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Understanding contextual factors in falls in long-term care facilities
- Authors:
- SIXSMITH Andrew, et al
- Journal article citation:
- Quality in Ageing and Older Adults, 14(3), 2013, pp.160-166.
- Publisher:
- Emerald
Purpose – Despite the growing area of research involving falls in the residential care setting, the link between contextual and environmental factors in falls is poorly understood. This paper aims to draw upon existing research being undertaken in long-term care (LTC) in Metro Vancouver, Canada, with a particular focus on identifying contextual factors contributing to fall events. Design/methodology/approach – This paper presents the results of a qualitative observational analysis of video-captured data collected through a network of high-quality video systems in two LTC facilities. The research comprised workshops involving experienced researchers who reviewed six video sequences of fall events. The outcome of the workshops was a written narrative summarising the discussion and researchers’ interpretation of fall sequences. Findings – The analysis indicates that there are a broad range of environmental, behavioral and situational factors that contribute to falls in LTC. This suggests that a limited conceptualisation of a fall as an outcome of the person's impairment and environmental hazards fails to convey the complexity of potential contributory factors typical of most fall incidents. Research limitations/implications – Broadening our understanding of falls provides the potential to make recommendations for falls prevention practice across multiple levels, including the individual, social and organisational context. Originality/value – The paper evaluates the potential of video-based data in fall analysis and points to the development of a case study approach to analysing fall incidents to capture the complex nature of contributory factors beyond research that focuses solely on intrinsic and extrinsic risk factors. (Publisher abstract)
Depressive symptoms in the very old living alone: prevalence, incidence and risk factors
- Authors:
- WILSON Kenneth, MOTTRAM Patricia, SIXSMITH Andrew
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(4), April 2007, pp.361-366.
- Publisher:
- Wiley
Living alone is one of many risk factors associated with depression. This project is nested within the ENABLE-AGE project designed to explore the relationship between housing environment and health in the very old living alone in their own homes. The aim of this specific study is to describe the prevalence, incidence and associated risk factors of clinically significant depressive symptoms in this population with particular emphasis on the role of the home environment. The authors conducted a one year follow up of 376 subjects aged between 80 and 90 years old. Data collected included variables concerned with housing, social circumstances, physical health and psychological well being. A prevalence rate of 21% and an annual incidence of 12.4% (Geriatric Depression Score of five or more) were found. Risk factors associated with prevalence depression include not living close to friends and family, poor satisfaction with living accommodation and poor satisfaction with finances. Subsequent development of clinically significant depressive symptoms was associated with base line increased scores in depression. These results are consistent with findings in the general population of similar age with the exception of considerably higher prevalence and incidence rates. However, the authors were unable to demonstrate that housing related variables were significant risk factors in terms of incidence cases. Older people living alone are particularly vulnerable to depression and may benefit from targeted screening and development of appropriate care pathways.