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.

scholarly journals 111 Disparities between Actual and Perceived Fall Risk Affect Participation in 5 Fall Prevention Interventions

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv18-iv27
Author(s):  
Pey June Tan ◽  
Silvia Sim ◽  
Noor Hafizah Ismail ◽  
Jagadish Mallya ◽  
Angelique Chan ◽  
...  
Keyword(s):  
Older Adults ◽  
Fall Prevention ◽  
Fall Risk ◽  
Help Seeking ◽  
Fear Of Falling ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Risk Level ◽  
Prevention Interventions ◽  
Aware Group

Abstract Introduction Older adults have been found to under- or overestimate their fall risk. However, no studies have investigated implications on help-seeking behaviours in falls prevention. This study examines how disparities between actual and perceived fall risk affects participation in 5 fall prevention interventions among community-dwelling older adults in Singapore. Methods This was a cross-sectional survey of a nationally representative sample of community-dwelling adults aged ≥60 years in Singapore identified by stratified random sampling. Having previous falls in the past 12 months (faller/non-faller) indicated actual fall risk. Level of fear-of-falling (cut-off ≥23 on 16-item Falls Efficacy Scale International) was used as perceived fall risk (high/low). Four profiles based on combinations of actual and perceived risk were associated with participation in 5 fall prevention interventions in a multiple logistic regression. The model was adjusted for age, gender, ≥2 comorbidities and knowledge that the intervention is to prevent falls. Results Final analysis included 549 older adults (mean age 70.6±6.9 years, 61% females). Majority (46%) were in the Vigorous group (no falls, low fear), 35% Anxious (no falls, high fear), 11% Frail Aware (falls, high fear) and 8% Stoics (falls, low fear). Only those in Anxious and Frail Aware group were significantly more likely to have talked to a healthcare professional on strategies to avoid falls [OR 1.8 (1.1-3.1) and 3.2 (1.6-6.4) respectively] and made home modifications [OR 1.9 (1.3-2.8) and 2.0 (1.1-3.6)] after adjustments. No association was found for participation in exercise, medication review and falls education. Discussion Individual profiles with high fear-of-falling component have different help-seeking behaviours compared to those with low fear regardless of history of falls. However, individuals in Frail Aware group have higher likelihood to uptake the interventions compared to Anxious group. Future research should examine other drivers of behaviour that will influence participation in other interventions.

scholarly journals 136 Barriers to Discussing Fall Prevention with Healthcare Professionals amongst Community-Dwelling Singaporean Older Adults

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv28-iv33
Author(s):  
Nivedha Balachandar ◽  
Silvia Sim ◽  
Pey June Tan ◽  
Jagadish Mallya ◽  
Noor Hafizah Ismail ◽  
...  
Keyword(s):  
Older Adults ◽  
Fall Prevention ◽  
Fall Risk ◽  
Healthcare Professionals ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Cross Sectional Survey ◽  
Chi Square ◽  
Cross Sectional ◽  
Modifiable Factors

Abstract Introduction A multitude of modifiable factors can contribute to one’s fall risk. Healthcare professionals (HCP) are equipped to identify such factors, and make appropriate recommendations to help older adults prevent falls. However, there is limited evidence on the awareness and practice of this in Asian communities. Thus, this paper aims to understand the participation and barriers for community-dwelling Singaporeans to discuss falls with their HCPs. Methods A cross-sectional survey was conducted on a nationally-representative sample of Singaporeans aged ≥60 living in the community. Participants were asked if they have fallen in the past 12 months, if they discussed what they can do to avoid falls with their HCPs (doctor/nurse) and for their perceived barriers via a semi-structured questionnaire with multiple responses. Unstructured data was coded using content analysis by two researchers and pooled with structured data. Sub-group differences between fallers and non-fallers were anaylsed using chi square tests. Results Of 549 participants (70.6±6.9 years and 61% female), most (n=447, 81%) have never talked to their HCPs. More fallers discussed falls prevention with HCPs than non-fallers (p=0.037). The top barriers cited for discussing falls with HCPs – low perception of fall risk (55%) and misconceptions regarding falls and/or HCPs (29%) – were more prevalent amongst non-fallers (p=0.008) and fallers (p<0.001) respectively. Other barriers identified include competing priorities (8%) and actively taking alternate management to mitigate falls risk (4%). Discussion Fallers and non-fallers have different reasons behind not discussing falls with HCPs. Findings indicate that despite having higher fall risk, fallers may still not talk to HCPs as they are either unaware that fall risk can be mitigated, or of HCP’s role in fall prevention. Future studies should address fallers’ knowledge and attitudes to improve their participation in interventions in the community, and investigate health practitioners’ readiness to address concerns about falls.

scholarly journals Older adults, falls and technologies for independent living: a life space approach

2011 ◽  
Vol 31 (5) ◽  
pp. 829-848 ◽  
Author(s):  
CATHY BAILEY ◽  
TIMOTHY G. FORAN ◽  
CLIODHNA NI SCANAILL ◽  
BEN DROMEY
Keyword(s):  
Older Adults ◽  
Independent Living ◽  
Fear Of Falling ◽  
Research Programme ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Daily Activities ◽  
Life Space ◽  
Risky Behaviour ◽  
Fear Of Falls

ABSTRACTThis paper draws attention to the need for further understanding of the fine details of routine and taken-for-granted daily activities and mobility. It argues that such understanding is critical if technologies designed to mitigate the negative impacts of falls and fear-of-falling are to provide unobtrusive support for independent living. The reported research was part of a large, multidisciplinary, multi-site research programme into responses to population ageing in Ireland, Technologies for Independent Living (TRIL). A small, exploratory, qualitative life-space diary study was conducted. Working with eight community-dwelling older adults with different experiences of falls or of fear-of-falls, data were collected through weekly life-space diaries, daily-activity logs, two-dimensional house plans and a pedometer. For some participants, self-recording of their daily activities and movements revealed routine, potentially risky behaviour about which they had been unaware, which may have implications for falls-prevention advice. The findings are presented and discussed around four key themes: ‘being pragmatic’, ‘not just a faller’, ‘heightened awareness and blind spots’ and ‘working with technology’. The findings suggest a need to think creatively about how technological and other solutions best fit with people's everyday challenges and needs and of critical importance, that their installation does not reduce an older adult to ‘just a faller’ or a person with a fear-of-falls.

scholarly journals Pilot Outcomes of a Multicomponent Fall Risk Program Integrated Into Daily Lives of Community-Dwelling Older Adults

2020 ◽  
pp. 073346482091266
Author(s):  
Sarah L. Szanton ◽  
Lindy Clemson ◽  
Minhui Liu ◽  
Laura N. Gitlin ◽  
Melissa D. Hladek ◽  
...  
Keyword(s):  
Older Adults ◽  
Fall Prevention ◽  
Fall Risk ◽  
Pilot Trial ◽  
Balance Training ◽  
Community Dwelling ◽  
Control Group ◽  
Timed Up And Go ◽  
Daily Lives ◽  
Fall Risk Factors

Objectives: To evaluate whether a fall prevention intervention reduces fall risk in older adults who have previously fallen. Design: Randomized controlled pilot trial. Setting: Participants’ homes. Intervention: LIVE-LiFE, adapted from Lifestyle-Intervention Functional Exercise (LiFE) integrates strength and balance training into daily habits in eight visits over 12 weeks. The adaptations to LiFE were to also provide (a) US$500 in home safety changes, (b) vision contrast screening and referral, and (c) medication recommendations. Control condition consisted of fall prevention materials and individualized fall risk summary. Measurement: Timed Up and Go (TUG) and Tandem stand. Falls efficacy, feasibility, and acceptability of the intervention. Results: Sample ( N = 37) was 65% female, 65% White, and average 77 years. Compared with the control group, each outcome improved in the intervention. The LIVE-LiFE intervention had a large effect (1.1) for tandem stand, moderate (0.5) in falls efficacy, and small (0.1) in the TUG. Conclusion: Simultaneously addressing preventable fall risk factors is feasible.

scholarly journals ABILITY OF THE PHYSIOLOGICAL PROFILE ASSESSMENT TO CLASSIFY FALLER TYPE: A PROSPECTIVE COHORT STUDY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S471-S471
Author(s):  
Deborah A Jehu ◽  
Jennifer C Davis ◽  
Kristin Velsey ◽  
Winnie Cheung ◽  
Teresa Liu-Ambrose
Keyword(s):  
Older Adults ◽  
Risk Assessment ◽  
Fall Prevention ◽  
Fall Risk ◽  
Vancouver General Hospital ◽  
Community Dwelling ◽  
Medical Attention ◽  
Physiological Profile ◽  
Fall Risk Assessment ◽  
Physiological Profile Assessment

Abstract Accurately identifying older adults who will experience subsequent falls is important for the provision of secondary fall prevention. The purpose of this study was to determine the accuracy of the Physiological Profile Assessment (PPA) – a valid and reliable fall-risk assessment [1] – in predicting subsequent falls over a 12-month period in older adults who sought for medical attention after an index fall. Seven hundred thirty-seven community-dwelling adults, aged 70 years and older, who were seen at the Vancouver General Hospital Fall Prevention Clinic, completed the PPA at their initial visit. Falls over the subsequent 12 months were tracked prospectively via monthly falls calendars. All individuals received geriatric care at baseline. Binary logistic regressions were performed to determine the accuracy of classifying two prospective faller types: 1) no additional falls; 2) one or more additional fall(s). Baseline PPA, age, and sex were entered as independent variables. During the 12 month observation period, 345 participants had no additional falls (Age:81.3±6.6yrs;Female=251) and 392 fell one or more times (Age:82.3±6.5yrs;Female=230). The classification accuracy was 51.3% for those who had no additional falls and 64.8% for those with one or more additional fall(s) (Overall:58.5%;χ2=29.0;PPA:β=-0.21;Age:β=-0.01;Sex:β=-60). The PPA was not able to accurately differentiate between those who did and did not subsequently fall. Fall-risk assessment sensitivity and specificity should be improved in older adults seeking medical attention following an index fall to inform secondary fall prevention. [1] Lord SR, et al., 2003. Phys Ther.

Prevalence of falls and associated factors among community-dwelling older adults: a cross-sectional study

2020 ◽  
pp. 1-7
Author(s):  
M. Almada ◽  
P. Brochado ◽  
D. Portela
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Associated Factors ◽  
Fear Of Falling ◽  
Financial Burden ◽  
Social Systems ◽  
Female Gender ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Cross Sectional

Aim: As a person ages, the risk of falls increases, which affects quality of life and represents a financial burden to health- and social-systems, and a greater morbidity and mortality risk. Falls lead to decreased social contact, anxiety, long-term physical disability, severe dependency and hospitalizations. Currently, few studies address this phenomenon using a uniform methodology; therefore, this study aims to explore the prevalence of falls and associated-variables in older adults across Europe. Methods: In this cross-sectional analysis, we used data from Wave 6 of SHARE. The prevalence of falls was assessed through the answer “falling down” to the question “For the past six months at least, have you been bothered by any of the health conditions on this card?”. Multilevel logistic regression was used, using falls as a dependent variable. Multilevel univariable logistic regression models were made to identify potential associated factors. Results: From the 41,098 participants, 56.3% were female, and the average age was of 70.0 ± 8.9 years. The prevalence of falls was 8.2% (CI 8.0% to 8.4%), being higher in women (10.1% vs. 5.8%) and increasing with age. Age, female gender, being frail or pre-frail, higher scores on the EURO-D scale, polypharmacy and fear of falling were found to be significantly associated with falls. Conclusions: We found that falls are prevalent in the European community-dwelling population, with variations between countries. As a public health priority, identification of the variables associated with falls is important in order to identify/monitor the risk in older groups and develop tailored and cost-effective interventions for falls prevention.

Community Fall Prevention Programs: Comparing Three InSTEP Models by Level of Intensity

2014 ◽  
Vol 22 (3) ◽  
pp. 372-379 ◽  
Author(s):  
B. Josea Kramer ◽  
Beth Creekmur ◽  
Michael N. Mitchell ◽  
Debra J. Rose ◽  
Jon Pynoos ◽  
...  
Keyword(s):  
Older Adults ◽  
Fall Prevention ◽  
Fall Risk ◽  
Community Dwelling ◽  
Medical Risk ◽  
Fall Risk Factors ◽  
Within Subjects ◽  
Prevention Center ◽  
Gait Function ◽  
Community Dwelling Older Adults

The Fall Prevention Center of Excellence designed three progressive-intensity fall prevention program models, Increasing Stability Through Evaluation and Practice (InSTEP), to reduce risk in community-dwelling older adults. Each model included physical activity, medical risk, and home safety components and was implemented as a 12-week program for small class sizes (12–15 people) in community and senior centers. Change in fall rates and fall risk factors was assessed using a battery of performance tests, self-reports of function, and fall diaries in a 3-group within-subjects (N = 200) design measured at baseline, immediately postintervention, and at 3 and 9 months postintervention. Overall, participants experienced a reduction in falls, improved self-perception of gait and balance, and improved dynamic gait function. The medium-intensity InSTEP model signifcantly (p = .003) reduced self-reported falls in comparison with the other models. InSTEP is a feasible model for addressing fall risk reduction in community-dwelling older adults.

scholarly journals Differences in fear of falling and fall risk indicators among white and black older adults: a cross sectional study

2019 ◽  
Author(s):  
Allison Anne Bay ◽  
Smrithi Ramachandran ◽  
Hayley A. Silverstein ◽  
Jiayang Song ◽  
Ariel R. Hart ◽  
...  
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Community Dwelling ◽  
Wilcoxon Test ◽  
Risk Indicators ◽  
Physical Component Score ◽  
Component Score ◽  
Community Dwelling Older Adults

Abstract Background Falling among older adults is common and can cause chronic health complications. This study investigated differences between White and Black community-dwelling older adults in fall history, fear of falling, and indicators of fall risk.Methods All assessments and analyses were conducted in a clinical laboratory at Emory University in the Department of General Medicine and Geriatrics on 84 diverse community-dwelling older adults (White, n=37; Black, n=47). Statistical analyses included one-way ANOVA for continuous variables, the Fisher exact test for categorical variables, the Mann-Whitney-Wilcoxon test for ordinal variables, and an ordinal logistic regression model to examine which factors predicted fear of falling. Measures included fall history, fear of falling, and fall risk indicators. The Montreal Cognitive Assessment, Activities-Specific Balance Confidence Score, Gait Speed, Short Form 12 Physical Component Score and Mental Component Score, fear of falling and quality of life rating scales and demographics questionnaires were administered.Results Falls history was not significantly different between groups. Black participants had significantly fewer years of education (p=.007), lower MoCA scores (p=0.002), and slower fast gait speed (p=0.032) than White participants. However, Black participants reported significantly less fear of falling (p=0.043). Race (Black/White) (p=<0.001), sex (p=0.028), preferred gait speed (p=0.036), and a dichotomous variable of use of assistive device for walking (p=0.023) were significant predictors of fear of falling in the logistical model.Conclusions These factors may explain the observed differences in fear of falling observed between white and black groups in this study. This work offers an explanation of possible factors related to the well-documented yet poorly understood fact that while Black older adults have more risk factors for falling, White older adults tend to fall more frequently and are more afraid of falling.

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