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Article
Publication date: 14 November 2019

Kim Lombard, Laura Desmond, Ciara Phelan and Joan Brangan

As one ages, the risk of experiencing a fall increases and poses a number of serious consequences; 30 per cent of individuals over 65 years of age fall each year. Evidence-based…

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Abstract

Purpose

As one ages, the risk of experiencing a fall increases and poses a number of serious consequences; 30 per cent of individuals over 65 years of age fall each year. Evidence-based falls prevention programmes demonstrate efficacy in reducing the rate and risk of falls among older adults, but their use in Irish occupational therapy practice is unknown. This study aims to investigate the implementation of falls prevention programmes by occupational therapists working with older adults in Ireland.

Design/methodology/approach

A cross-sectional survey was used to gather data on the use of falls prevention programmes among occupational therapists working with older adults in any clinical setting across Ireland. Purposeful, convenience and snowball sampling methods were used. The Association of Occupational Therapists of Ireland acted as a gatekeeper. Descriptive statistics and summative content analysis were used to analyse quantitative and qualitative data, respectively.

Findings

In all, 85 survey responses were analysed. Over 85 per cent of respondents reported “Never” using any of the evidence-based falls prevention programmes. The “OTAGO” Exercise Programme was the most “Frequently” used programme (9.5 per cent, n = 7); 29 respondents reported using “in-department” developed falls prevention programmes and 14 provided additional comments regarding current falls prevention practices in Ireland.

Originality/value

In the absence of Irish data on the subject, this study provides a benchmark to describe the use of evidence-based falls programmes by Irish occupational therapists with older adults.

Details

Irish Journal of Occupational Therapy, vol. 48 no. 1
Type: Research Article
ISSN: 2398-8819

Keywords

Article
Publication date: 1 November 2004

Linda Dobrzanska, Debbie Crossland, Maggie Domanski and Sue Towriss

The Falls Exercise Prevention Programme for older people was introduced as a new project for North Bradford Primary Care Trust in 2002. The introduction of this new service was in…

Abstract

The Falls Exercise Prevention Programme for older people was introduced as a new project for North Bradford Primary Care Trust in 2002. The introduction of this new service was in response to an identified need to help reduce the incidence of falls, reduce serious injuries as a result of falling, and help improve and maintain the quality of life for those older people who had been identified as having had a fall or being at high risk of falling. The service was not established to be a front line service but to be incorporated into the falls referral pathway. The exercises undertaken are all evidence based and proven to be effective with this population. However, the Group promotes other aspects of quality of life for older people and promotes a holistic approach including health promotion and education. The group has now expanded to incorporate a ‘Walking for Health’ project; a ‘Walk From Home’ project and a ‘Buddy‐Up’ system. The Group is continually growing and future plans are to incorporate ‘Walks for Fallers’. Evaluation of the service provides information to continually improve and extend the services on offer.

Details

Quality in Ageing and Older Adults, vol. 5 no. 3
Type: Research Article
ISSN: 1471-7794

Keywords

Article
Publication date: 1 March 2007

Lorna Conn

Falls among older people cause significant mortality and morbidity, thus presenting a serious issue for older people and health and social care professionals alike. The simple…

Abstract

Falls among older people cause significant mortality and morbidity, thus presenting a serious issue for older people and health and social care professionals alike. The simple occurrence of a fall conceals the range of physical, psychological, social and environmental factors, which can contribute to this event. Research advocates that professionals should engage with health promotion and develop individualised preventions in order to minimise risk of falling. In this study, a multi‐disciplinary, falls prevention initiative was developed with older people who had recently fallen. The initiative started with a common assessment but was followed by a variable, individualised programme of different interventions. The older people involved were assessed pre‐ and post‐intervention, using a questionnaire checklist, on several different dimensions associated with falling. Outcomes were assessed in terms of reduction in risk and the incidence of falls, both of which were found to be statistically significant in several of the identified dimensions post‐intervention. Consequently, it could be estimated that approximately 44 falls were prevented through this nine‐month initiative. This study would support the integration of this falls prevention initiative into routine community care practice through the existing over‐75 health check and the development of a specialised falls team. Further research would be beneficial to follow up whether the reduction in the incidence of falling is sustained over time. Enhanced participation of user, carer, voluntary and community partners is recommended as this would allow older people themselves to play an active role in improving their own well‐being and that of others.

Details

Quality in Ageing and Older Adults, vol. 8 no. 1
Type: Research Article
ISSN: 1471-7794

Keywords

Article
Publication date: 21 March 2022

Jacqueline Francis-Coad, Tessa Watts, Caroline Bulsara and Anne-Marie Hill

The purpose of this study was to co-design a falls prevention education programme with aged care home residents and staff and evaluate its feasibility. The intention of providing…

Abstract

Purpose

The purpose of this study was to co-design a falls prevention education programme with aged care home residents and staff and evaluate its feasibility. The intention of providing the education programme was to assist residents to stay safe and mobile whilst reducing their risk of falling.

Design/methodology/approach

A two-phase mixed methods participatory design using a resident (n = 6) and care staff (n = 5) consumer engagement panel, pre- and post-programme resident (n = 35) survey and semi-structured care staff interviews (n = 8) was undertaken in two countries.

Findings

A poster, brochure, video and staff education guide featuring 12 safety messages depicting fall prevention behaviours were co-designed. Residents, supported by staff, perceived the falls prevention education programme as enjoyable and informative, but there were no significant differences in capability, opportunity or motivation. However, several residents were observed enacting fall prevention behaviours such as “If I feel unwell, I'll ring the bell” and waiting for staff assistance. Challenges to programme demand, acceptability and implementation which may have impacted residents' exposure and engagement with the programme were identified, along with recommendations to improve feasibility.

Practical implications

When developing falls prevention education programmes partnering with residents and staff, providing choices to meet personal and aesthetic preferences along with frequent, shorter duration learning opportunities are important for translating education messages into actions.

Originality/value

The use of bespoke resources, novel rhymes, positive messages emphasising safety and co-designing with residents themselves was a welcomed point of programme difference.

Details

Health Education, vol. 122 no. 5
Type: Research Article
ISSN: 0965-4283

Keywords

Article
Publication date: 12 June 2017

Jill Manthorpe and Jo Moriarty

The purpose of this paper is to explore the equalities’ dimension of falls prevention services in light of the Equality Act 2010 and its protected characteristics. Research and…

Abstract

Purpose

The purpose of this paper is to explore the equalities’ dimension of falls prevention services in light of the Equality Act 2010 and its protected characteristics. Research and policy are discussed in light of the Act and public services’ duties to be aware of their responsibilities.

Design/methodology/approach

An initial research review was undertaken in 2012 and updated in 2016.

Findings

The research on falls prevention services does not always collect data on users of the service and services do not always collect data about their users that would enable them to build a picture of their users in line with the Equality Act 2010.

Practical implications

Services and commissioners will need to be able to show that the services funded by the public purse are accessible, acceptable and appropriate to the UK’s increasingly diverse older population. This paper describes some of the existing resources and research papers that contain elements of attention to the protected characteristics of the Equality Act 2010.

Originality/value

This is an update on a research review undertaken in 2012.

Details

Working with Older People, vol. 21 no. 2
Type: Research Article
ISSN: 1366-3666

Keywords

Article
Publication date: 11 June 2018

Henry O’Lawrence and Michell Poyaoan-Linzaga

The purpose of this paper is to determine the association between patients who talked to their doctor about their risk of falling, or occurrence of balance problem. This study…

Abstract

Purpose

The purpose of this paper is to determine the association between patients who talked to their doctor about their risk of falling, or occurrence of balance problem. This study analyzed a secondary data set based on the Medicare Health Outcomes Survey (HOS) for the Medicare Advantage patients of 65 years and older. This study guided by two hypotheses that: patients who talked to their doctor about falling or balance problem are more likely to have fallen in the past than those who did not talk to their doctor about their fall risk; and patients talking to their doctor about a fall or balance problem are more likely to receive an early intervention such as patient education to prevent a future fall.

Design/methodology/approach

This study utilized a secondary data set to test its hypotheses. The Centers for Medicare and Medicaid Services (CMS) is dedicated to monitoring the quality of care provided to Medicare population in a managed care setting. Inter-University Consortium for Political and Social Research conducts the HOS to measure outcomes of quality improvement interventions developed by CMS in collaboration with the National Committee for Quality Assurance for Medicare Advantage Organizations (MAOs). The measures are focused on assessing the physical functioning and mental health being of Medicare beneficiaries and are aligned with reporting evidence of standards of care. Medicare HOS is administered in each Spring surveying a random sample of Medicare beneficiaries from MAOs that have a minimum of 500 enrollees; the cohort is surveyed again two years later as a follow-up measurement.

Findings

Reporting of a fall or balance problem is a critical component in fall prevention strategies. This study analyzed the distribution of beneficiaries who talked with their doctor about a fall or balance problem to understand if personal disposition (i.e. social class – educational level, gender, and race) would have been a factor in patients communicating with their doctor about their risk factors. The study found that 67.77 percent of patients who talked with their doctor about a fall or balance problem have at least a high school education compared with 32.23 percent who have less than a high school education or GED.

Research limitations/implications

All patients who responded to the survey and fulfilled the inclusion criteria were included in the study. Therefore, the data presented a limitation due to a self-report of no doctor visits, which could indicate inopportunity for provider-patient communication to take place. Additionally, such an information on fall or balance problem, including actual fall occurrence in the past 12 months, was based on self-report that could present inaccuracy since the elderly population tend to have diminished or poor memory, which may also be problematic.

Practical implications

Although this specific interaction starts with patient reporting of a health problem such as a fall or balance problem, provider must take a proactive approach in deploying prevention strategies, such as to conduct a comprehensive fall-risk assessment regardless of a report of a fall history by the patient. Further investigation of this study is recommended to ascertain pre-dispositional factors that affect patient communication, in order to address any barriers that could impede patient-provider collaboration. Nonetheless, enhancing patient-provider communication is fundamental to any quality intervention strategies such as fall prevention.

Social implications

Another key finding in this study is that patient communication facilitates fall prevention. Patients who talked to their doctor about their fall or gait problem were provided with patient education on how to prevent falls by their doctor. The provider is informed on patient’s balance problem, which leads to further evaluation of patient health status in order to identify other related factors since a comprehensive fall-risk assessment would have been likely conducted providing adequate information beyond the fall occurrence. This affirms the need for provider-patient communication to serve as catapult for effective care coordination, which is effectual in any intervention strategies.

Originality/value

Fall prevention is increasingly drawing attention and gaining momentum among healthcare organizations (including non-managed care) since falls and fall-related injuries are easily preventable (Lach et al., 2011). Efforts that can identify and accurately analyze patient health status, including intrinsic and extrinsic risk factors, promote effective interaction between patient and provider. This study has shown the positive effect of patient communication in order to allow doctors to effectively intervene (i.e. prevent a future fall) through the provision of patient education.

Details

International Journal of Organization Theory & Behavior, vol. 21 no. 2
Type: Research Article
ISSN: 1093-4537

Keywords

Article
Publication date: 1 November 2003

Lori Weeks and Karen Roberto

Although older women are at disproportionate risk of falling and becoming injured, little is known about the effect of falling on their quality of life. In this qualitative study…

Abstract

Although older women are at disproportionate risk of falling and becoming injured, little is known about the effect of falling on their quality of life. In this qualitative study, we examined the perceived causes of falling among older women, identified how older women's quality of life is influenced by falls, and explored how women can be empowered to prevent falls from occurring in their lives. Women who participated in focus groups indicated that the consequences of falling ranged in severity and duration and encompassed physical and psychosocial domains. The women took some ownership of preventing falls in their lives and believed that falls were caused by factors in the physical environment and personal health factors and practices. The results allow us to gain insight into the consequences of falls on the lives of older women, and that older women can influence change by preventing falls from occurring in their lives.

Details

Quality in Ageing and Older Adults, vol. 4 no. 3
Type: Research Article
ISSN: 1471-7794

Keywords

Article
Publication date: 12 February 2018

Mwali Muray, Charles H. Bélanger and Jamil Razmak

The purpose of this paper is to document the need for implementing a fall prevention strategy in an emergency department (ED). The paper also spells out the research process that…

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Abstract

Purpose

The purpose of this paper is to document the need for implementing a fall prevention strategy in an emergency department (ED). The paper also spells out the research process that led to approving an assessment tool for use in hospital outpatient services.

Design/methodology/approach

The fall risk assessment tool was based on the Morse Fall Scale. Gender mix and age above 65 and 80 years were assessed on six risk assessment variables using χ2 analyses. A logistic regression analysis and model were used to test predictor strength and relationships among variables.

Findings

In total, 5,371 (56.5 percent) geriatric outpatients were deemed to be at fall risk during the study. Women have a higher falls incidence in young and old age categories. Being on medications for patients above 80 years exposed both genders to equal fall risks. Regression analysis explained 73-98 percent of the variance in the six-variable tool.

Originality/value

Canadian quality and safe healthcare accreditation standards require that hospital staff develop and adhere to fall prevention policies. Anticipated physiological falls can be prevented by healthcare interventions, particularly with older people known to bear higher risk factors. An aging population is increasing healthcare volumes and medical challenges. Precautionary measures for patients with a vulnerable cognitive and physical status are essential for quality care.

Details

International Journal of Health Care Quality Assurance, vol. 31 no. 1
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 1 October 2003

Lilian Mwanri and Jeffrey Fuller

Describes the development of a management plan for prevention of falls and reduction of falls injuries for older and frail people in the community, nursing homes and acute care…

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Abstract

Describes the development of a management plan for prevention of falls and reduction of falls injuries for older and frail people in the community, nursing homes and acute care settings in Whyalla, South Australia. Falls among the elderly have been described as the most common causes of injury and hospital admissions for trauma in Australia. Prevention and control of injury is one of the five National Health Policy Priority Areas in Australia. As a response to the national initiative, and a felt need, the South Australian Centre for Rural and Remote Health was commissioned by the local health service to develop a plan that would address falls prevention in the older people in Whyalla. The plan was developed in consultation with the key stakeholders. An evidence‐based plan that uses messages from the scientific literature but modified to account for stakeholders’ feedback on what is feasible in practice, is considered a good example of best practice. Furthermore, the alignment of literature review alongside stakeholders’ consultation provides higher chances of the plan being adopted locally.

Details

Health Education, vol. 103 no. 5
Type: Research Article
ISSN: 0965-4283

Keywords

Article
Publication date: 3 April 2018

Ellen Freiberger

Age-related processes are marked by physiological, psychological and social decline, threatening health, quality of life, functional status and the mobility of individuals. As the…

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Abstract

Purpose

Age-related processes are marked by physiological, psychological and social decline, threatening health, quality of life, functional status and the mobility of individuals. As the impact of demographic change also begins to affect persons with intellectual disabilities (ID), issues and needs regarding the aging process are slowly entering the field of ID research. The paper aims to discuss these issues.

Design/methodology/approach

In the population of older people with ID, important, age-related events such as falls have prompted increasing research. Falls may lead to several negative health outcomes, require that an individual receives higher levels of care sometimes including hospitalisation and, in the worst case, hasten death. Falls also lead to psychological consequences such as fear of falling which fuels a vicious circle in which older persons afraid of falling reduce their physical activity, in turn hastening their functional decline.

Findings

Fall prevention in persons with ID is just evolving and further research is clearly necessary. This research can draw on the existing evidence from other fall prevention areas, especially the work carried out with the general older population.

Originality/value

As stated by Finlayson, a useful next step would be the development of a consensus on the definitions and methodology that should underpin future fall prevention research with persons with ID.

Details

Tizard Learning Disability Review, vol. 23 no. 2
Type: Research Article
ISSN: 1359-5474

Keywords

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