Multifactorial and functional mobility assessment tools for fall risk among older adults in community, home-support, long-term and acute care settings

Introduction: To evaluate fall-prevention rehabilitative slippers for use by self-caring, independent older adults. Materials and Methods: This assessor-blinded, randomized, and controlled 1-year study included 59 self-caring, independent participants (49 women) who attended day services. The mean age of participants was 84.0 ± 5.3 years. Participants were randomly selected from 8 nursing homes. We tested slippers top-weighted with a lead bead (200, 300, or 400 g). Intervention group participants walked while wearing the slippers for 10-20 min, 1-3 days/week at the day service center. Fall risk was measured using the Berg Balance Scale and the Tinetti Performance-Oriented Mobility Assessment (POMA) before and at 3-month intervals after the intervention/control phase. Results: After 12 months, the intervention group demonstrated significant improvement. Berg Balance and POMA compared to the control group ( p < .05 p < .01, respectively). Mobility scores improved significantly for both measurements in the intervention group before and after ( p < .01), but the control group had significantly lower scores. Discussion: Overall, falls decreased in the intervention group from 10 to 7, and control group falls increased from 9 to 16 ( p = .02). No adverse events related to the intervention were reported. Conclusions: Rehabilitation training slippers may reduce falls in older adults.

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The Impact of Function Focused Care From Acute Care to Home Care and Nursing Homes

Innovation in Aging ◽

10.1093/geroni/igaa057.2148 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 629-629

Author(s):

Silke Metzelthin ◽

Sandra Zwakhalen ◽

Barbara Resnick

Keyword(s):

Older Adults ◽

The Netherlands ◽

Home Care ◽

Acute Care ◽

Long Term Care ◽

Functional Decline ◽

Term Care ◽

The Us ◽

The Impact

Abstract Functional decline in older adults often lead towards acute or long-term care. In practice, caregivers often focus on completion of care tasks and of prevention of injuries from falls. This task based, safety approach inadvertently results in fewer opportunities for older adults to be actively involved in activities. Further deconditioning and functional decline are common consequences of this inactivity. To prevent or postpone these consequences Function Focused Care (FFC) was developed meaning that caregivers adapt their level of assistance to the capabilities of older adults and stimulate them to do as much as possible by themselves. FFC was first implemented in institutionalized long-term care in the US, but has spread rapidly to other settings (e.g. acute care), target groups (e.g. people with dementia) and countries (e.g. the Netherlands). During this symposium, four presenters from the US and the Netherlands talk about the impact of FFC. The first presentation is about the results of a stepped wedge cluster trial showing a tendency to improve activities of daily living and mobility. The second presentation is about a FFC training program. FFC was feasible to implement in home care and professionals experienced positive changes in knowledge, attitude, skills and support. The next presenter reports about significant improvements regarding time spent in physical activity and a decrease in resistiveness to care in a cluster randomized controlled trial among nursing home residents with dementia. The fourth speaker presents the content and first results of a training program to implement FFC in nursing homes. Nursing Care of Older Adults Interest Group Sponsored Symposium

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The validity and utility of violence risk assessment tools to predict patient violence in acute care settings: An integrative literature review

International Journal of Mental Health Nursing ◽

10.1111/inm.12645 ◽

2019 ◽

Vol 28 (6) ◽

pp. 1248-1267 ◽

Cited By ~ 2

Author(s):

Manonita Ghosh ◽

Di Twigg ◽

Yvonne Kutzer ◽

Amanda Towell‐Barnard ◽

Gideon De Jong ◽

...

Keyword(s):

Risk Assessment ◽

Literature Review ◽

Acute Care ◽

Assessment Tools ◽

Violence Risk ◽

Violence Risk Assessment ◽

Patient Violence ◽

Risk Assessment Tools ◽

Acute Care Settings

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Use of clinical frailty scale in acute care settings as a predictor of in-hospital and short-term mortality in older adults with severe acute respiratory illness: A prospective pilot cohort study from India

Journal of the Indian Academy of Geriatrics ◽

10.4103/jiag.jiag_25_21 ◽

2021 ◽

Vol 17 (3) ◽

pp. 89

Author(s):

Sunny Singhal ◽

Pramod Kumar ◽

Akshata Rao ◽

Sunil Jyani ◽

Nayer Jamshed ◽

...

Keyword(s):

Older Adults ◽

Cohort Study ◽

Acute Care ◽

Respiratory Illness ◽

Acute Respiratory Illness ◽

Short Term ◽

Clinical Frailty Scale ◽

Short Term Mortality ◽

Acute Care Settings ◽

Severe Acute Respiratory Illness

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Barriers and Facilitators for Screening Older Adults on Fall Risk in a Hospital Setting: Perspectives from Patients and Healthcare Professionals

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17051461 ◽

2020 ◽

Vol 17 (5) ◽

pp. 1461

Author(s):

Lotte M. Barmentloo ◽

Manon L. Dontje ◽

Moniek Y. Koopman ◽

Branko F. Olij ◽

Christian Oudshoorn ◽

...

Keyword(s):

Older Adults ◽

Healthcare Worker ◽

Acute Care ◽

Fall Risk ◽

Chronic Care ◽

Healthcare Professionals ◽

Assessment Instrument ◽

Barriers And Facilitators ◽

Worker Characteristics ◽

Program Characteristics

We aimed to gain insight into the barriers and facilitators to fall risk screening of older adults visiting the hospital as experienced by patients and healthcare professionals, and to examine the differences between chronic- and acute-care patients. We invited patients (≥ 70 years) attending the nephrology and emergency department to participate in the screening. Patients and their healthcare professionals were asked to complete a self-administered questionnaire based on the “Barriers and Facilitators Assessment Instrument”. Differences in barriers and facilitators between acute- and chronic-care patients were examined with chi-square tests. A total of 216 patients were screened, and 103 completed the questionnaire. They considered many factors as facilitators, and none as barriers. Acute-care patients were more positive than chronic-care patients about healthcare worker characteristics, such as knowledge and skills. After screening, patients were more open to receiving advice regarding fall prevention. The 36 healthcare professionals considered program characteristics to be facilitators and mainly factors regarding healthcare worker characteristics as barriers to implementation. For patients, the outpatient setting seemed to be a good place to be screened for fall risk. Healthcare professionals also suggested that program characteristics could enhance implementation. However, healthcare professionals’ mindsets and the changing of routines are barriers that have to be addressed first.

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Towards Using the Instrumented Timed Up-and-Go Test for Screening of Sensory System Performance for Balance Control in Older Adults

Sensors ◽

10.3390/s19030622 ◽

2019 ◽

Vol 19 (3) ◽

pp. 622 ◽

Cited By ~ 3

Author(s):

Thomas Gerhardy ◽

Katharina Gordt ◽

Carl-Philipp Jansen ◽

Michael Schwenk

Keyword(s):

Older Adults ◽

System Performance ◽

Fall Risk ◽

Balance Control ◽

Sensory System ◽

Sensory Systems ◽

Community Dwelling ◽

Functional Mobility ◽

Timed Up And Go ◽

Community Dwelling Older Adults

Background: Decreasing performance of the sensory systems’ for balance control, including the visual, somatosensory and vestibular system, is associated with increased fall risk in older adults. A smartphone-based version of the Timed Up-and-Go (mTUG) may allow screening sensory balance impairments through mTUG subphases. The association between mTUG subphases and sensory system performance is examined. Methods: Functional mobility of forty-one community-dwelling older adults (>55 years) was measured using a validated mTUG. Duration of mTUG and its subphases ‘sit-to-walk’, ‘walking’, ‘turning’, ‘turn-to-sit’ and ‘sit-down’ were extracted. Sensory systems’ performance was quantified by validated posturography during standing (30 s) under different conditions. Visual, somatosensory and vestibular control ratios (CR) were calculated from posturography and correlated with mTUG subphases. Results: Vestibular CR correlated with mTUG total time (r = 0.54; p < 0.01), subphases ‘walking’ (r = 0.56; p < 0.01), and ‘turning’ (r = 0.43; p = 0.01). Somatosensory CR correlated with mTUG total time (r = 0.52; p = 0.01), subphases ‘walking’ (r = 0.52; p < 0.01) and ‘turning’ (r = 0.44; p < 0.01). Conclusions: Supporting the proposed approach, results indicate an association between specific mTUG subphases and sensory system performance. mTUG subphases ‘walking’ and ‘turning’ may allow screening for sensory system deterioration. This is a first step towards an objective, detailed and expeditious balance control assessment, however needing validation in a larger study.

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EXAMINING DISCREPANCIES IN SOCIAL ROBOT VERSUS HUMAN ASSESSMENTS OF GERIATRIC WELL-BEING

Innovation in Aging ◽

10.1093/geroni/igz038.1199 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S329-S329

Author(s):

Erin Harrington ◽

Ha Do ◽

Alex J Bishop ◽

Celinda Reese-Melancon ◽

and Weihua Sheng

Keyword(s):

Older Adults ◽

Fall Risk ◽

Social Connectedness ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Well Being ◽

Falls Prevention ◽

Assessment Tools ◽

Assessment Scores ◽

Loneliness Scale

Abstract Socially assistive robotic (SAR) technologies represent a viable tool for monitoring the safety and health of older adults. However, it is unclear whether SARs can comprehensively screen geriatric well-being as effectively as trained human clinicians. The purpose of this study was to compare SAR versus human assessment of geriatric well-being. Participants included 30 older adults (Mage = 73.40, SD = 7.88) who completed a robot-administered well-being assessment session during which human-administered evaluation was simultaneously performed. Standardized clinical screening assessment tools common in geriatric care were administered (e.g., Short Blessed Test (SBT), UCLA Loneliness Scale, Geriatric Depression Scale, PHQ-4, Iowa Fatigue Scale, Fall Risk). Multiple dependent sample t-tests were used to explore variability in assessment scores between SAR and human evaluation. Assessment scores significantly differed on several measures, including the SBT (t(29) = -9.33, p < .001), UCLA Loneliness scale (t(19) = 2.37, p < . 05), and fall risk assessment (t(29) = 3.03, p < .01). Specifically, the SAR indicated that older adults were significantly more cognitively impaired, less lonely, and more likely to fall compared to the human administrator. Other observed differences and hypothesized explanations will be discussed in greater detail. The current study indicates that there is a divergence in geriatric assessment outcomes based on human versus SAR administration. Findings have implications relative to further developing SAR technology to align with human-based evaluations to enhance cognitive well-being, social connectedness, and falls prevention.

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