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Randomised factorial trial of falls prevention among older people living in their own homes
- Authors:
- DAY Leslie, et al
- Journal article citation:
- British Medical Journal, 20.07.02, 2002, pp.128-131.
- Publisher:
- British Medical Association
Three interventions, group based exercise, home hazard management and vision improvement were examined to prevent falls. The group based exercise was the most successful and the reduction in falls seems to be associated with improved balance. Falls were further reduced by the other two interventions.
Content validity of an assessment tool to identify home fall hazards: the Westmead Home Safety Assessment
- Authors:
- CLEMSON Lindy, FITZGERALD Maureen H., HEARD Robert
- Journal article citation:
- British Journal of Occupational Therapy, 62(4), April 1999, pp.171-179.
- Publisher:
- Sage
Reports on a study to develop a valid assessment tool for occupational therapists to identify home fall hazards. Looks at how the Westmead Home Safety Assessment was refined and the accompanying manual compiled.
Abuse of patients with dementia by carers: out of sight but not out of mind
- Authors:
- COONEY Colm, HOWARD Robert
- Journal article citation:
- International Journal of Geriatric Psychiatry, 10(9), 1995, pp.735-741.
- Publisher:
- Wiley
Elderly people with dementia living with a carer are at significantly higher risk of abuse than the general population over 65. This review looks at the limitations of the research to date discusses risk factors in both carers and patients that predispose them to abuse. Management strategies are discussed with reference to the growing research base.
Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials
- Authors:
- CHANG John, et al
- Journal article citation:
- British Medical Journal, 20.03.04, 2004, pp.680-683.
- Publisher:
- British Medical Association
This study assesses the relative effectiveness of interventions to prevent falls in older adults to either a usual care group or control group. Data sources used included Medline, HealthSTAR, Embase, the Cochrane Library, other health related databases, and the reference lists from review articles and systematic reviews. Forty trials were identified. A random effects analysis combining trials with risk ratio data showed a reduction in the risk of falling whereas combining trials with incidence rate data showed a reduction in the monthly rate of falling. The effect of individual components was assessed by meta-regression. A multifactorial falls risk assessment and management programme was the most effective component on risk of falling and monthly fall rate. Exercise interventions also had a beneficial effect on the risk of falling and monthly fall rate. Concludes that interventions to prevent falls in older adults are effective in reducing both the risk of falling and the monthly rate of falling. The most effective intervention was a multifactorial falls risk assessment and management programme.
Ever ready
- Author:
- LEWIS Carol
- Journal article citation:
- Health Service Journal, 8.03.04, 2004, pp.126-27.
- Publisher:
- Emap Healthcare
Describes an American model of care for older people which is being piloted in the UK by 10 Primary Care Trusts (PCTs). 'Evercare' has helped nurse practitioners cut admissions and prescriptions through improved risk management.
High-risk management guidelines for elderly suicidal patients in primary care settings
- Authors:
- BROWN Gregory K., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 16(6), June 2001, pp.593-601.
- Publisher:
- Wiley
Older adults, especially older white men, are more likely to commit suicide than other age-groups. The assessment and management of suicide ideation and behaviour for the elderly is especially relevant for primary care physicians because many patients visit their physician shortly before committing suicide. In 1993, the Agency for Health Care Policy and Research (AHCPR) in the United States released clinical practice guidelines for the treatment of depression in primary care settings. The AHCPR guidelines offered some assistance with respect to detecting and treating patients who are suicidal. However, these guidelines lacked detailed and specific instructions for managing high-risk patients within the context of intervention research. The current set of guidelines builds upon this previous work by describing (1) a general approach for interacting with suicidal patients; (2) structured assessments for determining the degree of risk for suicide; (3) crisis intervention strategies; and (4) ongoing management procedures for working with suicidal patients in primary care settings.
The relationship between self-destructive behaviour and nursing home environment
- Authors:
- LOW L-F, DRAPER B., BRODATY H.
- Journal article citation:
- Aging and Mental Health, 8(1), January 2004, pp.29-33.
- Publisher:
- Taylor and Francis
The aim of this study was to explore the relationship between self-destructive behaviour and nursing home environment. We performed a cross-sectional study comprising 647 residents in 11 nursing homes in Sydney, Australia using the Harmful Behaviours Scale (HBS), Abbreviated Mental Test Scale and the Resident Classification Index. The Directors of Nursing completed a questionnaire that rated physical design, staff and resident characteristics and demographics were obtained from nursing home records. On regression analysis a greater number of design features for frail and residents with dementia in general, and increased security measures were associated with greater HBS total score and risk-taking and passive self-harm subscales. A residential environment in which the residents were more functionally dependent and more likely to be in a shared room, managerial policies less geared towards managing difficult behaviour and less staff availability and training were associated with the 'uncooperativeness' factor. There were no significant predictors of the other two factors. The relationship between nursing home environment and self-destructive behaviours and the environment is complex and there needs to be an individualized approach to placement.
Suspected financial abuse among cases administered by the PGO
- Authors:
- BROWN Hilary, BURNS Sophie, WILSON Barry
- Journal article citation:
- Journal of Adult Protection, 5(2), May 2003, pp.26-37.
- Publisher:
- Emerald
The risk of financial abuse is a major concern for the Public Guardianship Office (PGO) in England and Wales and the Court of Protection. This article reports on a study analysing case files identified by Public Guardianship Office staff as those in which abuse was a strong possibility. Presents summaries of some of the cases. Analysis of the cases suggested that a more proactive system of risk management could be developed. Three interacting risk domains were highlighted: the person's vulnerability; the character/intention of the person's representative; and the financial arrangements in place.
Risk, social policy and welfare
- Author:
- KEMSHALL Hazel
- Publisher:
- Open University Press
- Publication year:
- 2002
- Pagination:
- 167p.,bibliog.
- Place of publication:
- Buckingham
Traditionally, need has been the major mechanism for allocating resources in public services, and social policy texts have addressed various state responses to social problems and the alleviation of need. However, in a period of state retrenchment and welfare restriction, rationing and targeting have become more intense. This book explores the extent to which, as a result, risk and vulnerability have replaced need as the key principles of welfare rationing and provision. It begins with an introductory overview of current theories on risk and goes on to examine the relevance of risk to social policy and welfare developments. Draws on recent social policy and case examples from health, the personal social services and mental health as illustrations.
Responding to residents: a report of inspections of local authority residential care homes for older people
- Author:
- GREAT BRITAIN. Department of Health. Social Services Inspectorate
- Publisher:
- Great Britain. Department of Health. Social Services Inspectorate
- Publication year:
- 1995
- Pagination:
- 70p.,bibliog.
- Place of publication:
- London
Report gathering information from inspections of residential care homes in 9 SSDs. Targeted at those responsible for residential care, it highlights issues arising from the inspections.