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The ABC scale and fall risk: a systematic review
- Authors:
- STASNY Bernadette Marie, et al
- Journal article citation:
- Physical and Occupational Therapy in Geriatrics, 29(3), September 2011, pp.233-242.
- Publisher:
- Informa Healthcare
This systematic review focuses on the Activities-specific Balance Confidence (ABC) scale in order to assess how well it predicts falls in older adults living in the community. The evidence is from only three studies, all of which were judged to be good quality. The results suggest that the ABC scale is a useful measure of balance confidence in older adults, but research on its ability to predict falls is limited. Large, longer-term, prospective studies are needed.
Falls after discharge from hospital: is there a gap between older peoples’ knowledge about falls prevention strategies and the research evidence?
- Authors:
- HILL Anne-Marie, et al
- Journal article citation:
- Gerontologist, 51(5), October 2011, pp.653-662.
- Publisher:
- Oxford University Press
This study explored whether older people were prepared to engage in appropriate falls prevention strategies after discharge from hospital in Swan Districts hospital, Perth, Australia. Three hundred and thirty three older patients about to be discharged from hospital were surveyed about their knowledge regarding falls prevention strategies. Participants were asked to suggest strategies to reduce their falls risk at home after discharge, and their responses were compared with reported research evidence for falls prevention interventions. Strategies were classified into 7 categories: behavioural; support while mobilising; approach to movement; physical environment; visual; medical; and activities or exercise. Although exercise has been identified as an effective falls risk reduction strategy, only about 3% of participants suggested engaging in exercises. Falls prevention was most often conceptualised by participants as requiring one or two strategies for avoiding an accidental event, rather than engaging in sustained multiple risk reduction behaviours. Overall, patients had low levels of knowledge about appropriate falls prevention strategies. The authors concluded that health care workers should design and deliver falls prevention education programmes specifically targeted to older people discharged from hospital.
Taking control after fall induced hip fracture
- Authors:
- McMILLAN Laura, et al
- Journal article citation:
- 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.
Preventing falls: how to monitor risk and intervene
- Author:
- -
- Journal article citation:
- Nursing and Residential Care, 13(2), February 2011, pp.82-84.
- Publisher:
- MA Healthcare Ltd.
- Place of publication:
- London
Highlights what care homes can do to prevent falls in their older residents. The article looks at possible risks and preventive interventions such as physical exercise.
Ethical issues in the use of fall detectors
- Authors:
- GANYO Michelle, DUNN Michael, HOPE Tony
- Journal article citation:
- Ageing and Society, 31(8), November 2011, pp.1350-1367.
- Publisher:
- Cambridge University Press
This article explores the ethical issues raised by the use of fall detectors – a form of remote monitoring technology designed to enhance the well-being of adults at risk from falling. The article begins with a description of the fall detection devices currently available and a summary of how these devices carers to respond in particular ways. The ethical issues associated with the use of fall detectors are classified under four headings: autonomy; privacy; benefit; and the use of resources. It is argued that these issues arise out of the nature of the technology itself, and the way that this technology is integrated into the day-to-day support package of the person for whom it is provided. It is suggested that manufacturers have a duty to provide information about the ethical side-effects associated with the use of a particular device, and that the process of making a decision to provide a person with a fall detector should include a checklist of questions designed to enable decision makers to work through the ethical issues raised. Implications for practice are discussed.
Fall assessment in older people
- Authors:
- CLOSE Jacqueline C. T., LORD Stephen R.
- Journal article citation:
- British Medical Journal, 17.9.11, 2011, pp.579-582.
- Publisher:
- British Medical Association
... Challenges such as the multifactoral nature of falls prevention and the need for further research on falls prevention initiatives are also discussed.
Attempts to reach the oldest and frailest: recruitment, and adherence, and retention of urban elderly persons to a falls reduction exercise program
- Authors:
- STINEMAN Margaret G., et al
- Journal article citation:
- Gerontologist, 51(S1), June 2011, pp.S59-S72.
- Publisher:
- Oxford University Press
The Exercise and Training in Aging (EXTRA) protocol development study aimed to design a culturally appropriate intervention for elderly, mostly African American urban residents who suffered a fall of sufficient severity to need an emergency department visit. EXTRA included 2 elements: an intervention to reduce the risk of falls, and an intervention to increase adherence and retention, tailored
Rhythmic stepping exercise under cognitive conditions improves fall risk factors in community-dwelling older adults: preliminary results of a cluster-randomized controlled trial
- Authors:
- YAMADA Minoru, et al
- Journal article citation:
- Aging and Mental Health, 15(5), July 2011, pp.647-653.
- Publisher:
- Taylor and Francis
In Japan, roughly half of older adults living in the community experience fear of falling. This pilot evaluated whether a 24-week programme of rhythmic stepping exercise (RSE) would be effective in improving physical function and reducing fear of falling in older adults. Twenty five participants from two living units from Kyoto, Japan, were randomised into an RSE group, and a 27 from another two living units into non-rhythmic stepping exercise (NRSE) group participated in a pilot cluster randomised controlled trial. Each exercise group received 60 min group training sessions once a week for 24 weeks. Measurement was based on the difference in physical functions between the RSE and NRSE groups. Findings revealed significant differences between the two groups for locomotive function. Relative risk was much higher for fear of falling for participants in the NRSE group compared with patients in the RSE group. The authors concluded that the results suggest that the RSE programme is more effective in improving locomotive function and fear of falling.
Older adults, falls and technologies for independent living: a life space approach
- Authors:
- BAILEY Cathy, et al
- Journal article citation:
- Ageing and Society, 31(5), July 2011, pp.829-848.
- Publisher:
- Cambridge University Press
This paper aims to further understand routines which lead to falling in older adults, and how new technology might be used to provide unobtrusive support in independent living. A small study was conducted in Ireland with eight community-dwelling older adults with varying experiences of falls or fear-of-falls. Data were collected through weekly life-space diaries, daily-activity logs,
Mediating effects of psychosocial factors on concerns about falling and daily activity in a multicomponent cognitive behavioral group intervention
- Authors:
- ZIJLSTRA G.A. Rixt, et al
- Journal article citation:
- Aging and Mental Health, 15(1), January 2011, pp.68-77.
- Publisher:
- Taylor and Francis
This study explored the mediating effects of psychosocial factors on concerns about falling and daily activity in a cognitive behavioural group intervention. Five hundred and forty older people, with concerns about falling and activity avoidance, participated in a randomised controlled trial evaluating this intervention. Control beliefs, self-efficacy beliefs, outcome expectations, social interactions, and concerns about falling and daily activity were assessed at baseline, and at 2, 8, and 14 months. Moderate statistically significant effects of the intervention on the potential mediators were found at nearly all follow-up assessments. Separate psychosocial factors showed modest mediating effects on the outcomes. Overall, the multicomponent cognitive behavioural intervention improved control beliefs, self-efficacy, outcome expectations, and social interactions. These variables mediated the association between the intervention and concerns about falling or daily activity in older people. The authors suggest that this study may enable further improvement and development of interventions to reduce concerns about falling for old people.