Older Adults and Their Caregivers

Background and Importance

Increasing Numbers of Older Adults and Family Caregivers: By the year 2030, the proportion of the population of Belknap County that is 65 years of age or older is projected to reach 30% - nearly double the current percentage.[1] This rapid and substantial demographic shift has profound implications for the capacity and array of health care, housing, social services and other supports needed for an aging population. As people age, they naturally look for alternatives to institutional care and ways to limit the direct costs of health care.  This demographic shift has important implications for the support needs of increasing numbers of family members who will be involved in providing regular care for a relative, partner or friend.

Older Adult Falls:  Every year about one out of three older adults (those aged 65 or older) experiences a fall, but less than half talk to their healthcare providers about it.[2] Among older adults, falls are the leading cause of both fatal and nonfatal injuries. Falls can cause moderate to severe injuries, such as hip fractures and head traumas, and can increase the risk of early death. In New Hampshire, more males than females age 65 and older are seen in emergency departments for injuries due to falls, while females are more likely to need inpatient hospitalization as a result of a fall.

As shown by the map on the next page, the rate of emergency department visits and observation stays due to falls was higher in the Winnipesaukee Public Health Region than for the state overall during the period 2005-2009.  The annual age adjusted rate in the Winnipesaukee PHR over this time period was 614.1 per 10,000 people age 65 and over compared to the NH state rate of 523.3.

The rate of hospitalizations due to falls was also higher in the Winnipesaukee Public Health Region than for the state overall during the period 2005-2009.  The annual age adjusted rate in the Winnipesaukee PHR over this time period was 146.4 per 10,000 people age 65 and over compared to the NH state rate of 133.2.

Regional Initiatives and Opportunities

The Aging and Disability Work Group is leading efforts to improve the health and well-being of older adults and their caregivers through this Community Health Improvement Plan. Existing resources and initiatives that can be built upon in this priority area include:

·         ServiceLink  Resource Center of Belknap County provides up-to-date information and assistance to help individuals and families make informed choices about health care and other services for older adults, people with disabilities and their families.

·         ServiceLink, LRGHealthcare and other community partners provide support to family caregivers through caregiver grants, support groups in local communities, caregiver website offering resources, “Powerful Tools for Caregivers”, and “Remembering When” and Chronic Disease Self-Management classes.

·         “Matter of Balance” training partners to promote falls prevention led by Community Action Program Belknap-Merrimack Counties with LRGHealthcare, Catholic Charities and Lakes Region VNA.

·         Multiple community partners working together on assessment of home environments for falls risks and reduction strategies including Municipal Fire Departments, Emergency Medical Services, Home Health providers and through support of Senior Safety Day.

Goals, Objectives and Strategic Approach

Goal 1

Support aging in place by improving services and supports for unpaid caregivers and senior companions of older adults

Objective 1


Increase the proportion of older adult caregivers who perceive having sufficient caregiving skills and emotional support

Goal 2

Prevent older adult injury, disability and death due to falls.

Objective 1

Reduce emergency department visits and hospitalizations due to older adult falls by 10% by 2020.

Objective 2


Reduce the proportion of Emergency Medical Service run activity that is related to older adult falls by 10% by 2020.

Strategic Approach

Increased Support for Aging in Place

STRATEGY 1:  increase opportunities for Peer support through the Caregiver Network. Provide respite care to caregivers to enable them to attend peer support offerings.

STRATEGY 2:  Provide information and training through expanded implementation of "Powerful Tools for Caregivers" and Chronic Disease Self-Management Programs. Connect with existing social and respite programs.

STRATEGY 3:  Increase resources for respite care. Include a focus on eliminating service gaps for low income families.

STRATEGY 4:  Increase inter-generational opportunities for social interaction and recreation (e.g. utilization of the Bessie Rowell inter-generational center in Franklin)


Prevention of Older Adult Falls

STRATEGY 1:  Train 5 lay leaders/coaches in the “Matter of Balance” curriculum. Implement “Matter of Balance” classes for older adults and their caregivers.

STRATEGY 2:  Train professionals going into homes on home environment risk assessment and strategies for falls risk reduction (e.g. FIRE/EMS, Home Health, Friendly/Home Visitors). Facilitate inter-organizational information and referrals for assistance to high risk individuals.

STRATEGY 3: Increase capacity to Implement "Remembering When" classes (from the national fire protection academy) for general adult education on protection from falls. 

Strategy 4: Increase awareness of existing resources for fitness and recreation with an emphasis on outreach to high risk older adults and caregivers. 

[1] New Hampshire Center for Public Policy Studies, Senior Housing Perspectives. March, 2014.

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