Fall Prevention Center of Excellence

CDC Fall Prevention “Podcasts” on the Internet

First there were websites, then we learned about “blogs”, and now it is “podcasts” that allow fast dissemination of information online. For example, the Centers for Disease Control (CDC) maintain on their website a special “podcasts” section where internet users find information on a wide variety of health issues. Most recently, the CDC presented the podcast “Preventing Older Adult Falls”, authored by the National Center for Injury Prevention and Control (NCIPC) and published by the Morbididty and Mortality Weekly Report (MMWR). The two and a half minute podcast is available at http://www2a.cdc.gov/podcasts/browse.asp by selecting “Falls - Older Adults” under “Topics”.

The podcast outlines the severity of falls among older adults, identifies risk factors for falls, and suggests ways to prevent falls among individuals at greatest risk for falling. The CDC hopes to increase the circulation of knowledge on health issues by using podcasting technology. A podcast is essentially a media file (usually audio only) that can be played on a desktop, laptop, or portable music device. The podcasts posted by the CDC are free and include transcripts of the podcast files. CDC podcasts can also be saved to a computer for later use.

The CDC opted for podcasts in order to limit the production of paper pamphlets. “Young” older adults – ages 60 to 65 – who use the internet frequently as a source of information may become podcast users with very little training. Individuals with modest or no prior exposure to the internet may be less enchanted with the new technology.

Aging in Place, Housing and the Law

USC gerontologist delivers 2008 Anne F. Baum Memorial Elder Law lecture at the University of Illinois College of Law. More Information...

The Veterans Health Administration (VHA) will present a lecture on gait and balance disorders in the elderly on March 27th at 12:00pm PST as part of an ongoing collaborative audio-conference series .
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FPCE At GSA 2007 in San Francisco, CA

From November 16th to the 20th, staff members of the Fall Prevention Center of Excellence attended this year's Gerontological Society of America's yearly meeting.
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FPCE's Carrie Greer Interviewed on Social Services Corner

Minnesota Governor Tim Pawlenty had declared September 23rd, the first day of fall, as Fall Prevention Day in the state of Minnesota. By bringing awareness to falls, the governor hoped to reduce the number of falls and the severity of injuries.

Click To Read the Proclamation
MN Falls Prevention

Archstone Foundation Awards Phase II of the California Senior Fall Prevention Projects

The Archstone Foundation proudly announced the approval of 14 grants under the Fall Prevention Initiative. Of these 14 grants, thirteen are included in Phase Two of the California Senior Fall Prevention Projects. The projects that received these grants will work towards reducing the risk of falls in the elderly.

Click To Read the Press Release

After a series of falls due to unsafe sidewalks in the Little Tokyo area, elderly residents began circulating a petition urging local politicians to make changes. Councilwoman Jan Perry and Public Works Board President Valerie Shaw responded with large improvements being made.

Journal of the American Geriatrics Society Release New Article Pertaining to Falls

A new article released in the April 2007 issue Journal of the American Geriatrics Society explores fall prevention programs and the quality of life for those who fall.

A new act is being presented to Congress in an attempt to gain support for a national approach to reducing falls in the elderly population. The bill, named the “Keeping Seniors Safe From Falls Act of 2007”, outlines many different tools planned to be used in hopes of raising fall awareness and knowledge.

USC Davis School Researchers Present at the Nation’s Largest Convention on Aging

Experts from the USC Davis School and its research component, the USC Andrus Gerontology Center, made a strong showing at the 2007 American Society on Aging (ASA) and National Council on Aging (NCOA) joint conference held March 7 through 10th in Chicago.

In an article from the Eureka Reporter, journalist Carol Harrison reports that the awareness of falls in the aging population is increasing but facilities have yet to gain the ability to meet the needs of an elderly population of over 22,000 people. While strength exercise and training have helped reduce the risk of falls, balance, vision impairment, and disease have been over looked as causes for falls and related injuries in the elderly. This will attribute to the 43.8 billion dollars in projected costs by government and health programs by the year 2020.

A study recently released focuses on the causes and problems associated with outdoor falls. The study, released through the American Journal of Public Health, surveyed a population of 2193 middle aged to elderly men and women from different ethnic groups.

The results showed that outdoor falls were some of most frequent types for those who fell. Sidewalks, curbs, and streets were the most common causes, while white, younger, more educated men were the most likely to fall outdoors from those who were surveyed.

SACRAMENTO - Gov. Arnold Schwarzenegger on Tuesday appointed a former assemblywoman who was defeated in the November election to head the California Department of Aging.

Lynn Daucher, 60, a Republican from Brea, chaired the Assembly's Committee on Aging and Long Term Care during her six years in the Assembly. Her run for the state Senate failed in November when she was defeated by former Assemblyman Lou Correa, D-Anaheim, in the Senate's tightest race.

Daucher is a member of the baby boom generation, which will make up a quarter of the state's population by 2010, Schwarzenegger said in his announcement.

"Lynn has been a strong advocate for California's seniors, and I look forward to her ideas on how the state can better serve that population," the governor said in a statement.

The Department of Aging is part of the California Health and Human Services Agency. It administers senior centers and services that include home-delivered meals, protection of the elderly, adult day care and Alzheimer's day care.

Daucher replaces the department's chief deputy director Lora Connolly, who has been acting director since Oct. 2004. Connolly returns to the No. 2 position at the department.

"The administration was always looking for a permanent person to fill this position, and we weren't able to find a person to fill the skill set we were looking for until now," Schwarzenegger spokeswoman Sabrina Lockhart said, adding that Connolly had done "a terrific job."

Daucher, a former elementary school teacher, previously served on the Brea City Council and school board, among other local government posts.

Falls and fall related injuries among older adults are growing public health issues, which can be addressed in part by promoting a safe home environment. The National Council on Aging in collaboration with the Falls Free™ Coalition is seeking to identify and promote ten Creative and Best Practices in Home Safety Assessment and Modification that serve to address fall risks and that are linked to, or part of, a more comprehensive fall prevention intervention. They are looking to promote programs or services that make a difference in the lives of the older adults they serve. In addition to national prominence, selected programs will receive a cash award and certificate. The self-nomination process is simple using an easy to complete survey tool available on the web through the month of January (Click Here).

Physical inactivity, depression and falls all increase risk of developing a disability in later life. But targeting falls may be a particularly effective way to reduce the nation's disability levels, according to a new study.

Fall-prevention efforts that combine education about risks with exercise, home safety and health assessments offer the most promise, at least in the short run, found researchers led by Vicki Freedman, Ph.D., a professor at the University of Medicine and Dentistry of New Jersey.

Freedman and her colleagues compared three strategies to reduce late-life disability: increasing physical activity, identifying and treating depression and avoiding falls. Their findings, published in the current issue of The Milbank Quarterly, arise from a review of more than 100 intervention studies.

The review found that fall prevention efforts targeted at frail adults can reduce the risk of falling and related injuries by about 25 percent. Community-wide efforts that have been tested abroad were shown to reduce fall-related fractures by 6 percent to 33 percent.

“Both medical and environmental aspects of disability need to be addressed in a disability prevention program,” Freedman said. “Approaches that recognize the complexities of disability appear to be more successful than those that address only a single factor.”

About one-third of people aged 65 or older - or nearly 12 million people - experience falls, said Freedman. Of these, about 20 percent to 25 percent experience severe injuries or limitations.

Traditional health insurance programs may address medical aspects of a disability, but they rarely fund home safety changes or assistive technologies that may help an older adult live independently. The researchers call for additional research that considers how best to finance and deliver a multicomponent disability prevention program.

“Ideally, such an effort should consider not only which components to target, but also which audiences to target - older adults, their families, providers or perhaps entire communities.”

Freedman said she was surprised how little evidence she and her colleagues could find about the likely long-term effects of different intervention strategies. Most studies lasted less than a year. This scarcity of evidence is significant, she said, because conclusions about the long run could be very different.

Jon Pynoos, Ph.D., co-director of the Fall Prevention Center of Excellence, said that the review correctly identified medical risk assessment/management, physical activity and environmental modifications as the “big three” interventions capable of significantly reducing falls.

“Now we need to create ‘real-world' programs that combine these elements and make them available to persons at moderate to high risk of falls who need them,” he said.

Pynoos said that one challenge is coordinating components from various fields - such as medicine, exercise and home modifications - with different eligibility requirements, reimbursement systems and approaches. It is also important to understand what “dose” effect or level of each intervention is needed to have an impact, he said.

“At the Fall Prevention Center of Excellence, we are working to create sustainable community-based programs that will serve as models that can be replicated in various settings,” Pynoos said.

Freedman VA, et al. Promoting declines in the prevalence of late-life disability: comparisons of three potentially high-impact interventions. The Milbank Quarterly 84(3), 2006.

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Bed Safety is a priority when it comes to fall prevention for older adults. Metal bedrails that run along the side of the bed are commonly misused as a means to protect people against falls. Due to the difficulty associated with getting into and out of the bed, bedrails often lead to entrapment and other hazards.

Many people have little or no knowledge about dangers in and around the bed that give seniors and people with disabilities a false sense of safety. The Food and Drug Administration along with the Centers for Medicare/Medicaid Services want the use of ineffective products such as bedrails to be eliminated when safer, more effective alternatives are available.

Falls are the leading cause of unintentional death for those 65 and up. Last year, according to the Center for Disease Control, there were 1.8 million emergency room visits and over 420,000 hospital admissions of those 65 and over from falls. Beds are second only to stairs/steps as the leading cause of fall deaths according to the Consumer Products Safety Commission (CPSC).

Builders, designers and those working with government agencies and providers need to be aware of safety issues around the bed. An effective home modification strategy is the best means to deal with the problem. There is no one-size-fits-all solution. However, some universally designed products can work towards a safer, healthier living environment.

Educate to stop the use of ineffective, cheaply made devices that lack integrity and have safety issues. When it comes to bed safety, the status quo should not be based on speculation and theory. Instead bed protection should be based on universally designed products that benefit the user.

Health and Human Services announced today it will offer $1.75 billion over five years to states who help shift Medicaid patients from institutions to home and community-based services.

Through competitive grants, the Centers for Medicare & Medicaid Services (CMS) will fund states to help shift Medicaid from its historical emphasis on institutional long-term care services to a system that offers more choices for senior citizens and persons with disabilities from all age groups, including home and community-based services.

This Money Follows the Person “rebalancing” initiative was included in the Deficit Reduction Act of 2005 (DRA) currently being implemented by CMS. This endeavor is also a part of President Bush's New Freedom Initiative.

“With this program, people who need long-term care and prefer to live in their own homes and communities can do so,” HHS Secretary Mike Leavitt said.

“States will also get more for their money by giving the elderly and people with disabilities more control over how and where they get the Medicaid-funded long-term care services they need.”

“We’ve worked with advocates and states for years to end the institutional bias in Medicaid, and now we’ve got the best opportunity ever to do it,” said Mark B. McClellan, M.D., Ph.D., CMS Administrator. “We need to move as quickly as possible to make that shift across Medicaid. With new Federal funding, there is no longer any excuse for the status quo.”

States interested in applying for a “Money Follows the Person” grant can propose new programs to CMS that are aimed at sustaining people in their homes or communities who would have otherwise received care in a nursing home or other institution.

The qualified expenditures may be eligible for an enhanced match rate from the federal government equal to an increase of 50 percent of the usual state Medicaid percentage contribution in addition to the usual match rate.

In effect, the federal government will pay for 75 to 90 percent of the costs of transitioning individuals out of nursing homes and into community settings, and the associated long-term care benefit costs. Grant funds may also be used to help control how they receive these services.

The higher matching rate will be applied to certain services provided to an individual for a one year period after the individual moves out of an institution and into the community. Funds can be used not only for alternatives to institutional care services, such as home health care; they can also be used for home modification costs, respite services to augment informal or unpaid caregivers, personal care and assistive devices. In their applications, states are encouraged to coordinate with local and state housing authorities to provide coordinated assistance for community-based housing needs.

CMS and the Department of Housing and Urban Development (HUD) have made steps to establish a new interagency liaison to support this coordination.

“We know that accessible, affordable, integrated housing is critical to a person's ability to make the transition into the community, HUD Secretary Alphonso Jackson said. “My agency will strongly urge the Public Housing Agencies and Housing Finance Agencies in the states to work collaboratively with Medicaid programs to help create opportunities for those moving out of institutions into the community.”

Each state awarded a grant must continue to provide community services after the year of enhanced match as long as the person needs community services and is Medicaid eligible. The deadline for the first year’s applications is Nov. 1, 2006. Demonstration grants will be competitively awarded to states from Jan. 1, 2007 through Sept. 30, 2011. Funds will be available for a five-year period; however, states must participate in the demonstration for a minimum of two consecutive years.

The Medicaid program traditionally pays for care for persons who are elderly and those with disabilities living in institutions who needed help with activities of daily living, because institutional care was the norm when the Medicaid law was enacted forty years ago.

To provide home and community-based services, states must get a “waiver” of normal program rules designed to pay for care in institutions. Waivers and demonstration programs offer the promise of significantly lower costs per beneficiary and reductions in overall Medicaid spending as a result of giving individuals control over how to get their services, rather than requiring them to use institutional care in order to get Medicaid long-term care benefits.

But rebalancing Medicaid coverage may have some short-term costs, which the new federal program enables states to overcome.

In addition to the Money Follows the Person initiative, the DRA made many changes in Medicaid that will allow states to add home and community-based services to their permanent array of benefits without having to go through the waiver process. For example, under another DRA provision, states now have the option to provide home and community-based services without needing a waiver.

“Even though personal control leads to better results and lower costs for people with a disability, it’s still true today that most elderly or disabled enrollees do not have a choice about how they get their long-term care services under Medicaid,” said Dr. McClellan.

“By working with states, advocates, and Medicaid enrollees to take advantage of these unprecedented opportunities, that’s going to change."

A copy of the “2006 Money Follows the Person Rebalancing Initiative Demonstration Program,” including the application forms, can be obtained at www.grants.gov. For more details about the New Freedom Initiative, visit the CMS Web site at: http://www.cms.hhs.gov/NewFreedomInitiative/.

Nancy Makay is a universal design consultant. Her customers are people who require home modifications in order to accommodate special living needs.

Based in Erie, Pennsylvania, she started her company, Live with Ease: Universal Design Consulting, shortly after completing the online Executive Certificate program from the University of Southern California Andrus Gerontology Center in 2003.

The following year, her first clients were a husband and wife in Texas who contacted her after reading an article she published in the magazine Real Living with Multiple Sclerosis. The wife was suffering from MS, and their bathroom needed to be modified in order to give her more space. Ms. Makay suggested a walk-in shower replacing the Jacuzzi bathtub. She also advised a higher toilet to make it easier for the wife to sit and stand. She performed the entire job remotely, sending specifications via email and communicating with the husband over the telephone.

Washington, D.C. – Representatives Ralph M. Hall (R-4th TX) and Frank Pallone (D-6th NJ) have introduced H.R. 5608 the Keeping Seniors Safe from Falls Act of 2006 in the U.S. House of Representatives. The bill addresses the growing public health problem of falls and fall-related injuries among older adults and focuses on preventing the 12,900 senior deaths and 1.8 million senior emergency room visits that occur each year.

The Falls Free Coalition Advocacy Workgroup, consisting of the National Council on the Aging (NCOA), the Home Safety Council (HSC) and the National Safety Council (NSC), commend Representatives Hall and Pallone for their leadership on such an important safety and health issue.

Study results suggest that modifying the home and behavior can ameliorate home hazards and fear of falling.

A recent study in the Journal of the American Geriatrics Society (JAGS) reports that implementing appropriate home modifications and behavior changes among older adults can improve their quality of life.

Dr. Jon Pynoos Reports to USC faculty and students on the 2005 White House Conference on Aging

On Thursday, April 6, at the University of Southern California’s Hamovitch Research Center, The California Social Welfare Archives presented a synopsis of the 2005 White House Conference on Aging (WHCoA). Held every ten years, the WHCoA took place from December 11 -14th in Washington D.C.

Debra Rose Receives 2006 Health Promotion Institute’s Best Practice Award from the National Council on Aging

USC Fall Prevention Center Sends Three Representatives to The International Conference On Aging, Disability and Independence in St. Petersburg, Florida, February 1-5, 2006

The International Conference on Aging, Disability and Independence (ICADI) was held in St. Petersburg, Florida from February 1 – 5, 2006. The aim of the conference was to help people around the world to maintain their independence by practicing healthy behaviors and health promotion activities as they age. Symposiums were presented on the use of assistive technology, home modifications, products that follow the principles of universal design and successfully adapting the workplace environment. The event brought together researchers, practitioners, business leaders and aging policy experts from all over the world.

Dr. Jon Pynoos, Co-Director of the Fall Prevention Center of Excellence and professor at the USC Leonard Davis School of Gerontology, was featured in a recent New York Times article entitled, "Aging at Home: For a Lucky Few, a Wish Come True." The story, which ran on Thursday, February 9, 2006, examined the brief history of the Beacon Hill Village, a nonprofit organization based in Boston, Massachusetts that was created by and for local residents determined to grow old in familiar surroundings.

Beacon Hill Village originated five years ago as the brainchild of a dozen civic-minded residents of the rustic 19th-century neighborhood. They wished to remain at their homes and independent from adult children when everyday activities such as household chores and transportation became too difficult.

The organization, which has benefited from advocates at the nearby Harvard Business School and other grants from wealthy members, now has 340 members ages 52 to 98, and an annual budget of $300,000. The yearly fee for members is $550 for an individual and $780 for a household, plus the additional cost of other services. But the question remains, writes author Jane Gross, whether or not similar, residential based, assisted living communities could flourish in lower income neighborhoods.

Leonard Davis School of Gerontology professor Jon Pynoos asserts that funding may be available for elderly communities in other, less affluent, areas through federal and state pilot programs that support seniors at home. He points to the United States Administration on Aging, which is currently paying for service coordinators at 60 "naturally occurring retirement communities," or NORCÕs. Even state Medicaid programs are giving vouchers to help purchase home care services, the article states, when Medicaid has historically been limited to nursing homes.

To view the full-text article please click here

In order to prevent falls among older adults the Vancouver Coastal Health plans to spend $700,000 to the first year of a five year fall prevention program. There goal is to reduce fall-related injuries by 20 percent in 2010.

The safe environment prevention program will target seniors in Vancouver who live in either their own homes or in a residential and acute care institution.

Every year approximately one third of all British Columbia older adults have a falling accident. According to the Vancouver Coastal Health every year approximately one third of all British Columbia older adults have a falling accident which results to about 3,000 hip fractures, 1,000 deaths and 10,000 hospitalizations.

In Western Australia, the Royal Perth Hospital uses nursing assessments and care planning in order to prevent senior adult falls.

A group at RPH which composed of nurses with aging care and medical division experience, research nurses, and an aged care physiotherapist conducted a study to develop an approach to falls prevention. There assessment is done through Falls Risk Assessment Tool (FRAT), an idea the group created.

A total of 1357 patients over 65 years with an average admission time of eight days was a part of this study. These patients that were apart of the study was rated as low, medium or high falls risk. At each risk category, a specific amount of attention was paid to that physical environment, patient mobility and communication and elimination needs.

FRAT currently consists of five components: assessing the risk; criteria for identifying patients at risk; assessment; planning interventions and reassessment.

After the implementation of FRAT there were 80 percent less cases of falls injury within the hospital in comparison to the year before.

Aging is associated with changes to the structure and function of the foot and ankle, and there is preliminary evidence that foot problems impair balance and increase the risk of falls.

A study determines the relative contribution of several foot and ankle characteristics to performance on a range of balance and functional tests. One hundred seventy-six people (56 men and 120 women, mean age 80.1 years, standard deviation 6.4 years) residing in a retirement village underwent tests of foot and ankle characteristics (including foot posture, range of motion, strength, and deformity), sensorimotor function (including vision, sensation, strength, and reaction time), and balance and functional ability (including tests of standing balance, leaning balance, stepping, sit-to-stand, and walking speed). Many foot and ankle characteristics and sensorimotor measures were associated with performance on the balance and functional tests in univariate analyses.

Multiple regression analysis consistently revealed that ankle flexibility, plantar tactile sensitivity, and toe plantarflexor strength were significant and independent predictors of balance and functional test performance, explaining up to 59% of the variance in these test scores. Foot and ankle characteristics, particularly ankle flexibility, plantar tactile sensation, and strength of toe plantarflexor muscles, are significant independent predictors of balance and functional ability in older people.

Programs to improve the strength and flexibility of the foot and interventions to augment plantar sensation may be beneficial in improving mobility and reducing the risk of falls.

According to Michael Norris, the coroner of Cumberland County, in 2005 there were over 10 seniors whose deaths were falls related accidents, a 19 percent increase from 2004.

Most of these falls were caused in the victims’ homes and falls were the leading cause of accidental deaths in 2005.

Several of the counties in Pennsylvania are questioning whether increase safety education should be a top priority for the county. Although fall prevention public messages have been circulated for years, people in the past have usually ignored these warnings.

Barry Bloss, the coroner of York County travels to various nursing homes and retirement communities to discuss the dangers of falls. This past year there were over 32 falls related deaths in York County.

ORLANDO, Fla., Nov. 4 /PRNewswire/ -- A scientific peer-reviewed paper entitled Posturographic Changes and Fall Prevention Associated with Music Therapy: The Nolwenn Effect (USA ClinicalTrials.gov Identifier: NCT00121693) is featured at the 7th Annual American Music Therapy Association Conference in Orlando, Florida, Nov 15-20, 2005. This major conference attracts participants from around the world. Falls are a serious health issue and are the greatest cause of death in the elderly, a leading cause of morbidity and mortality among children and a common cause of serious infant injuries, all of which are commonly associated with neurological syndromes.

Drs. Elena Ogerro, Guido Pagnacco and Frederick Carrick are the investigators of a year-long study in which they used a variety of music from Mozart and different popular singers while they recorded changes in postural stability and the possibility of falling in a large multi-blinded controlled brain-based clinical trial. Dr. Pagnacco noted, "The prevention of falls allows us to save lives, and the use of music, especially that of Nolwenn Leroy, increases human stability." Dr. Elena Ogerro stated that the "study began after observations of positive behavioral and postural changes in a young autistic boy listening to the music of Nolwenn Leroy, a French singer. These changes would stop when other music was played and were only present with songs by Nolwenn Leroy."

Music is used in a variety of neurological applications. Professor Carrick explained, "When patients with severe dementia listen to background music playing or caregiver singing, there are strong influences on both body and sensory awareness resulting in straightened posture, stronger and more symmetric movements, and a greatly increased awareness of themselves and their environment. When individuals listen to music, there is activity in the motor-related structures of the brain, specifically in lateral premotor areas, supplementary motor areas, and somatomotor areas."

Because of the statistically significant changes observed with the Nolwenn Leroy group, they thought the effect might be due to listening to French singers, but this was proven not true. They found that there was improvement in stability scores for all French and U.S. singers used in the study but not in the control group. Thus, they concluded that the procedure of listening to music each day appears to have a positive effect regardless of the artist with some music (Mozart and Nolwenn Leroy) having superior outcomes.

Only Mozart and the Nolwenn Leroy conditions improved a substantial percentage of the subjects to the normal stability range. The success rate for the Nolwenn Leroy treatment conditions was greater than Mozart and all other music at 71.8% plus/minus 10.7%. If repeated samples were drawn from the population, the expected success rate for the Nolwenn Leroy treatment conditions would fall between 61.1% and 82.5% for 95% of those samples.

Interestingly, the doctors found hundreds of subjects without any symptoms of disequilibrium or vertigo to be at severe risk of falling when tested with dynamic computerized posturography. Early detection of fall probability can lead to treatment before a fall occurs. The researchers have named the effects of postural changes after music listening the NOLWENN EFFECT. They stated that the use of music in applications of human stability and fall prevention is an inexpensive modality that might contribute to change in the clinical practice of neurology and society in general.

The Coalition for Housing Opportunities In the Community for Everyone (CHOICE) collaborated with Rolling Productions made a 25-minute film that chronicles 8 different accessibility success stories in which people with disabilities in Northern Virginia gained freedom and independence through various modifications funded by a state grant.

One of the first clips of the film is a man who is unable to use his own bathroom because it was now inaccessible due to using a wheelchair following a spinal cord injury. However, with help from CHOICE, ten days later his bathroom transformed into a model of accessibility.

In another clip, a woman diagnosed with cerebral palsy is trapped inside her home when her friend or family was not there to help her up and down a steep wooden ramp outside her home. After CHOICE came in, the woman had an aluminum ramp so that she can steer her electric scooter in and out of her home unassisted.

Several different types of home modifications were used in the process such as camera monitoring and door-opener systems, roll-in showers, and wood or aluminum ramps. All these equipments at home enabled the recipient to look for employment.
CHOICE is a private non-profit organization was created in 2002 by Fatima Miller who is diagnosed with MS and Neel Ellis. The video was inspired by her personal experiences to find adequate and affordable housing due to her MS.

The video has become a great way to create awareness in the importance of affordable, accessible housing opportunities for people with disabilities. The documentary continues to air on Fairfax County Government Channel 16.

This project was originally intended to help five people in Northern Virginia but that number increased to eight people and now there is currently $1,000 available for a ninth home modification.

In 2003 CHOICE received a $100,000 grant for the Virginia Department. The purpose of CHOICE is to fund home modifications for those with disabilities who could not work because their homes were inaccessible.