Search results for ‘Subject term:"older people"’ Sort:
Results 1 - 10 of 24
Fear of falling and activity avoidance in a national sample of older adults in the United States
- Authors:
- BERTERA Elizabeth, BERTERA Robert L.
- Journal article citation:
- Health and Social Work, 33(1), February 2008, pp.54-62.
- Publisher:
- Oxford University Press
This study assesses the relationship between fear of falling and avoidance of nine everyday activities critical to independence among community-dwelling older adults in the United States. Secondary data analysis was performed with National Survey of Self-Care and Aging interview data from 3,474 respondents age 65 years or older. Falls were reported by 24 percent of respondents, fear of falling was reported by 22 percent of respondents, and both increased with age. Fear of falling was the most important factor in predicting activity avoidance among older adults; the number of falls experienced increases the impact that fear of falling has on activity avoidance. Other factors were as follows: needing help with activities of daily living and the number of prescriptions taken. Assessments of older individuals should include fear of falling and fall history. Reductions in fear of falling and increases in activity level could provide significant benefits by helping older adults to maintain functioning and the ability to live independently.
Determinants of disparities between perceived and psychological risk of falling among elderly people: cohort study
- Authors:
- DELBAERE Kim, et al
- Journal article citation:
- British Medical Journal, 28.8.10, 2010, p.436.
- Publisher:
- British Medical Association
This study investigated older people’s fear of falling by exploring the prevalence and determinants of perceived fall risk (measured by the falls efficacy scale international) and physiological fall risk (measured by the physiological profile assessment) and to understand the role of disparities in perceived and physiological risk in the cause of falls. It was found that many elderly people underestimated or overestimated their risk of falling. These disparities were primarily associated with psychological measures and strongly influenced the probability of falling. It is concluded that measures of both physiological and perceived fall risk should be included in fall risk assessments to allow tailoring of interventions for preventing falls in elderly people.
Falls and catastrophic thoughts about falls predict mobility restriction in community-dwelling older people: a structural equation modelling approach
- Authors:
- DELBAERE Kim, et al
- Journal article citation:
- Aging and Mental Health, 13(4), July 2009, pp.587-592.
- Publisher:
- Taylor and Francis
How and when concerns about falls emerge is not yet completely known, because these concerns are present in both people with and without a falls history. The aim of this study was to investigate the role of catastrophic beliefs about falls and previous falls in the development of concerns about falls and resulting mobility restrictions (MR). Within a cross-sectional design, 896 older people living independently in the community in the Netherlands completed a battery of questionnaires. Self-report data was gathered on previous falls, catastrophic beliefs about consequences of a fall (Catastrophizing About Falls Scale), concerns about falls (modified Falls Efficacy Scale) and mobility restrictions during daily life (Sickness Impact Profile 68). Using structural equation modelling, it was found that the number of falls in the previous year was not directly related to mobility restrictions in daily life, but via an increase of concerns about falls. Also catastrophic beliefs about the consequences of falls were related to concerns about falls and to mobility restrictions. Goodness-of-fit indices revealed that the presented model had an acceptable fit. Alternative models resulted in lesser-fit indices. Both previous falls and catastrophic beliefs about falls are unique and independent predictors of concerns about falls and, subsequently, of mobility restrictions. A cognitive-behavioural perspective upon mobility restrictions may provide important additional components for treatment and prevention of excessive concerns about falls in older people.
Constructions of frailty in the English language, care practice and the lived experience
- Author:
- GRENIER Amanda
- Journal article citation:
- Ageing and Society, 27(3), May 2007, pp.425-445.
- Publisher:
- Cambridge University Press
The way frailty is conceptualised and interpreted has profound implications for social responses, care practice and the personal experience of care. This paper begins with an exegesis of the concept of frailty, and then examines the dominant notions of frailty, including how ‘frailty’ operates as a ‘dividing-practice’ through the classification of those eligible for care. The definitions and uses of ‘frailty’ in three discursive locations are explored in: (a) the Oxford English Dictionary, (b) the international research literature, and (c) older women's accounts of their lived experience. Three distinctive discourses are found, and applying a Foucauldian analysis, it is shown that the differences reflect overlaps and tensions between biomedical concepts and lived experiences, as well as negative underlying assumptions and ‘subjugated knowledge’. The concept of frailty represents and orders the context, organisational practices, social representations and lived experiences of care for older people. The evidence suggests that if, as the older women's accounts recommended, socially- and emotionally-located expressions of frailty were recognised in addition to the existing conceptions of risk of the body, frailty might no longer be thought of primarily as a negative experience of rupture and decline. To encourage this change, it is suggested that practice focuses on the prevention of frailty and associated feelings of loss, rather than reinforcing the feelings and experiences which render a person ‘frail’.
Interventions to reduce fear of falling in community-living older people: a systematic review
- Authors:
- ZIJLSTRA G. A .R., et al
- Journal article citation:
- Journal of the American Geriatrics Society, 55(4), 2007, pp.603-615.
- Publisher:
- Blackwells Publishing
This review of 19 randomised controlled trials (12 judged to be of higher methodological quality) was conducted according to Cochrane principles and shows the following approaches to be effective in reducing the fear of falling: five fall-related multifactorial interventions (three home- and two group-based); three group-based tai chi programmes; two home-based exercise interventions; and a hip protector intervention. The primary aim of most of these interventions was to reduce falls rather than the fear of falling, and most also succeeded in this respect. The authors conclude that there is limited but fairly consistent evidence in favour of these interventions, and that more high quality, well reported and directly comparable research is needed.
Defining a fall and reasons for falling: comparisons among the views of seniors, health care providers, and the research literature
- Authors:
- ZECEVIC Aleksandra A., et al
- Journal article citation:
- Gerontologist, 46(3), June 2006, pp.367-376.
- Publisher:
- Oxford University Press
The purpose of this Canadian study was (a) to obtain information about the perceptions held by seniors and health care providers concerning what constitutes a fall and potential reasons for falling, and (b) to compare these perceptions to the research literature. As part of a larger telephone survey, interviewers asked 477 community-dwelling seniors to define a fall and to provide reasons for falling. In addition, 31 health care providers from the community were interviewed on the same topics. In order to capture patterns in conceptualized thinking, content analysis was used to develop codes and categories for a fall definition and reasons for falling. Selected articles were reviewed in order to obtain a comprehensive overview of fall definitions currently used in the research and prevention literature. The results found that a fall had different meanings for different groups. Seniors and health care providers focused mainly on antecedents and consequences of falling, whereas researchers described the fall event itself. There were substantial differences between the reasons for falling as reported by seniors and the risk factors as identified in the research literature. The authors conclude that if not provided with an appropriate definition, seniors can interpret the meaning of a fall in many different ways. This has the potential to reduce the validity in studies comparing fallers to nonfallers. Research reports and prevention programs should always provide an operational definition of a fall. In communication between health care providers and seniors, an appropriate definition increases the possibility for early detection of seniors in greater need of care and services.
The symbolic value of tai chi for older people
- Author:
- SCOURFIELD Peter
- Journal article citation:
- Quality in Ageing, 7(2), June 2006, pp.4-12.
- Publisher:
- Pier Professional
- Place of publication:
- Brighton
This article is based on a small-scale study into a tai chi class for older people at risk of falling. The aims of the research were to explore what benefits the class members felt they derived from practicing Tai Chi and whether they practiced Tai Chi at home. The research revealed that members did not believe that Tai Chi had reduced their risk of falling, though their commitment to Tai Chi was very strong. The findings suggest that tai chi had a symbolic value for this predominantly middle class group.
Fall detectors: do they work or reduce the fear of falling?
- Authors:
- BROWNSELL S, HAWLEY M.
- Journal article citation:
- Housing Care and Support, 7(1), February 2004, pp.18-24.
- Publisher:
- Emerald
This study sought to discover the views of users and providers on fall detectors and to quantify the impact fall detectors have on the fear of falling. Five focus groups comprising of a total of 34 older people from Age Concern day centres, residents from a sheltered housing scheme and representatives form older people's forums in South Yorkshire were conducted. Six groups were also held with service providers, where 25 people were consulted. The study also included a trial of an automatic fall detector, conducted with 55 users aged 60 or over how had fallen in the previous six months or users over the age of 75. The results of the study suggest that fall-monitoring equipment is not considered routinely as part of a care package, and knowledge of devices is poor. A trial of automatic fall detectors provided indicated that they may reduce fear of falling for certain users and so should be considered in falls management, but more evidence and understanding are required to appreciate both the benefits and shortfalls of providing equipment of this sort.
Exploration of older people's perceptions of behavioural factors associated with falls
- Authors:
- ROBSON Kristy, COYLE Julia, POPE Rodney
- Journal article citation:
- Age and Ageing, 47(5), 2018, pp.734-740.
- Publisher:
- Oxford University Press
Background: Falls rates in older people continue to rise despite concerted efforts to manage falls risks. As more effective strategies to reduce falls in older people may arise from better understanding their perspectives on falls risk, this study aimed to explore perceptions and behavioural decisions that may affect risk of falling among older people living in regional Australia. Method: This qualitative research, informed by hermeneutics, explored older people’s perspectives on decisions they made that could affect their falls risk. The study involved 26 participants (21 females) aged 65–84 years, residing in regional Australia. In total, 13 participated in semi-structured focus groups and 13 in semi-structured, in-depth interviews. Results: Six key themes illuminated the challenges older people faced in relation to falls risk. These were: the role that independence played in decision making regarding risk; the influence of previous falls experience; older people’s level of understanding of risks; ability and willingness to engage with support; the need or desire to cover up a fall history; and the influence of finances in managing risk. Older people’s accounts demonstrated they experienced competing influences that impacted upon decisions they made with respect to falls risks. Most significantly, the complex interplay of these influences drove the decisions older people made, sometimes placing them at greater risk of falling. Conclusion: Consideration of the multifaceted issues older people face when managing falls risk, and the influence these factors have on their behaviours, is vital to successfully reducing rates of fall related injuries in this population. (Publisher abstract)
Seniors' narratives of asking (and not asking) for help after a fall: implications for identity
- Authors:
- MILLER Patricia A., et al
- Journal article citation:
- Ageing and Society, 36(2), 2016, pp.240-258.
- Publisher:
- Cambridge University Press
Falls among community-dwelling seniors constitute a major public health concern because of the potential morbidity and mortality associated with the fall. This study examined the informal care networks accessed by Canadian seniors who had visited the Emergency Department as a result of a fall, and considered the implications of the processes of asking for and receiving help on the senior's identity. Four themes were identified. The first was valuing independence. The remaining three themes concerned threats to the participants' identities linked to the need to ask for or receive help from family and friends. They were: becoming indebted, feeling devalued and becoming a burden to others. Seniors were noted to excuse family members from the expectation of helping because of work and family commitments, and illness. Participants described a mutually beneficial relationship with friends wherein both parties valued their independence and provided assistance to the other when needed. Their comments suggested that assistance was viewed as a good to be traded among peers. The findings indicate that seniors value their independence and may not seek help even when it appears to be available, if asking threatens valued identities. Health and social care practitioners and policy makers responsible for planning and delivery of services should take this into account in order to ensure the best possible care for injured community-dwelling seniors. (Edited publisher abstract)