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North West London Strategic Health Authority falls services baseline survey
- Authors:
- YOUNG Michael, ELIAS Ralph
- Publisher:
- North West London Strategic Health Authority
- Publication year:
- 2006
- Pagination:
- 7p.
- Place of publication:
- London
Falls are one of the sector’s priorities within the implementation of the older peoples national service framework (OP NSF). This paper contains a draft baseline survey aimed at taking a “snapshot” of the health and social care economy with respect to this important area. The aim is to finalise the survey by the end of January, to conduct it in February and to report back result by early March 2006.
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.
Exploring enablers and barriers to accessing health services after a fall among people with intellectual disability
- Authors:
- HO Portia, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 33(3), 2020, pp.604-617.
- Publisher:
- Wiley
Background: Adults with intellectual disability experience high rates of falls making falls prevention an important health need. The purpose of the study was to seek perspectives of older adults with intellectual disability and their caregivers to (a) explore the experiences of older adults with intellectual disability when seeking healthcare services after a fall and (b) identify enablers and barriers when taking up evidence‐based falls recommendations. Method: A qualitative exploratory study was undertaken as part of a prospective observational cohort study. Semi‐structured interviews were conducted with a purposeful sample. Data were analysed thematically using Colaizzi's method. Results: Seventeen interviews were conducted (n = 21). Emergent themes demonstrated that participants had limited knowledge about falls prevention. Enablers included individualizing falls prevention strategies. Barriers included not being offered access to established falls prevention pathways. Conclusion: There is an urgent need to develop high‐quality falls prevention services for older adults with intellectual disability. (Edited publisher abstract)
Which factors are associated with fear of falling in community-dwelling older people?
- Authors:
- KUMAR Arun, et al
- Journal article citation:
- Age and Ageing, 43(1), 2014, pp.76-84.
- Publisher:
- Oxford University Press
Background: Fear of falling (FOF) is common in older people and associated with serious physical and psychosocial consequences. Identifying those at risk of FOF can help target interventions to both prevent falls and reduce FOF. Objective: To identify factors associated with FOF. Study design: Cross-sectional study in 1,088 community-dwelling older people aged ≥65 years. Methods: Data were collected on socio-demographic characteristics, self-perceived health, exercise, risk factors for falls, FOF (Short FES-I), and functional measures. Logistic regression models of increasing complexity identified factors associated with FOF. Results: High FOF (Short FES-I ≥11) was reported by 19%. A simpler model (socio-demographic + falls risk factors) correctly classified as many observations (82%) as a more complex model (socio-demographic + falls risk factors + functional measures) with similar sensitivity and specificity values in both models. There were significantly raised odds of FOF in the simpler model with the following factors: unable to rise from a chair of knee height (OR: 7.39), lower household income (OR: 4.58), using a walking aid (OR: 4.32), difficulty in using public transport (OR: 4.02), poorer physical health (OR: 2.85), black/minority ethnic group (OR: 2.42), self-reported balance problems (OR: 2.17), lower educational level (OR: 2.01) and a higher BMI (OR: 1.06). Conclusions: A range of factors identify those with FOF. A simpler model performs as well as a more complex model containing functional assessments and could be used in primary care to identify those at risk of FOF, who could benefit from falls prevention interventions. (Publisher abstract)
Falls: assessment and prevention of falls in older people: CG161
- Author:
- NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
- Publisher:
- National Institute for Health and Care Excellence
- Publication year:
- 2013
- Pagination:
- 315
- Place of publication:
- Manchester
Falls and fall-related injuries are a common and serious problem for older people. People aged 65 and older have the highest risk of falling, with 30% of people older than 65 and 50% of people older than 80 falling at least once a year. This clinical guideline is for healthcare and other professionals and staff who care for older people who are at risk of falling. It provides evidence and recommendations on the assessment and prevention of falls in older people. It extends and replaces ‘Falls: assessment and prevention of falls in older people’ (NICE clinical guideline 21; 2004), by including additional recommendations about preventing falls in people admitted to hospital (inpatients). This document includes all the recommendations, details of how they were developed, and summaries of the evidence they were based on. (Edited publisher abstract)
Falls in older people: assessing risk and prevention: CG161
- Author:
- NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
- Publisher:
- National Institute for Health and Care Excellence
- Publication year:
- 2013
- Pagination:
- 33
- Place of publication:
- Manchester
This clinical guideline is for healthcare and other professionals and staff who care for older people who are at risk of falling. It extends and replaces NICE clinical guideline 21 (published November 2004). It offers evidence-based advice on preventing falls in older people; and also offers best practice advice on the care of older people who are at risk of falling. New recommendations have been added about assessing and preventing falls in older people during a hospital stay. All people aged 65+r are covered by all guideline recommendations. People aged 50 to 64 who are admitted to hospital and are judged by a clinician to be at higher risk of falling because of an underlying condition are also covered by the guideline recommendations about assessing and preventing falls in older people during a hospital stay. The full guideline, 'Falls: assessment and prevention of falls in older people' contains details of the methods and evidence used to develop the guideline; it was developed by the Internal Clinical Guidelines Programme at NICE. (Edited publisher abstract)
Impact and economic assessment of assistive technology in care homes in Norfolk, UK
- Authors:
- AL-ORAIBI Saleh, FORDHAM Ric, LAMBERT Rod
- Journal article citation:
- Journal of Assistive Technologies, 6(3), 2012, pp.192-201.
- Publisher:
- Emerald
This study looked at whether new assistive technology (AT) systems in care homes for elderly residents, reduced the number of falls and demands for formal health services. The project collected retrospective data about the incidence of falls before and after AT systems were installed in two care homes in Norfolk, UK. These homes were selected purposefully because a recent assessment identified the need for upgrading their call system. They had different resident profiles regarding the prevalence of dementia. Standard incident report forms were examined for a period starting ten months before the upgrades to ten months after in Care Home 1 and from six months before to six months afterwards in Care Home 2. Overall there were 314 falls reported during the course of the study; the number reduced from 202 to 112 after the introduction of AT. The mean health care costs associated with falls in Care Home 1 were significantly reduced (more than 50%). In Care Home 2 there was no significant difference in the mean cost. The results suggest that installing an AT system in residential care homes can reduce the number of falls and health care cost in homes with a lower proportion of residents with advanced dementia compared to those with more residents with advanced dementia.
A systematic review of older people's perceptions of facilitators and barriers to participation in falls-prevention interventions
- Authors:
- BUNN Frances, et al
- Journal article citation:
- Ageing and Society, 28(4), May 2008, pp.449-472.
- Publisher:
- Cambridge University Press
The prevention of falls is currently high on the health policy agenda in the United Kingdom, which has led to the establishment of many falls-prevention services. If these are to be effective, however, the acceptability of services to older people needs to be considered. This paper reports a systematic review of studies of older people's perceptions of these interventions. The papers for review were identified by searching electronic databases, checking reference lists, and contacting experts. Two authors independently screened the studies and extracted data on the factors relating to participation in, or adherence to, falls-prevention strategies. Twenty-four studies were identified, of which 12 were qualitative. Only one study specifically examined interventions that promote participation in falls-prevention programmes; the others explored older people's attitudes and views. The factors that facilitated participation included social support, low intensity exercise, greater education, involvement in decision-making, and a perception of the programmes as relevant and life-enhancing. Barriers to participation included fatalism, denial and under-estimation of the risk of falling, poor self-efficacy, no previous history of exercise, fear of falling, poor health and functional ability, low health expectations and the stigma associated with programmes that targeted older people.
Falls and the use of health services in community-living elderly people
- Authors:
- STODDART Helen, et al
- Journal article citation:
- British Journal of General Practice, 52(484), November 2002, pp.923-925.
- Publisher:
- Royal College of General Practitioners
Describes the unmet need in relation to falls in older people. A postal questionnaire was sent to a random sample of 2000 elderly people in the southwest of England. 79% returned a completed questionnaire. Results found that although falling, fear of falling, and activity restriction are common, many people do not seek assistance from healthcare professionals. Concludes that people who have fallen or at risk of falling need to be identified, and local policies and information regarding treatment for osteoporosis are needed.
Effect of orthostatic hypotension on falls risk
- Authors:
- WINDSOR Julie, et al
- Journal article citation:
- Nursing Times, 112(43/44), 2016, pp.11-13.
- Publisher:
- Nursing Times
Orthostatic hypertension (OH) occurs frequently in older patients, particularly when they are in hospital. It can caus lightheadedness, unsteadiness and falls, This article looks at the role of nurses in understanding, assessing, monitoring and treating OH. (Edited publisher abstract)