and falls prevention for the
Intellectual Disability population
within Ireland
1
2

19. Web Sites:
www.happybones.ie
www.bonehealth.co
Facebook: Happy Bones & eBonehealth
Contact Us:
daragh.rodger@hse.ie
lorraine.ledger@smh.ie