Objectives: Falls can have detrimental effects on older adults' psychological well-being, physical health, and survival rates. However, certain psychosocial mediators may lessen the negative impact of suffering a fall on health and well-being. Perceived control is a psychosocial factor that was examined as a mediator of the falls – health and well-being relationship in the current study. Method: Participants were 232 community-dwelling older adults, age 68 or older who took part in a longitudinal study in 2008 and 2010 and completed measures of perceived control, self-rated health, health-care utilization, number of falls, depressive symptomology, and perceived stress. Survival was also tracked for seven years from 2008 through 2015. Results: Older adults who suffered a fall had poorer health and well-being two years later compared to those who did not suffer a fall. Perceived control mediated the negative impact of falls on subsequent health and well-being outcomes two years later. Among older adults who experienced a fall, higher levels of perceived control predicted better subsequent health and well-being. Suffering one or more falls also predicted less likelihood of survival seven years later,
(Edited publisher abstract)
Objectives: Falls can have detrimental effects on older adults' psychological well-being, physical health, and survival rates. However, certain psychosocial mediators may lessen the negative impact of suffering a fall on health and well-being. Perceived control is a psychosocial factor that was examined as a mediator of the falls – health and well-being relationship in the current study. Method: Participants were 232 community-dwelling older adults, age 68 or older who took part in a longitudinal study in 2008 and 2010 and completed measures of perceived control, self-rated health, health-care utilization, number of falls, depressive symptomology, and perceived stress. Survival was also tracked for seven years from 2008 through 2015. Results: Older adults who suffered a fall had poorer health and well-being two years later compared to those who did not suffer a fall. Perceived control mediated the negative impact of falls on subsequent health and well-being outcomes two years later. Among older adults who experienced a fall, higher levels of perceived control predicted better subsequent health and well-being. Suffering one or more falls also predicted less likelihood of survival seven years later, beyond the effects of age, gender, marital status, and education. Conclusion: Findings highlight the importance of assessing risk of falling and levels of perceived control in later life.
(Edited publisher abstract)
One of six films made as part of an ESRC funded participatory research project which explored what well-being means to older people and how it is generated. The research was carried out by a team of older people, university researchers and a voluntary sector manager. This film introduces Patrick who is in his nineties. His wife Gillian is currently in hospital following a recent fall and he is increasingly becoming aware that where he and his wife are living is not meeting their needs. With this is mind he has rung Paul, a voluntary sector worker, who he has met before, to discuss the situation. The film is a scripted scenario based on interviews.
(Edited publisher abstract)
One of six films made as part of an ESRC funded participatory research project which explored what well-being means to older people and how it is generated. The research was carried out by a team of older people, university researchers and a voluntary sector manager. This film introduces Patrick who is in his nineties. His wife Gillian is currently in hospital following a recent fall and he is increasingly becoming aware that where he and his wife are living is not meeting their needs. With this is mind he has rung Paul, a voluntary sector worker, who he has met before, to discuss the situation. The film is a scripted scenario based on interviews.
(Edited publisher abstract)
Subject terms:
falls, hospital discharge, wellbeing, environment, housing, older people, voluntary organisations;
SHEFFIELD HALLAM UNIVERSITY. Sport Industry Research Centre
Publisher:
Sheffield Hallam University. Sport Industry Research Centre
Publication year:
2019
Pagination:
27
Place of publication:
Sheffield
An evaluation of the Dance to Health falls prevention dance programme. The evaluation investigates whether Dance to Health is an effective and cost-effective way to address older people’s falls and whether the programme helps older people in danger of falling overcome lost confidence, reduced independence and increased isolation. The evaluation used a mixed methods approach that included quantitative, qualitative and econometric research. Primary outcome measures included the impact on falls, positive side-effects (mentally and physically), patient pull, attendance and adherence, fidelity to existing falls prevention programmes and cost effectiveness. The findings show that Dance to Health is helping older people in danger of falling overcome lost confidence, reduced independence and increased isolation. There was a 44 percent reduction in the number of falls, positive improvements in participants' physical and mental wellbeing, including improved Timed Up and Go (TUG) times and reduced fear of falling. Additionally, based on the analysis conducted, there is a potential cost saving of over £149m over a 2-year period, of which £120m is a potential cost saving for the NHS. Dance to Health's fidelity to existing physiotherapy programmes was also confirmed. The evidence suggests that Dance to Health offers the health system a more effective and cost-effective means to address the issue of older people's falls.
(Edited publisher abstract)
An evaluation of the Dance to Health falls prevention dance programme. The evaluation investigates whether Dance to Health is an effective and cost-effective way to address older people’s falls and whether the programme helps older people in danger of falling overcome lost confidence, reduced independence and increased isolation. The evaluation used a mixed methods approach that included quantitative, qualitative and econometric research. Primary outcome measures included the impact on falls, positive side-effects (mentally and physically), patient pull, attendance and adherence, fidelity to existing falls prevention programmes and cost effectiveness. The findings show that Dance to Health is helping older people in danger of falling overcome lost confidence, reduced independence and increased isolation. There was a 44 percent reduction in the number of falls, positive improvements in participants' physical and mental wellbeing, including improved Timed Up and Go (TUG) times and reduced fear of falling. Additionally, based on the analysis conducted, there is a potential cost saving of over £149m over a 2-year period, of which £120m is a potential cost saving for the NHS. Dance to Health's fidelity to existing physiotherapy programmes was also confirmed. The evidence suggests that Dance to Health offers the health system a more effective and cost-effective means to address the issue of older people's falls.
(Edited publisher abstract)
Subject terms:
dance, falls, prevention, older people, evaluation, cost effectiveness, social isolation, wellbeing, intervention;
Quality in Ageing and Older Adults, 19(4), 2018, pp.261-272.
Publisher:
Emerald
Purpose: A six-month randomized controlled trial was conducted to examine the impact of a home-based nutrition and exercise intervention on functional capacity to prevent falls among rural seniors. The paper aims to discuss this issue. Design/methodology/approach: Men and women (n=134), aged 60 and older were assigned to one of four groups: exercise, nutrition, exercise-nutrition and control. and findings promotes seniors to age in place in rural context. It shows feasibility of delivering a practical intervention in the rural setting through the health care infrastructure of home care. Originality/value: Apart from the rural context, the study was innovative at many levels. Specifically, this intervention addressed a significant health issue (functional capacity, falls and injuries), involved
(Edited publisher abstract)
Purpose: A six-month randomized controlled trial was conducted to examine the impact of a home-based nutrition and exercise intervention on functional capacity to prevent falls among rural seniors. The paper aims to discuss this issue. Design/methodology/approach: Men and women (n=134), aged 60 and older were assigned to one of four groups: exercise, nutrition, exercise-nutrition and control. Participants in the exercise and exercise-nutrition groups performed a home-based exercise programme (Home Support Exercise Program), and the nutrition and exercise-nutrition groups received a liquid nutritional supplement (Ensure®) for six months. Participants were assessed at baseline and six months on functional mobility, balance, flexibility and endurance. Findings: There were significant group differences over time for functional reach and the Timed Up and Go test, with significant differences existing between exercise and nutrition-exercise and exercise and nutrition groups, respectively. Overall, the exercise group out-performed the other groups in terms of functional capacity and psychological well-being. Research limitations/implications: Improvement of functional health among rural seniors is achievable through the delivery of a home-based intervention focusing on exercise and nutrition. Practical implications: The study also shows that the effective delivery of an intervention to successfully address a fundamental and persistent problem is possible using existing resources; however, it requires a commitment of focus and energy over considerable time. Social implications: The approach and findings promotes seniors to age in place in rural context. It shows feasibility of delivering a practical intervention in the rural setting through the health care infrastructure of home care. Originality/value: Apart from the rural context, the study was innovative at many levels. Specifically, this intervention addressed a significant health issue (functional capacity, falls and injuries), involved frail rural seniors (often hard to reach through community-based programmes), provided a feasible intervention (multiple component exercise programme), used existing infrastructure (e.g. home care), and espoused community development principles (active involvement of community partners, researchers, and trainees). As well, the study had built-in mechanisms for monitoring and support through the involvement of home service workers who received training. This approach created a strong research to practice connection (another innovation) and was critical for the credibility of the investigation, as well as the sustainability of the intervention. Another innovation was the inclusion of a population health perspective as the study framework. From the population health perspective, this research addressed several determinants of health in rural and urban areas that include: physical environment (intervention within people’s home and rural context), social environment and social support networks (through existing infrastructures of home support workers), health services (availability of health promotion strategy delivered through the health care system) and personal health practices and coping skills (exercise).
(Edited publisher abstract)
Subject terms:
home care, rural areas, falls, prevention, nutrition, physical exercise, intervention, older people, wellbeing;
Background: The annual prevalence of falls in people with dementia ranges from 47 to 90%. Falls are a common reason for hospital admission in people with dementia, and there is limited research evidence regarding the care pathways experienced by this population. In addition to immediate management of an injury, prevention of further falls is likely to be an important part of any successful and Complementary Medicine Database, and Physiotherapy Evidence Database (PEDro)) and citation chaining. Studies including people with a known diagnosis of dementia living in the community and who present at health services with a fall, with or without injury, were included. Outcomes of interest included mobility, recurrent falls, activities of daily living, length of hospital stay, and post-discharge residence. assessment. Multidisciplinary care and early mobilisation showed short-term improvements for some outcomes. Only an annual administration of zoledronic acid showed long-term reduction in recurrent falls. Conclusions: Due to high heterogeneity across the studies, definitive conclusions could not be reached. Most post-fall interventions were not aimed at patients with dementia and have shown little efficacy
(Edited publisher abstract)
Background: The annual prevalence of falls in people with dementia ranges from 47 to 90%. Falls are a common reason for hospital admission in people with dementia, and there is limited research evidence regarding the care pathways experienced by this population. In addition to immediate management of an injury, prevention of further falls is likely to be an important part of any successful intervention. This review aims to assess the effectiveness of interventions for improving the physical and psychological wellbeing of people with dementia who have sustained a fall-related injury. Methods: Systematic review methodologies were employed utilising searches across multiple databases (MEDLINE, CENTRAL, Health Management Information Consortium, EMBASE, CINAHL, Web of Science, Allied and Complementary Medicine Database, and Physiotherapy Evidence Database (PEDro)) and citation chaining. Studies including people with a known diagnosis of dementia living in the community and who present at health services with a fall, with or without injury, were included. Outcomes of interest included mobility, recurrent falls, activities of daily living, length of hospital stay, and post-discharge residence. Results were independently reviewed and quality assessed by two researchers, and data extracted using a customised form. A narrative synthesis was performed due to heterogeneity of the included studies. Results: Seven studies were included. Interventions clustered into three broad categories: multidisciplinary in-hospital post-surgical geriatric assessment; pharmaceuticals; and multifactorial assessment. Multidisciplinary care and early mobilisation showed short-term improvements for some outcomes. Only an annual administration of zoledronic acid showed long-term reduction in recurrent falls. Conclusions: Due to high heterogeneity across the studies, definitive conclusions could not be reached. Most post-fall interventions were not aimed at patients with dementia and have shown little efficacy regardless of cognitive status. Minor improvements to some quality of life indicators were shown, but these were generally not statistically significant. Conclusions were also limited due to most studies addressing hip fracture; the interventions provided for this type of injury may not be suitable for other types of fractures or soft tissue injuries, or for use in primary care.
(Edited publisher abstract)
Subject terms:
systematic reviews, falls, dementia, older people, intervention, evaluation, outcomes, wellbeing, quality of life;
Outlines the results of Aesop's falls prevention dance programme for older people, Dance to Health. This arts based intervention address older people's falls and problems with some current falls prevention exercise programmes, by incorporating evidence-based exercise programmes into creative, social and engaging dance activity. The programme was developed using the Aesop 7-item checklist, which lists the features an arts programme should have for it to be taken up by the health system and made available to every patient who could benefit. The report outlines the rationale for creating the programme, the outcomes achieved - in addition to reduced falls, cost effectiveness, and the wider impact of the programme. It reports that the pilot successfully brought people from the worlds of dance and older people's exercise together, was able to train dance artists in the evidence-based falls programme, and also developed six evidence-based falls prevention programmes with 196 participants. A total of 73 per cent of participants achieved the target of 50 hours’ attendance over the six months, compared with a national average for completing standard falls prevention exercise programmes of 31 per
(Edited publisher abstract)
Outlines the results of Aesop's falls prevention dance programme for older people, Dance to Health. This arts based intervention address older people's falls and problems with some current falls prevention exercise programmes, by incorporating evidence-based exercise programmes into creative, social and engaging dance activity. The programme was developed using the Aesop 7-item checklist, which lists the features an arts programme should have for it to be taken up by the health system and made available to every patient who could benefit. The report outlines the rationale for creating the programme, the outcomes achieved - in addition to reduced falls, cost effectiveness, and the wider impact of the programme. It reports that the pilot successfully brought people from the worlds of dance and older people's exercise together, was able to train dance artists in the evidence-based falls programme, and also developed six evidence-based falls prevention programmes with 196 participants. A total of 73 per cent of participants achieved the target of 50 hours’ attendance over the six months, compared with a national average for completing standard falls prevention exercise programmes of 31 per cent for primary prevention and 46 per cent for secondary prevention. Additional outcomes identified included increases in group identification, relationships and reduced loneliness, functional health and wellbeing, and mental health and wellbeing.
(Edited publisher abstract)
One of six films made as part of an ESRC funded participatory research project which explored what well-being means to older people and how it is generated. The research was carried out by a team of older people, university researchers and a voluntary sector manager. This film re-visits Patrick and Gillian who have not been coping as well as they would have liked following Gillian's discharge from hospital after recovering from a fall. Taking the advice of Paul, a voluntary sector worker, they have contacted Social Services to request a formal assessment. Chloe, a social worker meets them to carry out this assessment. This scenario explores the way in which well-being involves making decisions about support and necessary adjustments that work for both partners. The film is a scripted scenario based on interviews.
(Edited publisher abstract)
One of six films made as part of an ESRC funded participatory research project which explored what well-being means to older people and how it is generated. The research was carried out by a team of older people, university researchers and a voluntary sector manager. This film re-visits Patrick and Gillian who have not been coping as well as they would have liked following Gillian's discharge from hospital after recovering from a fall. Taking the advice of Paul, a voluntary sector worker, they have contacted Social Services to request a formal assessment. Chloe, a social worker meets them to carry out this assessment. This scenario explores the way in which well-being involves making decisions about support and necessary adjustments that work for both partners. The film is a scripted scenario based on interviews.
(Edited publisher abstract)
Subject terms:
hospital discharge, falls, assessment, social workers, partners, wellbeing, decision making, older people;
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.
... on the results of rapid reviews of international and UK evidence to show the relative cost-effectiveness and return on investment on preventing loneliness and social isolation; caring for older carers; and preventing falls. It concludes that enabling people to work for longer, facilitating volunteering and supporting working parents through care of grandchildren brings many economic returns in terms being in older age, with a focus on reducing social isolation and loneliness; maintaining services to promote prevention (particularly falls prevention), rehabilitation and reablement; investment in sustainable homes, transport and communities; and support for informal carers.
(Edited publisher abstract)
This report, commissioned by Public Health Wales, explores the economic case for investing in older people in Wales to support people to live longer in good health in older age. It looks at investing in older people as assets, highlighting the importance of their contribution to the economy in Wales and the importance of housing and enabling independence in later life. It then draws on the results of rapid reviews of international and UK evidence to show the relative cost-effectiveness and return on investment on preventing loneliness and social isolation; caring for older carers; and preventing falls. It concludes that enabling people to work for longer, facilitating volunteering and supporting working parents through care of grandchildren brings many economic returns in terms of improving wellbeing; reducing loneliness, and supporting formal and wider community services. In addition co-production enables older people to remain active in the community and provides intergenerational benefits within the community and public sector services. The report concludes that Wales should focus investment on: fully integrated health and care services; maintaining physical and mental well being in older age, with a focus on reducing social isolation and loneliness; maintaining services to promote prevention (particularly falls prevention), rehabilitation and reablement; investment in sustainable homes, transport and communities; and support for informal carers.
(Edited publisher abstract)
Subject terms:
older people, prevention, health, wellbeing, cost effectiveness, intervention, loneliness, social isolation, falls, carers, employment, independent living, literature reviews;
NORTHERN IRELAND. Department of Health, Social Services and Public Safety
Publisher:
Northern Ireland. Department of Health, Social Services and Public Safety
Publication year:
2013
Pagination:
269
Place of publication:
Belfast
This Service Framework for Older People is one of a range of Service Frameworks which set out standards for health and social care to be used by patients, service users, carers and their wider families to help them understand the standard of care they can expect to receive in Northern Ireland. It sets standards in relation to people over 65 whilst taking account of the needs of those over 50, where appropriate, particularly in relation to preventative measures. The Framework sets standards in relation to: Person-centred Care; Health and Social Wellbeing Improvement; Safeguarding; Carers; Conditions more Common in Older People; Medicines Management and Transitions of Care. Each standard is accompanied by a statement on what the standard is intended to achieve. It also sets out the evidence base and rationale for the development of the standard, the impact of the standard on quality improvement as well as the performance indicators that will be used to measure that the standard during the three year period 2013 - 2016. The Framework has been developed by multidisciplinary Programme Board with the involvement of patients, users of services and their carers. The Framework will be regularly review in the light of new evidence.
(Edited publisher abstract)
This Service Framework for Older People is one of a range of Service Frameworks which set out standards for health and social care to be used by patients, service users, carers and their wider families to help them understand the standard of care they can expect to receive in Northern Ireland. It sets standards in relation to people over 65 whilst taking account of the needs of those over 50, where appropriate, particularly in relation to preventative measures. The Framework sets standards in relation to: Person-centred Care; Health and Social Wellbeing Improvement; Safeguarding; Carers; Conditions more Common in Older People; Medicines Management and Transitions of Care. Each standard is accompanied by a statement on what the standard is intended to achieve. It also sets out the evidence base and rationale for the development of the standard, the impact of the standard on quality improvement as well as the performance indicators that will be used to measure that the standard during the three year period 2013 - 2016. The Framework has been developed by multidisciplinary Programme Board with the involvement of patients, users of services and their carers. The Framework will be regularly review in the light of new evidence.
(Edited publisher abstract)
Subject terms:
older people, standards, person-centred care, safeguarding adults, carers, service transitions, medication, wellbeing, health, falls, end of life care, health care, social care, performance indicators;