Impact of a Pharmacy-Led Fall Prevention Program for Institutionalized Older People

2021 ◽  
Vol 36 (4) ◽  
pp. 217-222
Author(s):  
Kylee Gross ◽  
Ashley N. King ◽  
Elizabeth Steadman
Keyword(s):  
Older People ◽  
Behavioral Health ◽  
Older Adult ◽  
Health Care Providers ◽  
Fall Risk ◽  
Inpatient Rehabilitation ◽  
Acceptance Rate ◽  
Care Providers ◽  
Recurrent Falls ◽  
The Impact

OBJECTIVE: To evaluate the impact of pharmacy interventions on recurrence of falls in older people. DESIGN: Prospective case-crossover study. SETTING: LECOM Health Nursing and Rehabilitation (LNR) and Senior Living Center (SLC) and Millcreek Community Hospital older adult behavioral health and inpatient rehabilitation units (IRU). PARTICIPANTS: Twenty and 15 residents of the SLC and LNR, respectively, and 5 and 2 patients of the older adult behavioral health unit and IRU, respectively, experienced a fall during the 8-week study period. INTERVENTIONS: Medication reviews were conducted by a pharmacist assessing for fall risk-increasing drugs (FRIDs). Adverse effects, drug interactions, and nonpharmacologic causes were evaluated, and recommendations were made to reduce future fall risk. MAIN OUTCOME MEASURES: Recommendation acceptance rate, FRID use, and incidence of recurrent falls. RESULTS: Eighty percent of fall risk-reduction recommendations were accepted and implemented by the medical team. The mean number of potential FRIDs prescribed per participant was reduced from 3.71 to 3.38. There was a 12.4% reduction in recurrent falls after pharmacy intervention (P = 0.0336; odds ratio [95% confidence interval] = 1.783 [1.045-3.112]). CONCLUSION: Pharmacist interventions for older people who experience a fall were associated with a high acceptance rate by health care providers, a reduction in FRID use, and decreased rate of recurrent falls.

scholarly journals Understanding Modifiable and Unmodifiable Older Adult Fall Risk Factors to Create Effective Prevention Strategies

2019 ◽  
pp. 155982761988052 ◽  
Author(s):  
Gwen Bergen ◽  
Mark R. Stevens ◽  
Ramakrishna Kakara ◽  
Elizabeth R. Burns
Keyword(s):  
Risk Factors ◽  
Older Adult ◽  
Health Care Providers ◽  
Fall Risk ◽  
The United States ◽  
Adult Patients ◽  
Care Providers ◽  
Effective Prevention ◽  
Fall Injuries ◽  
Fall Injury

Each year, more than 1 in 4 older adults in the United States report a fall and 1 in 10 a fall injury. Using nationally representative data from the 2016 US Behavioral Risk Factor Surveillance System, we evaluated demographic, geographic, functional, and health characteristics associated with falls and fall injuries among adults aged 65 years and older. Analyses included descriptive statistics and multivariable logistic regression to produce crude and adjusted percentages by characteristic. Characteristics most strongly associated with increased fall risk in order of adjusted percentage were depression, difficulty doing errands alone, and difficulty dressing or bathing. Characteristics most strongly associated with fall injury risk in order of adjusted percentage were depression, difficulty dressing or bathing, and being a member of an unmarried couple. The diverse health and functional characteristics associated with increased falls and fall injuries confirm the importance of screening and assessing older adult patients to determine their individual unique risk factors. Health care providers can use tools and resources from the Centers for Disease Control and Prevention’s STEADI (Stopping Elderly Accidents, Deaths, and Injuries) initiative to screen their older adult patients for fall risk, assess at-risk patients’ modifiable risk factors, and intervene to reduce risk by prescribing evidence-based interventions.

scholarly journals THE IMPACT OF DENTURES ON THE NUTRITIONAL HEALTH OF THE ELDERLY

2015 ◽  
pp. 1-4
Author(s):  
M. Cafaro Gellar ◽  
D. Alter
Keyword(s):  
Older Adult ◽  
Health Care Providers ◽  
Disease Process ◽  
The Elderly ◽  
Published Data ◽  
Care Providers ◽  
Physiological Factors ◽  
Factors Affecting ◽  
Loss Of Appetite ◽  
The Impact

Objective: There are many factors that can affect appetite in the older adult. Physiological factors affecting appetite can include cardiovascular disease, pulmonary disease, renal disease, mental health issues, and even side effects of medications. Decreased ability to ambulate due to joint issues or pain can also negatively impact an older adult’s appetite. But perhaps one significant factor that is commonly overlooked is the ill fitting partial or complete denture. According to the American Dental Association, there are approximately 57% of people ages 65 to 74 wearing some form of denture. Due to this large number of denture wearers, it becomes imperative that health care providers learn to incorporate an oral assessment into their plan of care each time an older adult patient is examined. This assessment can assist providers to identify and differentiate unintentional weight loss and loss of appetite as being either part of a disease process or as a symptom of denture issues. Only then can the overall health of the elderly be holistically viewed and treated. The aim of this paper is to provide a summary of published data expressing the nutritional issues that occur in the elderly due to either being edentulous or from wearing improperly fitting dentures.

scholarly journals Impact of Social Restriction Imposed by 2019-ncov Pandemic on the Mobility of Older People: A Scope Review Protocol

2020 ◽  
Author(s):  
Sarah Bandeira ◽  
Patricia Batista ◽  
Cristina Cristóvão Ribeiro Silva ◽  
Ruth Caldeira Melo ◽  
Monica Rodrigues Perracini
Keyword(s):  
Older People ◽  
Latin American ◽  
Health Care Providers ◽  
Adverse Outcomes ◽  
Care Providers ◽  
Targeted Interventions ◽  
Thomson Reuters ◽  
Social Restriction ◽  
The Impact ◽  
At Home

Abstract Background The 2019‑nCoV pandemic represents a high risk for older people that sustain higher mortality rates compared to young adults. Limited social contact and restriction of mobility in the community (stay-at-home precautions) are recognised as measures to prevent SARS-CoV-2 infection among older people. The impact of these measures on health, physical function and emotional wellbeing are numerous, and might result in long-term adverse outcomes such as disability, falls and limited mobility. Thus, the objective of this scope review is to map the estimated impact of measures of social restrictions on the mobility of older people living in the community and to systematize the existing recommendations, anticipating possible intervention strategies gaps.Methods The search will be carried out using a standardized protocol in Latin American and Caribbean Literature on Health Sciences (LILACS), consulted by the Virtual Health Library (VHL), and the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrieval System Online (MEDLINE), via PubMed; Web of Science, via Main Collection (Thomson Reuters Scientific) and SCOPUS. Documents and reports with recommendations from governmental and nongovernmental organizations will be consulted. Complete studies available in the English, Spanish or Portuguese languages included in the different methodological approaches (original articles, literature reviews, editorials and guidelines) that necessarily address the recommendations of social restriction measures for preventing Covid-19 disease and their impacts on mobility of older people will be included. Two reviewers will select the studies based on their titles and abstracts. The manuscripts and documents selected for full reading will be analysed by reviewers concerning the eligibility criteria. When disagreements occurred in any phase of the selection process, a third reviewer will be included for a consensus analysis. Data will be extracted using a template form and the PRISMA-ScR checklist will be used to guarantee quality and transparency. Results will be presented as a narrative summary, including tables and figures.Discussion Globally, recommendations to stay-at-home and social distancing are substantially affecting health and wellbeing of older people. Preserving mobility is crucial to active and healthy ageing. The evidence summarized in the selected studies will be analysed in order to answer the research questions. The results of this review will help clinical practitioners, health care providers and policy makers to estimate the impact of measures to protect older people from 2019‑nCoV and to identify gaps and anticipate needs for targeted interventions to prevent mobility decline. Systematic review registrationsubmitted on 10-09-2020 in https://osf.io/registries

The Role of Docusate for Constipation in Older People

2021 ◽  
Vol 36 (10) ◽  
pp. 501-507
Author(s):  
Timothy Nguyen
Keyword(s):  
Randomized Controlled Trial ◽  
Older People ◽  
Older Adult ◽  
Health Care Providers ◽  
Chronic Constipation ◽  
Data Extraction ◽  
Controlled Trial ◽  
Adult Population ◽  
Care Providers ◽  
Randomized Controlled

Objective: To provide brief information on the effectiveness of docusate use for constipation in older people. Data Sources: PubMed search using the following terms (“docusate and chronic constipation,” “docusate, chronic constipation and geriatric,” “docusate, chronic constipation and older adult,” “docusate and randomized controlled trial” and included relevant information related to docusate and chronic constipation in the population described. Study Selection: Studies that fit the criteria for “chronic/general constipation,” “geriatric/older adults,” and/or “randomized controlled trials” were included. Four studies described docusate for chronic/general constipation and older people. Not included were other studies not related to chronic/general constipation and older people (eg, surgery-related). Data Extraction: Data extraction from each study included primary outcomes related to chronic constipation and efficacy of docusate. Data also included relevant reports from other relevant trials and discussions. Data Synthesis: Docusate when compared with placebo or psyllium or sennosides in these trials did not show any benefits for constipation. Psyllium and sennosides showed to be more effective compared with docusate. No differences found between docusate versus placebo. In summary, there is a lack of data to support the use of docusate for constipation and the data presented that docusate is not effective for use in constipation. Conclusion: Docusate is commonly used for constipation despite little evidence supporting its efficacy. There is not enough randomized controlled trial and data to support the use of docusate for constipation. Pharmacists along with health care providers should reassess and reconsider whether to use it and add extra layers to an already complex medication regimen in the older adult population.

The meaning of the experience of anticipating falling

2014 ◽  
Vol 35 (9) ◽  
pp. 1839-1863 ◽  
Author(s):  
JAMES A. SHAW ◽  
DENISE M. CONNELLY ◽  
CAROL L. MCWILLIAM
Keyword(s):  
Risk Assessment ◽  
Older People ◽  
Health Care Providers ◽  
Fall Prevention ◽  
Fall Risk ◽  
Phenomenological Study ◽  
Later Life ◽  
Care Providers ◽  
Structured Interviews ◽  
Fall Risk Assessment

ABSTRACTFalling in later life continues to be a critical issue in gerontology research, health professional practice and ageing health policy. However, much research in the area of fall risk and fall prevention neglects the meaning of the experiences of older people themselves. This humanistic interpretive phenomenological study explored the meaning of the experience of anticipating falling from the perspective of older people in order to foster a more person-focused approach to fall risk assessment and fall prevention. Individual semi-structured interviews were conducted with nine participants over the age of 65 living independently in the community. Follow-up interviews with two key informants were completed to inform the emerging interpretations. For older participants residing in the community, the experience of anticipating falling meant confronting their embodied lived-identity in the context of ageing. Experiential learning shaped how participants understood the meaning of falling, which constituted tacit, pathic knowledge of vulnerability and anxiety with respect to falling. Findings emphasise the importance of critically reflecting on the social experience of anticipating falling to develop effective and relevant fall prevention interventions, programmes and policies. A lifeworld-led approach to fall risk assessment and fall prevention resonates with these findings, and may encourage health-care providers to adopt a sustained focus on embodied lived-identity and quality of life when engaging older people in fall prevention activities.

scholarly journals The Influence of Older Adults’ Beliefs and Attitudes on Adopting Fall Prevention Behaviors

2017 ◽  
Vol 12 (4) ◽  
pp. 324-330 ◽  
Author(s):  
Judy A. Stevens ◽  
David A. Sleet ◽  
Laurence Z. Rubenstein
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Older Adult ◽  
Health Care Providers ◽  
Fall Prevention ◽  
Fall Risk ◽  
Care Providers ◽  
Injury Death ◽  
Effective Interventions ◽  
Control And Prevention

Among Americans aged 65 years and older, falls are the leading cause of injury death and disability, and finding effective methods to prevent older adult falls has become a public health priority. While research has identified effective interventions delivered in community and clinical settings, persuading older adults to adopt these interventions has been challenging. Older adults often do not acknowledge or recognize their fall risk. Many see falls as an inevitable consequence of aging. Health care providers can play an important role by identifying older adults who are likely to fall and providing clinical interventions to help reduce fall risks. Many older people respect the information and advice they receive from their providers. Health care practitioners can encourage patients to adopt effective fall prevention strategies by helping them understand and acknowledge their fall risk while emphasizing the positive benefits of fall prevention such as remaining independent. To help clinicians integrate fall prevention into their practice, the Centers for Disease Control and Prevention launched the STEADI (Stopping Elderly Accidents, Deaths, and Injuries) initiative. It provides health care providers in primary care settings with resources to help them screen older adult patients, assess their fall risk, and provide effective interventions.

scholarly journals Substance Use Among Older People Living With HIV: Challenges for Health Care Providers

2019 ◽  
Vol 7 ◽  
Author(s):  
Sherry Deren ◽  
Tara Cortes ◽  
Victoria Vaughan Dickson ◽  
Vincent Guilamo-Ramos ◽  
Benjamin H. Han ◽  
...  
Keyword(s):  
Health Care ◽  
Substance Use ◽  
Older People ◽  
Health Care Providers ◽  
People Living With Hiv ◽  
Care Providers ◽  
Living With Hiv

scholarly journals 407 - The Baycrest Quick-Response Caregiver Tool: The Role for a New Tool for Caregivers of Persons with Dementia

2020 ◽  
Vol 32 (S1) ◽  
pp. 123-123
Author(s):  
Ken Schwartz ◽  
Robert Madan ◽  
Anna Berall ◽  
Marsha Natadira ◽  
Anna Santiago
Keyword(s):  
Family Caregivers ◽  
Health Care Providers ◽  
Healthcare Providers ◽  
Well Being ◽  
Moderate Degree ◽  
Quick Response ◽  
Care Providers ◽  
High Level ◽  
Person With Dementia ◽  
The Impact

Background:Responsive behaviours in dementia are associated with poor outcomes for the person with dementia (PWD) and caregiver burnout. Family caregivers need a variety of tools to manage responsive behaviours. The Baycrest Quick-Response Caregiver Tool was developed to provide caregivers with a tool that can be used in real time. In this study, the feasibility, impact, and effectiveness of this new tool were studied in family caregivers and health care providers (HCP) using quantitative and qualitative measures.Methods:Family caregivers were recruited and were asked to complete a pre-survey before being sent the link to the educational tool. One month after the telephone survey, caregivers were sent an online post-survey to gather their feedback on the tool and the impact of the tool on caregiver well -being. Healthcare providers were also recruited and reviewed the tool through an online feedback survey. The feasibility, impact, and effectiveness of the tool were assessed using quantitative and qualitative measures.Results:Caregivers had a moderate degree of and reported a high level of competence - these scores were maintained throughout the study. Caregivers reported that tool positively impacted their compassion towards the person with dementia (PWD), and that their interactions with improved. 100% of HCP who completed the feedback survey would recommend the tool to other HCP and to caregivers of PWD. The caregivers and HCP provided specific suggestions for improvement.Conclusions:The Baycrest Quick-Response Caregiver Tool was found to be feasible and helpful. It provides caregivers and HCP with an additional approach for responsive behaviours.

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