scholarly journals THE DAILY BALANCE PROJECT: AN INQUIRY INTO THE INTRAINDIVIDUAL DYNAMICS OF PERCEIVED AND ACTUAL FALL RISK

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S615-S615
Author(s):  
Shannon T Mejia ◽  
Katherine Hsieh ◽  
Jason Fanning ◽  
Jacob Sosnoff
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Fall Prevention ◽  
Adaptive Response ◽  
Fall Risk ◽  
Activity Monitor ◽  
Objective Measures ◽  
Intraindividual Variation ◽  
Balance Confidence ◽  
Confidence Scale

Abstract An accurate understanding of one’s abilities and limitations allows adaptive response to the challenges that are faced in daily life. However, older adults may over or under estimate their actual abilities. The Daily Balance Project examined the intraindividual dynamics of older adults’ perceived balance with objective measures of balance and physical activity. For 30 consecutive days, following a comprehensive fall risk assessment, 20 older adults rated their balance confidence (Activities Balance Confidence scale) at that moment and then performed five standardized balance assessments measured via smartphone accelerometer held to their chest. Physical activity was measured with an activity monitor. Baseline measurements of fall risk differentiated the extent of intraindividual variation and co-variation of balance and physical activity. For some participants, actual and perceived balance became more closely aligned as the study progressed. The implications of the findings for life-span perspectives on aging and fall prevention are discussed.

scholarly journals The Impact of Weather and Seasons on Falls and Physical Activity among Older Adults with Glaucoma: A Longitudinal Prospective Cohort Study

Sensors ◽  
2021 ◽  
Vol 21 (10) ◽  
pp. 3415
Author(s):  
Hursuong Vongsachang ◽  
Aleksandra Mihailovic ◽  
Jian-Yu E ◽  
David S. Friedman ◽  
Sheila K. West ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Fall Prevention ◽  
Regression Models ◽  
Activity Promotion ◽  
Injurious Fall ◽  
Multivariable Regression ◽  
Multivariable Regression Models ◽  
The Impact ◽  
The Relationship

Understanding periods of the year associated with higher risk for falling and less physical activity may guide fall prevention and activity promotion for older adults. We examined the relationship between weather and seasons on falls and physical activity in a three-year cohort of older adults with glaucoma. Participants recorded falls information via monthly calendars and participated in four one-week accelerometer trials (baseline and per study year). Across 240 participants, there were 406 falls recorded over 7569 person-months, of which 163 were injurious (40%). In separate multivariable regression models incorporating generalized estimating equations, temperature, precipitation, and seasons were not significantly associated with the odds of falling, average daily steps, or average daily active minutes. However, every 10 °C increase in average daily temperature was associated with 24% higher odds of a fall being injurious, as opposed to non-injurious (p = 0.04). The odds of an injurious fall occurring outdoors, as opposed to indoors, were greater with higher average temperatures (OR per 10 °C = 1.46, p = 0.03) and with the summer season (OR = 2.69 vs. winter, p = 0.03). Falls and physical activity should be understood as year-round issues for older adults, although the likelihood of injury and the location of fall-related injuries may change with warmer season and temperatures.

scholarly journals Perceptions of Care Among Older Adults Identified as Fall Risk During a Hospital Stay

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 139-139
Author(s):  
Barbara King
Keyword(s):  
Older Adults ◽  
Hospital Stay ◽  
Older Adult ◽  
Fall Prevention ◽  
Fall Risk ◽  
Medical Center ◽  
Academic Medical Center ◽  
Common Strategy ◽  
Open Coding ◽  
Perceptions Of Care

Abstract In-hospital falls are a significant clinical, legal and regulatory problem. The Centers for Medicare and Medicaid no longer reimburse hospitals for falls that result in injury, adding increase pressure on acute care settings to prevent falls. Additionally, evidence-based practice recommendations for fall prevention in hospitals do not exist, thus leaving administrators to create their own programs. One common strategy used by hospital providers to prevent falls is to restrict patient mobility. Little information on how older adult patients experience fall prevention during a hospital stay has been published. The purpose of this study was to understand perceptions of care among older adults identified as fall risk during a hospital stay. This qualitative study utilized inductive content analysis. Older adults (N=20) from a large academic medical center in the Midwest were recruited to participate in one-to one in-depth interviews. Open coding, categorization and abstraction was used to analyze the data. Three main categories were identified that summarized the older adult patient perception of hospitalization: Act of Caring, something they received from staff, provide to staff or provided to self; Being Restricted in movement resulting in either accepting or rejecting the restriction and Being Freed at discharge, often being told “just be careful”. Older adult identified as fall risk described being restricted in movement during a hospital stay. Many passively accepted this restriction even though they felt a lack of movement would be harmful to them. Additional research on the patient experience with fall prevention is needed.

scholarly journals Student-Led Fall Prevention Care Management Reduced Fall Risks at Assisted Living Facilities

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 238-238
Author(s):  
Hiroko Kiyoshi-Teo ◽  
Claire McKinley-Yoder ◽  
Erin Lemon ◽  
Olivia Ochoa
Keyword(s):  
Older Adults ◽  
Assisted Living ◽  
Fall Prevention ◽  
Fall Risk ◽  
Care Management ◽  
Assisted Living Facilities ◽  
Care Needs ◽  
Term Care ◽  
Fall Risks ◽  
The Impact

Abstract Older adults in residential care settings are four times more likely than those not living in care facilities to experience falls. Yet, fall prevention efforts at long-term care settings are under-resourced, under-regulated, and under-studied. To address this gap, we developed and studied the impact of a specialty clinical, Fall Prevention Care Management (FPCM), for nursing students to decrease older adults’ fall risks. We enrolled assisted living residents that facility liaison identified as being high fall risk (fall rates or fall risk were not tracked at the study sites) and MOCA ≥15, in 2 assisted living facilities in Northwest USA. Participants received weekly, 1-hour, individual, semi-structured, Motivational Interviewing-based care management visits by same students over 6 visits. Changes in fall risks were measured by the CDC STEADI assessment (unsteadiness & worry), Falls Self-Efficacy Scale International-Short (FESI-S), and Falls Behavioral Scale (FAB). Twenty-five residents completed the study. Students addressed the following (multiple responses possible): emotional needs (n=23), improved motivation to prevent falls (n=21), and individualized education/coaching (i.e., exercise, mobility aids) (n=10-17). FESI-S score improved from 16.0 to 14.4 (p=.001; decreased fear. FAB score improved from 2.94 to 3.10 (p=.05; more frequent fall prevention behaviors). Frequency of those who felt steady while standing or walking increased (24% to 40%, p=.07) and those who did not worry about falling increased (20% to 36%, p=.08). FPCM clinical offered valuable opportunity to address unmet care needs of older adults to reduce fall risks.

scholarly journals Effect of Physical Therapy on Fall-Risk and Physical Status in Older Adults with Frailty and Metabolic Syndrome

2020 ◽  
Vol 5 (6) ◽  
pp. 282-291
Author(s):  
N. P. Koval ◽  
◽  
M. G. Aravitska
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Metabolic Syndrome ◽  
Physical Therapy ◽  
Therapeutic Alliance ◽  
Fall Risk ◽  
Physical Therapist ◽  
Main Group ◽  
Frailty Syndrome ◽  
Physical Status

The constant increase in the proportion of the disabled or partially disabled elderly population and, accordingly, patients of this age contingent, leads to the need for rehabilitation and physical therapy of persons with geriatric syndromes and various comorbid pathologies. The purpose of the study was to determine the effectiveness of a physical therapy program based on the dynamics of indicators of the fall-risk and physical status in older adults with frailty syndrome and metabolic syndrome. Material and methods. 96 older adults were examined. The control group consisted of persons without metabolic syndrome and without frailty syndrome. The main group 1 consisted of persons with metabolic syndrome and frailty syndrome who did not express a desire to cooperate with a physical therapist and / or actively improve their health on their own (low level of therapeutic alliance). They were provided with recommendations on the WHO CINDI program (diet modification, extension of household and training physical activity). Main group 2 included patients who showed consent to take active steps to improve their own health under the supervision of a physical therapist (high level of therapeutic alliance). We developed a physical therapy program for them using kinesitherapy, massage, nutritional correction, education of the patient and his family, elements of cognitive training and occupational therapy for one year. The dynamics of the state was assessed according to the results of the Short Physical Performance Battery, hand dynamometry, Senior Fitness Test, the Berg Balance Scale. Results and discussion. Older adults with metabolic syndrome and frailty syndrome demonstrated a high fall-risk (according to the results of a Short battery of physical activity tests and the Berg scale) and a statistically significant lag in physical status parameters (coordination, balance, strength, flexibility, endurance, agility) according to the parameters of the Senior Fitness Test, hand dynamometry, Short battery of physical activity tests) from their peers. These results increase the risk of adverse health effects, loss of autonomy and death. The use of physical therapy in main group 1 subjects led to a statistically significant (р<0.05) improvement in physical qualities, a decrease in the intensity of frailty signs; leveling the fall-risk in them. The low level of therapeutic alliance of persons in the main group 2 led to unsatisfactory fulfillment or non-fulfillment of the recommendations provided and is associated with a lack of improvement in their physical status and a high fall-risk. Conclusion. It is advisable to include physical therapy means in the rehabilitation programs for elderly patients with comorbid pathology of frailty and metabolic syndrome

scholarly journals Comparison of Fall Risk Assessment Tools for Older Indonesian Adults in the Elderly Home and the Community

2019 ◽  
Vol 8 (3) ◽  
pp. 241
Author(s):  
Indri Hapsari Susilowati ◽  
Susiana Nugraha ◽  
Sabarinah Sabarinah ◽  
Bonardo Prayogo Hasiholan ◽  
Supa Pengpid ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Fall Risk ◽  
Assessment Tool ◽  
The Elderly ◽  
Risk Assessment Tool ◽  
Fall Risk Assessment ◽  
Elderly Home ◽  
Balance Confidence ◽  
Confidence Scale

Introduction: One of the causes of disability among elderly is falling. The ability to predict the risk of falls among this group is important so that the appropriate treatment can be provided to reduce the risk. The objective of this study was to compare the Stopping Elderly Accidents, Deaths, & Injuries (STEADI) Initiative from the Centers for Disease Control and Prevention (CDC) and The Johns Hopkins Fall Risk Assessment Tool (JHFRAT) from the Johns Hopkins University. Methods: This study used the STEADI tool, JHFRAT, Activities-Specific Balance Confidence Scale (ABC), and The Geriatric Depression Scale (GDS). The study areas were in community and elderly home in both public and private sectors and the samples were 427 after cleaning. Results: The results for the STEADI and JHFRAT tools were similar where the respondents at highest risk of falling among women (STEADI: 49%; JHFRAT: 3.4%), in Bandung area (63.5%; 5.4%), in private homes (63.3%; 4.4%), non-schools (54.6%; 6.2%), aged 80 or older (64.8%; 6.7%) and not working (48.9%;3.3%). The regression analysis indicated that there was a significant relationship between the risk factors for falls in the elderly determined by the JHFRAT and STEADI tools: namely, region, type of home, age, disease history, total GDS and ABC averages. Conclusion: Despite the similarity in the risk factors obtained through these assessments, there was a significant difference between the results for the STEADI tool and the JHFRAT. The test strength was 43%. However, STEADI is more sensitive to detect fall risk smong elderly than JHFRATKeywords: Activities-Specific Balance Confidence scale, elderly, fall risk,The Johns Hopkins Fall Risk Assessment Tool, the Stopping Elderly Accidents, Deaths, & Injuries

Audiologist's Role Within the Changing Climate of Fall Prevention: Are We Ready?

2016 ◽  
Vol 1 (8) ◽  
pp. 4-13
Author(s):  
Alaina M. Bassett ◽  
Julie A. Honaker
Keyword(s):  
Older Adults ◽  
Risk Assessment ◽  
Fall Prevention ◽  
Fall Risk ◽  
Reporting System ◽  
Risk Assessments ◽  
Mandated Reporting ◽  
Medicare Beneficiaries ◽  
Medical Settings ◽  
Quality Reporting

This article is aimed to address the vestibular audiologist's role in assessing patient fall risk as tasked by Medicare. With implementation of the Physician's Quality Reporting System (PQRS), audiologists performing standard measures of the vestibular battery must report on measures #154: Falls: Risk assessment and #155: Falls: Plan of care for Medicare beneficiaries. Mandated reporting of this measure includes vestibular audiologists in the multidisciplinary medical management of fall prevention in older adults. In order for audiologists to provide the most relevant care, it is important to evaluate the current fall risk assessments in medical settings, how the implementation of these measures can be structured within the audiology clinic, and challenges audiologist may face with implementation.

scholarly journals Older Adults’ Utilization of Community Resources Targeting Fall Prevention and Physical Activity

2018 ◽  
Vol 59 (3) ◽  
pp. 436-446 ◽  
Author(s):  
Siobhan K McMahon ◽  
Young Shin Park ◽  
Beth Lewis ◽  
Weihua Guan ◽  
J Michael Oakes ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Fall Prevention ◽  
Local Community ◽  
Phase 1 ◽  
Implementation Strategies ◽  
Community Resources ◽  
Phase 2 ◽  
Internal Resources ◽  
Diagnosis Of Dementia

Abstract Background and Objectives Despite the availability of community resources, fall and inactivity rates remain high among older adults. Thus, in this article, we describe older adults’ self-reported awareness and use of community resources targeting fall prevention and physical activity. Research Design and Methods In-depth, semistructured interviews were conducted in Phase 1 with community center leaders (n = 5) and adults (n = 16) ≥70 years old whose experience with community programs varied. In Phase 2, surveys were administered to intervention study participants (n = 102) who were ≥70 years old, did not have a diagnosis of dementia, and reported low levels of physical activity. Results Four themes emerged from Phase 1 data: (a) identifying a broad range of local community resources; (b) learning from trusted sources; (c) the dynamic gap between awareness and use of community resources; and (d) using internal resources to avoid falls. Phase 2 data confirmed these themes; enabled the categorization of similar participant-identified resources (10); and showed that participants who received encouragement to increase community resource use, compared to those who did not, had significantly greater odds of using ≥1 resource immediately postintervention, but not 6 months’ postintervention. Discussion and Implications Although participants in this study were aware of a broad range of local community resources for physical activity, they used resources that support walking most frequently. Additionally, receiving encouragement to use community resources had short-term effects only. Findings improve our understanding of resources that need bolstering or better dissemination and suggest researchers identify best promotion, dissemination, implementation strategies.

scholarly journals EXPERIENCES AND FACILITATORS OF FALLS PREVENTION AMONG ETHNICALLY DIVERSE OLDER ADULTS: A QUALITATIVE STUDY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S854-S854
Author(s):  
Ladda Thiamwong ◽  
Norma E Conner
Keyword(s):  
Older Adults ◽  
Fall Prevention ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Ethnically Diverse ◽  
Role Identity ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Facilitators And Barriers ◽  
And Behaviors

Abstract Background: Falls increase as people age and decrease the quality of life. Even though fall interventions have received great attention, fall incidence rates have still arisen. In order for older adults to reap the benefits of evidence-based fall interventions, a challenge of implementation in the real world and right context must be met. Understanding experiences, facilitators, and barriers of fall prevention among four major ethnic groups in the Unites States could be extremely valuable. Objective: The aim of this study was to describe experiences and highlight facilitators and barriers on fall and fear of falling interventions among ethnically diverse community-dwelling older adults. Methods: Four ethnically specified (African American, Asian, Hispanic and Non-Hispanic White) focus groups were conducted. A total of 28 older adults and four family caregivers were interviewed. Interviews covered experiences on falls and fear of falling, attitudes, factors, consequences, risk assessment, and interventions. Data were organized and analyzed with the NViVo software. Results: Falls related experiences and behaviors were multifaceted and varied. Three themes related to falls experiences and behaviors were identified, 1) falls prevention versus fear of falling amplification; 2) role identity, culture and family considerations; and 3) take care of you, take care of me. Facilitators of fall prevention were integration of individual learning within a group meeting, providing appropriate assistive devices and promoting environmental safety. Barriers were inconsistent fall risk assessments, low fall risk awareness and acknowledgment, and balance and visual impairment.

ACTIVITY-SPECIFIC BALANCE CONFIDENCE SCALE SCORES IN OLDER ADULTS

2001 ◽  
Vol 24 (1) ◽  
pp. 17
Author(s):  
K L McCulloch ◽  
J K Freburger ◽  
C A Giuliani ◽  
J Busby-White-head
Keyword(s):  
Older Adults ◽  
Balance Confidence ◽  
Scale Scores ◽  
Confidence Scale
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