Generations Review, 21(2), April 2011, Online only
Publisher:
British Society of Gerontology
Semi-structured interviews were carried out with 19 older people aged between 67-89 years who had sustained a fall-induced hip fracture, and had been discharged home. Using grounded theory, a core category of ‘taking control’ emerged. The three stages that people moved through in the process of taking control after hip fracture were: ‘going under’, ‘keeping afloat’ and ‘gaining ground’. Nautical metaphors emphasise the precarious and unstable conditions of life after hip fracture, as well as conceptualising the physical and emotional struggles that people faced in ‘balancing’ help and risk. The study stresses the role that healthcare professionals have in facilitating restoration of control and increasing self efficacy.
Semi-structured interviews were carried out with 19 older people aged between 67-89 years who had sustained a fall-induced hip fracture, and had been discharged home. Using grounded theory, a core category of ‘taking control’ emerged. The three stages that people moved through in the process of taking control after hip fracture were: ‘going under’, ‘keeping afloat’ and ‘gaining ground’. Nautical metaphors emphasise the precarious and unstable conditions of life after hip fracture, as well as conceptualising the physical and emotional struggles that people faced in ‘balancing’ help and risk. The study stresses the role that healthcare professionals have in facilitating restoration of control and increasing self efficacy.
Drawing on published research and guidance and the practical experience of health and social care professionals, this framework identifies and describes key actions to help prevent falls in the community in Scotland. Actions are provided for each of the four stages of the care pathway: supporting health improvement and self-management to reduce risk; identifying individuals at high risk of falls; responding to and individual who has just fallen and requires immediate assistance; and coordinated management, including specialist assessment. The actions represent the minimum standard of care an older person should expect to receive in Scotland. It provides a useful road map for developing a falls pathway and encourages and integrated approach between health, social care and the idependent sector.
(Original abstract)
Drawing on published research and guidance and the practical experience of health and social care professionals, this framework identifies and describes key actions to help prevent falls in the community in Scotland. Actions are provided for each of the four stages of the care pathway: supporting health improvement and self-management to reduce risk; identifying individuals at high risk of falls; responding to and individual who has just fallen and requires immediate assistance; and coordinated management, including specialist assessment. The actions represent the minimum standard of care an older person should expect to receive in Scotland. It provides a useful road map for developing a falls pathway and encourages and integrated approach between health, social care and the idependent sector.
(Original abstract)
Subject terms:
falls, assessment, prevention, risk assessment, older people, intervention, care pathways;
University of Stirling. Dementia Services Development Centre
Publication year:
2011
Pagination:
43p.
Place of publication:
Stirling
... response to falls, offering reassurance as well as a practical response in an emergency. It also describes how telehealthcare – that is, equipment combined with assessment, monitoring and response services – can reduce the risk of falling as part of a comprehensive individualised falls prevention and management programme. Additionally, it describes the role telehealthcare can play in providing support and reassurance to carers. In summary, this book outlines how telehealthcare can contribute to improved outcomes for people at high risk of falling. It includes sections on: definitions of telehealthcare (along with the related concepts of telecare, telehealth, assistive technology and environmental controls); the causes, consequences, prevention and management of falls; the importance of good needs and risk assessments; ethical dilemmas and how these can be resolved; how the risk of falls and the resultant harm they cause can best be reduced and managed using telehealthcare as part of a package of risk assessment, management, prevention, care and support; issues particular to carers; and case examples and an outline training programme.
As people grow older or develop certain disabilities, the risk of falling increases, and, almost as importantly, associated levels of anxiety can increase. People who are more vulnerable and dependent as a consequence of age or disability ought to have the same access to, and benefits from, the increasingly cheap and accessible technology. This book explains how telehealthcare can enable a fast response to falls, offering reassurance as well as a practical response in an emergency. It also describes how telehealthcare – that is, equipment combined with assessment, monitoring and response services – can reduce the risk of falling as part of a comprehensive individualised falls prevention and management programme. Additionally, it describes the role telehealthcare can play in providing support and reassurance to carers. In summary, this book outlines how telehealthcare can contribute to improved outcomes for people at high risk of falling. It includes sections on: definitions of telehealthcare (along with the related concepts of telecare, telehealth, assistive technology and environmental controls); the causes, consequences, prevention and management of falls; the importance of good needs and risk assessments; ethical dilemmas and how these can be resolved; how the risk of falls and the resultant harm they cause can best be reduced and managed using telehealthcare as part of a package of risk assessment, management, prevention, care and support; issues particular to carers; and case examples and an outline training programme.
Subject terms:
older people, prevention, assistive technology, disabilities, falls, telehealth;
Journal of Applied Research in Intellectual Disabilities, 28(3), 2015, p.257–264.
Publisher:
Wiley
Background: People with intellectual disabilities experience high rates of falls. Balance and gait problems are common in people with intellectual disabilities, increasing the likelihood of falls; thus, tailored exercise interventions to improve gait and balance are recommended. The present authors set up a physiotherapy-led falls pathway service (FPS) for clients with intellectual disabilities to promote exercise and prevent falls.
Method: Fifty clients with intellectual disabilities were referred in an 18-month period, 35 (70%) were prescribed exercise and 27 (54%) completed the exercise programme. The FPS was evaluated using the following outcome measures: Tinetti score, number of falls, clinician's judgement and carer's judgement.
Results: Improvement in balance and mobility and a decrease in the number of falls were reported post-exercise intervention.
Conclusion: Physiotherapists have a key role to play in promoting exercise to prevent falls in services for people with intellectual disabilities. This evaluation suggests positive outcomes for these clients to reduce or prevent further falls.
(Publisher abstract)
Background: People with intellectual disabilities experience high rates of falls. Balance and gait problems are common in people with intellectual disabilities, increasing the likelihood of falls; thus, tailored exercise interventions to improve gait and balance are recommended. The present authors set up a physiotherapy-led falls pathway service (FPS) for clients with intellectual disabilities to promote exercise and prevent falls.
Method: Fifty clients with intellectual disabilities were referred in an 18-month period, 35 (70%) were prescribed exercise and 27 (54%) completed the exercise programme. The FPS was evaluated using the following outcome measures: Tinetti score, number of falls, clinician's judgement and carer's judgement.
Results: Improvement in balance and mobility and a decrease in the number of falls were reported post-exercise intervention.
Conclusion: Physiotherapists have a key role to play in promoting exercise to prevent falls in services for people with intellectual disabilities. This evaluation suggests positive outcomes for these clients to reduce or prevent further falls.
(Publisher abstract)
Subject terms:
physical exercise, falls, learning disabilities, prevention, physiotherapy, adults, intervention, physiotherapists;
Noting the significant personal costs for individuals and financial costs for health and social care services associated with falls, this document reports on the findings of research into the impact and challenges of falls for older people. It covers vulnerability of survey respondents (including living alone and lack of social contact), severity of falls, reaction to falls (including loss of confidence), losing independence, and the response of statutory services. It reports that 26% of older people surveyed reported that they had fallen, either inside or outside their home, in the last year, and that only 11% of people had received a visit from a specialist falls prevention team, with English older people less likely to have had support from a falls team than their counterparts in Scotland or Wales. It also discusses national policies and guidelines to prevent falls in England, Wales, and Scotland. It argues that the survey findings indicate that those who are having falls are not being offered appropriate support, calls for implementation of the good practice in existing policy frameworks, and sets out recommendations for policy changes to help deliver cost effective and quality services to reduce overall incidence and severity of falls.
Noting the significant personal costs for individuals and financial costs for health and social care services associated with falls, this document reports on the findings of research into the impact and challenges of falls for older people. It covers vulnerability of survey respondents (including living alone and lack of social contact), severity of falls, reaction to falls (including loss of confidence), losing independence, and the response of statutory services. It reports that 26% of older people surveyed reported that they had fallen, either inside or outside their home, in the last year, and that only 11% of people had received a visit from a specialist falls prevention team, with English older people less likely to have had support from a falls team than their counterparts in Scotland or Wales. It also discusses national policies and guidelines to prevent falls in England, Wales, and Scotland. It argues that the survey findings indicate that those who are having falls are not being offered appropriate support, calls for implementation of the good practice in existing policy frameworks, and sets out recommendations for policy changes to help deliver cost effective and quality services to reduce overall incidence and severity of falls.
Subject terms:
independence, older people, prevention, social care provision, user views, costs, falls, health care;
Scottish Collaboration for Public Health Research and Policy
Publication year:
2010
Pagination:
157p.
Place of publication:
Edinburgh
... and frameworks that have been published internationally and in Scotland relevant to the care of an increasingly ageing population are discussed. Specific interventions are then considered under the following categories: complex interventions; interventions to prevent falls and fractures; physical activity and exercise interventions; nutritional interventions; information and communication technology
In Scotland, the population of older people is expected to rise and it will become increasingly difficult to maintain independent living for older people in their own homes or provide adequate pensions and social security systems. Disability and ill health in older people has been shown to be strongly linked to socioeconomic position. The aim of this review is to provide an overview of the evidence for interventions that prevent or delay physical disablement in later life with a view to informing policy makers and developing equitable intervention strategies. A search was conducted to find information relevant to research, interventions, policies and programmes delivered in Scotland or internationally that aim to impact on health and reduce inequalities in older people. The key policies and frameworks that have been published internationally and in Scotland relevant to the care of an increasingly ageing population are discussed. Specific interventions are then considered under the following categories: complex interventions; interventions to prevent falls and fractures; physical activity and exercise interventions; nutritional interventions; information and communication technology interventions; interventions to prevent social isolation and loneliness; and medication review.
Journal of Intellectual Disability Research, 54(11), November 2010, pp.966-980.
Publisher:
Wiley
Injuries, and in particular falls, are a major causes of death and disability. Research indicates that young people with intellectual disabilities (ID) have a higher rate and different pattern of injuries compared to the general population, but data for adults is very limited. This study was designed to determine the incidence and types of injuries experienced in a 12-month period by a community-based cohort of adults with ID (n = 511, 53% male, mean age 43.7 years, range 16-79) living in the Glasgow area. Face-to-face interviews were conducted with participants 2 years after they had first been recruited into a longitudinal study. Incidence of at least one injury in a 12-month period was 20.5% (105), of which 12.1% were related to falls. Analyses looked at the type and causes of injuries and risk factors in terms of the nature of the disability. The impact Incident injury was predicted by having epilepsy and not having autism. Incident fall injury was predicted by urinary incontinence, while Down syndrome reduced risk. It is concluded that adults with ID did have more injuries, falls and accidents when compared with the general population. The authors suggest that there needs
Injuries, and in particular falls, are a major causes of death and disability. Research indicates that young people with intellectual disabilities (ID) have a higher rate and different pattern of injuries compared to the general population, but data for adults is very limited. This study was designed to determine the incidence and types of injuries experienced in a 12-month period by a community-based cohort of adults with ID (n = 511, 53% male, mean age 43.7 years, range 16-79) living in the Glasgow area. Face-to-face interviews were conducted with participants 2 years after they had first been recruited into a longitudinal study. Incidence of at least one injury in a 12-month period was 20.5% (105), of which 12.1% were related to falls. Analyses looked at the type and causes of injuries and risk factors in terms of the nature of the disability. The impact Incident injury was predicted by having epilepsy and not having autism. Incident fall injury was predicted by urinary incontinence, while Down syndrome reduced risk. It is concluded that adults with ID did have more injuries, falls and accidents when compared with the general population. The authors suggest that there needs to be greater emphasis on individual injury/fall risk in the provision of support for people with ID at both the individual and organisational level.