Journal of Policy and Practice in Intellectual Disabilities, 10(4), 2014, pp.314-320.
Publisher:
Wiley
As a starting point to guide the development of research into possible fall prevention strategies for people with ID, the authors interviewed a purposive sample of physiotherapists and occupational therapists currently working for one service organization in New Zealand. A series of semistructured interviews were conducted using an open-ended questioning technique. Data were analyzed using a general inductive approach. Five categories emerged from the interviews: the therapist's roles, successful and unsuccessful strategies, justification of strategies, barriers, and future strategies. Four main fall prevention strategies were identified that therapists thought to be most useful, including environmental modifications, participation in physical activity and exercise, prescription of assistive mobility devices, and education on safe mobility. It was concluded that the experiences and insights of the therapists could provide direction for future research as well as for therapists currently working in the field.
(Edited publisher abstract)
As a starting point to guide the development of research into possible fall prevention strategies for people with ID, the authors interviewed a purposive sample of physiotherapists and occupational therapists currently working for one service organization in New Zealand. A series of semistructured interviews were conducted using an open-ended questioning technique. Data were analyzed using a general inductive approach. Five categories emerged from the interviews: the therapist's roles, successful and unsuccessful strategies, justification of strategies, barriers, and future strategies. Four main fall prevention strategies were identified that therapists thought to be most useful, including environmental modifications, participation in physical activity and exercise, prescription of assistive mobility devices, and education on safe mobility. It was concluded that the experiences and insights of the therapists could provide direction for future research as well as for therapists currently working in the field.
(Edited publisher abstract)
Subject terms:
falls, prevention, learning disabilities, physiotherapists, occupational therapists, intervention, physical exercise;
For older people in the UK, falls are a major cause of disability and the leading cause of mortality due to injury. Even minor falls can have significant consequences for older people, such as an on-going fear of falling and loss of confidence in moving around safely, or a reduction in mobility which can lead to social isolation and depression. Many older people will need rehabilitation after a fall whether they have been treated in hospital or remain at home. Exercise therapy will form a significant component of the rehabilitation programme, aiming to prevent further falls and fractures by improving muscle strength, exercise tolerance and balance, thereby reducing the risk of falling. This falls audit pack is designed to form an important resource for trusts, with which to evaluate their conformance with the National Service Framework. It should be used by therapists and others working with older people to assure the quality and effectiveness of their services and contribute to the reduction of falls and subsequent disability among older people.
For older people in the UK, falls are a major cause of disability and the leading cause of mortality due to injury. Even minor falls can have significant consequences for older people, such as an on-going fear of falling and loss of confidence in moving around safely, or a reduction in mobility which can lead to social isolation and depression. Many older people will need rehabilitation after a fall whether they have been treated in hospital or remain at home. Exercise therapy will form a significant component of the rehabilitation programme, aiming to prevent further falls and fractures by improving muscle strength, exercise tolerance and balance, thereby reducing the risk of falling. This falls audit pack is designed to form an important resource for trusts, with which to evaluate their conformance with the National Service Framework. It should be used by therapists and others working with older people to assure the quality and effectiveness of their services and contribute to the reduction of falls and subsequent disability among older people.
Subject terms:
occupational therapists, older people, physiotherapists, quality assurance, falls, good practice;
British Journal of Occupational Therapy, 71(4), April 2008, pp.141-145.
Publisher:
Sage
A literature review was conducted to facilitate allied health professionals' implementation of the recommendations made by the Prevention of Falls Network Europe (ProFaNE) (Yardley et al 2007a) on promoting older people's engagement in activities to prevent falls. The falls prevention literature was searched for relevant papers to aid allied health professionals' choice of strategies and to inspire ideas about how to implement ProFaNE's recommendations in everyday practice. Suggestions for each of the six ProFaNE recommendations are made, which may in turn promote older people's adherence to falls prevention interventions.
A literature review was conducted to facilitate allied health professionals' implementation of the recommendations made by the Prevention of Falls Network Europe (ProFaNE) (Yardley et al 2007a) on promoting older people's engagement in activities to prevent falls. The falls prevention literature was searched for relevant papers to aid allied health professionals' choice of strategies and to inspire ideas about how to implement ProFaNE's recommendations in everyday practice. Suggestions for each of the six ProFaNE recommendations are made, which may in turn promote older people's adherence to falls prevention interventions.
Subject terms:
intervention, literature reviews, occupational therapists, prevention, falls, health professionals;
British Journal of Occupational Therapy, 79(3), 2016, pp.133-143.
Publisher:
Sage
Introduction: The potential of environmental assessment and modification to reduce falls has recently received attention within the gerontology literature. Research investigating the clinical effectiveness of this intervention in falls prevention reports conflicting results. Discrepancies are due to variation in the risk profile of study participants and the health care background of the person providing the environmental intervention or the intensity of the intervention provided.
Method: The purpose of this paper is to compare and contrast two systematic reviews, which include meta-analyses, of environmental interventions for falls prevention in community dwelling older people, using the critical appraisal skills programme tool for systematic reviews.
Finding:s Both reviews found that: environmental assessment and modification was effective in falls prevention; intervention was effective with high but not low risk participants; and that high intensity environmental assessment was effective, whereas low intensity intervention was not. Environmental interventions which were delivered by occupational therapists were deemed high intensity, probably because their underpinning theoretical frameworks focus on the impact of the environment on function.
Conclusion: The authors discuss possible reasons why occupational therapist led environmental assessment and modification is clinically effective in falls prevention, for people at high risk of falls, whereas non occupational therapist led intervention is not.
(Edited publisher abstract)
Introduction: The potential of environmental assessment and modification to reduce falls has recently received attention within the gerontology literature. Research investigating the clinical effectiveness of this intervention in falls prevention reports conflicting results. Discrepancies are due to variation in the risk profile of study participants and the health care background of the person providing the environmental intervention or the intensity of the intervention provided.
Method: The purpose of this paper is to compare and contrast two systematic reviews, which include meta-analyses, of environmental interventions for falls prevention in community dwelling older people, using the critical appraisal skills programme tool for systematic reviews.
Finding:s Both reviews found that: environmental assessment and modification was effective in falls prevention; intervention was effective with high but not low risk participants; and that high intensity environmental assessment was effective, whereas low intensity intervention was not. Environmental interventions which were delivered by occupational therapists were deemed high intensity, probably because their underpinning theoretical frameworks focus on the impact of the environment on function.
Conclusion: The authors discuss possible reasons why occupational therapist led environmental assessment and modification is clinically effective in falls prevention, for people at high risk of falls, whereas non occupational therapist led intervention is not.
(Edited publisher abstract)
Subject terms:
falls, prevention, home care, assessment, occupational therapists, risk assessment, intervention, comparative studies, systematic reviews, environmental factors;
Practice guideline providing evidence-based recommendations to support occupational therapists working with adults in the prevention and management of falls. The recommendations are intended to be used alongside the therapist's clinical expertise in their assessment of need and implementation of interventions. The guideline reviewed evidence relating to improved identification and assessment of people at risk; improved intervention to reduce falls risk; interventions to maximise functional independence, including positive risk taking; self-management; and improved understanding of the importance of education and training. Details of the guideline development process and guideline methodology are also included. The guideline recommendations focus on three key categories, to reflect the occupational therapists role: keeping safe at home: reducing risk of falls; keeping active: reducing fear of falling; falls management: making it meaningful. This guideline will also be useful to inform service users and carers, other health professionals, managers and commissioners working in adult services, about the roles and responsibilities of the occupational therapist in this area. Appendices provide
(Edited publisher abstract)
Practice guideline providing evidence-based recommendations to support occupational therapists working with adults in the prevention and management of falls. The recommendations are intended to be used alongside the therapist's clinical expertise in their assessment of need and implementation of interventions. The guideline reviewed evidence relating to improved identification and assessment of people at risk; improved intervention to reduce falls risk; interventions to maximise functional independence, including positive risk taking; self-management; and improved understanding of the importance of education and training. Details of the guideline development process and guideline methodology are also included. The guideline recommendations focus on three key categories, to reflect the occupational therapists role: keeping safe at home: reducing risk of falls; keeping active: reducing fear of falling; falls management: making it meaningful. This guideline will also be useful to inform service users and carers, other health professionals, managers and commissioners working in adult services, about the roles and responsibilities of the occupational therapist in this area. Appendices provide details of the service user consultation; literature search strategy and evidence-based review tables.
(Edited publisher abstract)
British Journal of Occupational Therapy, 66(6), June 2003, pp.269-276.
Publisher:
Sage
Falling are common in older people and are associated with mortality, decreased mobility, premature nursing home admissions and a reduced ability to perform activities of daily living. In an attempt to reduce the incidence of falls, the National Service Framework for Older People has emphasised the need to develop falls services that provide support for older people who have fallen and use health promotion initiatives. This article reports the findings of an evaluation of a multifaceted falls prevention programme, which aimed to determine whether occupational therapy could enhance quality of life by educating people aged 65 years and over about the risk of falls. A pre-intervention and post-intervention non-standardised self-administered questionnaire was completed at week 1 and at week 14. Of the 172 older people attending the falls prevention programme, 45 percent completed both questionnaires. The findings from this study suggest that an occupational therapy falls prevention programme can reduce the impact of falls on older people by enhancing confidence to perform activities, which in turn can increase quality of life. However, further research is needed to determine the effectiveness
Falling are common in older people and are associated with mortality, decreased mobility, premature nursing home admissions and a reduced ability to perform activities of daily living. In an attempt to reduce the incidence of falls, the National Service Framework for Older People has emphasised the need to develop falls services that provide support for older people who have fallen and use health promotion initiatives. This article reports the findings of an evaluation of a multifaceted falls prevention programme, which aimed to determine whether occupational therapy could enhance quality of life by educating people aged 65 years and over about the risk of falls. A pre-intervention and post-intervention non-standardised self-administered questionnaire was completed at week 1 and at week 14. Of the 172 older people attending the falls prevention programme, 45 percent completed both questionnaires. The findings from this study suggest that an occupational therapy falls prevention programme can reduce the impact of falls on older people by enhancing confidence to perform activities, which in turn can increase quality of life. However, further research is needed to determine the effectiveness of anxiety management techniques.
Subject terms:
mobility impairment, occupational therapists, occupational therapy, older people, prevention, quality of life, activities of daily living, anxiety, falls, evaluation;
British Journal of Occupational Therapy, 81(8), 2018, p.463–473.
Publisher:
Sage
Introduction: Occupational therapy in primary care settings in Australia is developing. This study aimed to examine current practice in preventing falls among older people living in the community prior to attending a home safety workshop; explore the outcomes of the workshop on fall prevention practice; and investigate self-reported changes in practice 3 months after the workshop. Method:
(Edited publisher abstract)
Introduction: Occupational therapy in primary care settings in Australia is developing. This study aimed to examine current practice in preventing falls among older people living in the community prior to attending a home safety workshop; explore the outcomes of the workshop on fall prevention practice; and investigate self-reported changes in practice 3 months after the workshop. Method: The 3-hour workshop was focused on evidence-based home safety interventions and was offered to occupational therapists providing community-based services in the Sydney North Primary Health Network area. Knowledge surveys were used immediately pre and post workshop, and practice surveys were collected data at baseline and at 3-month follow-up. Results: Three workshops were run in 2015–2016, with a total of 40 occupational therapists. At follow-up, a positive impact on confidence and knowledge was reported. Less impact was observed on identifying and reducing an older person’s fall risk, and on fall prevention services provided and referrals received. Changes in practice were reported by 48% (n = 16) of the 33 participants who returned surveys at 3 months. Conclusion: These findings provide support for the benefit of professional development workshops to improve confidence and knowledge, but challenges remain in facilitating change in fall prevention service delivery. Further study on screening for fall risk and collaboration between community service providers in the primary care context is recommended.
(Edited publisher abstract)
Subject terms:
falls, prevention, evaluation, community care, occupational therapists, primary care, older people, independent living, intervention, skills, staff development, training;
British Journal of Occupational Therapy, 81(8), 2018, pp.474-481.
Publisher:
Sage
Introduction: A major threat to healthy ageing is accidental falls causing individual suffering as well as increasing costs for society. The aim of this study was to compare and evaluate a multifactorial falls-prevention programme, with ordinary falls prevention in primary healthcare. Method: Eligible patients were community-dwelling older adults (+65) who had fallen within the last 6 months or were concerned about falling. Participants (n = 131) were randomized to an intervention or control group. The primary outcome was measure of falls and the secondary was fear of falling. Results: There was a significant decrease in the risk of falls and fear of falling at 12 months in favour of the intervention group. When comparing groups over time, including baseline measures, only fear of falling remained significant. Conclusion: Small-group learning environments in combination with learning by doing, could be an effective approach for the translation of knowledge into everyday life and valued activities leading to a decrease in falls and fear of falling. Multifactorial and multi-disciplinary approaches against falls in a small-group learning environment could be effective in preventing falls
(Edited publisher abstract)
Introduction: A major threat to healthy ageing is accidental falls causing individual suffering as well as increasing costs for society. The aim of this study was to compare and evaluate a multifactorial falls-prevention programme, with ordinary falls prevention in primary healthcare. Method: Eligible patients were community-dwelling older adults (+65) who had fallen within the last 6 months or were concerned about falling. Participants (n = 131) were randomized to an intervention or control group. The primary outcome was measure of falls and the secondary was fear of falling. Results: There was a significant decrease in the risk of falls and fear of falling at 12 months in favour of the intervention group. When comparing groups over time, including baseline measures, only fear of falling remained significant. Conclusion: Small-group learning environments in combination with learning by doing, could be an effective approach for the translation of knowledge into everyday life and valued activities leading to a decrease in falls and fear of falling. Multifactorial and multi-disciplinary approaches against falls in a small-group learning environment could be effective in preventing falls and reducing fear of falling among older adults at risk.
(Edited publisher abstract)
Subject terms:
falls, occupational therapy, occupational therapists, health education, primary care, evaluation, intervention, older people, prevention, randomised controlled trials, comparative studies, risk, ageing, accidents, groupwork;
British Journal of Occupational Therapy, 63(6), June 2000, pp.260-269.
Publisher:
Sage
The Home Falls and Accidents Screening Tool (HOME FAST) was developed as a screening instrument for use in a community preventive care trial for older people. This article describes the first stage of the development of this screening tool. The objectives of the study were (i) to review existing home safety measures, (ii) to field test an instrument containing a pool of home safety items
The Home Falls and Accidents Screening Tool (HOME FAST) was developed as a screening instrument for use in a community preventive care trial for older people. This article describes the first stage of the development of this screening tool. The objectives of the study were (i) to review existing home safety measures, (ii) to field test an instrument containing a pool of home safety items with the goal of identifying those hazards associated with fall in the home and (iii) to select the items for inclusion in a 25-item tool using an expert panel. The field testing took place in a rural area of Australia, where the pooled checklist was used to evaluate hazards within the homes of 83 older people.
Subject terms:
home safety, intervention, occupational therapists, occupational therapy, older people, prevention, risk, screening, accidents, falls, health, health care;
British Journal of Occupational Therapy, 63(6), June 2000, pp.254-259.
Publisher:
Sage
Falling is a major problem for the elderly population and much research has been done to investigate the risk factors for and means of preventing falls. This postal survey was undertaken to investigate whether therapists do anything to try to prevent falls, assess elderly people for suitability and teach them how to rise after a fall. The results showed that almost all the respondents (127
Falling is a major problem for the elderly population and much research has been done to investigate the risk factors for and means of preventing falls. This postal survey was undertaken to investigate whether therapists do anything to try to prevent falls, assess elderly people for suitability and teach them how to rise after a fall. The results showed that almost all the respondents (127 of 137) identified falling as a problem that they had to deal with in their patients over 65 years. Over half the respondents had considered teaching people how to rise after a fall. A range of different methods was used, which broadly fell into physical and verbal instructions or referral to other health care professionals.
Subject terms:
occupational therapists, occupational therapy, older people, patients, physiotherapists, prevention, risk, training, assessment, education, falls, health, health care;