Older people’s experience of falls: understanding, interpretation and autonomy

Roe, Brenda; Howell, Fiona; Riniotis, Konstantinos; Beech, Roger; Crome, Peter; Ong, Bie Nio

doi:10.1111/j.1365-2648.2008.04735.x

Cited by 65 publications

(83 citation statements)

References 47 publications

(100 reference statements)

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“…In two other studies that evaluated older persons without cognitive disorders and post-stroke patients, only a minority did not know what caused their fall (Forster & Young, 1995;Roe et al, 2008). The unawareness of the cause in this study is probably due to the cognitive problems of our patients.…”

Section: Discussioncontrasting

confidence: 62%

“…The interviews lasted an average of 35 min (SD 14 min). An interview guide was used and included topics derived from the literature (Buri & Dawson, 2000;Kuzuya et al, 2006;Liddle & Gilleard, 1995;Roe et al, 2008;Weinberg & Strain, 1995;Yardley et al, 2006) and from daily practical experience. A panel of three experts (two in geriatrics and one medical psychologist) evaluated the validity of the two versions of the topic list.…”

Section: Data Collectionmentioning

confidence: 99%

“…In frail older persons, falls often coexist with cognitive impairment (Hauer et al, 2009). However, quantitative and qualitative research on falling and the fear of falling have focused on non-frail older persons without cognitive impairments rather than on frail older persons both with and without cognitive impairments (Ballinger & Payne, 2000;Gillespie et al, 2009;Kong, Lee, Mackenzie, & Lee, 2002;Roe et al, 2008;Weinberg & Strain, 1995;Wright, Aizenstein, Vogler, Rowe, & Miller, 1990;Zijlstra et al, 2007).…”

Section: Introductionmentioning

confidence: 98%

See 2 more Smart Citations

Qualitative study on the impact of falling in frail older persons and family caregivers: Foundations for an intervention to prevent falls

Faes¹,

Reelick²,

Banningh³

et al. 2010

Aging & Mental Health

117

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Falling has major physical and emotional consequences for patients and caregivers. A fall prevention programme should focus on reducing the consequences of falling and on promoting self-efficacy and activity. The causes of falls should be discussed. The programme should include dyads of patients and caregivers because caregivers are highly involved and also suffer from anxiety. Before beginning such a programme, providers should transform negative expectations about the programme into positive ones. Finally, caregivers must learn how to deal with the consequences of their CRs' falling as well as their cognitive impairment.

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Section: Discussioncontrasting

confidence: 62%

Section: Data Collectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

See 1 more Smart Citation

Qualitative study on the impact of falling in frail older persons and family caregivers: Foundations for an intervention to prevent falls

Faes¹,

Reelick²,

Banningh³

et al. 2010

Aging & Mental Health

117

View full text Add to dashboard Cite

show abstract

“…An awareness of increasing numbers of falls experienced by older people in the community has fuelled a raft of worldwide research into the risk factors associated with falling (Stevens et al, 2014), the impact of falls (Roe et al, 2008;Thomas et al, 2013) and preventative measures to reduce falls in the future (Gillespie et al, 2012). The impacts of falls are wide-ranging, including weakening health, reduced social networks/ activities and overall quality of life (Roe et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

Falls assessment and prevention in older people: an evaluation of the Crisis Response Service

Pyer

Campbell

Ward

et al. 2015

Journal of Paramedic Practice

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The elderly population of the world is growing with increasing trends of older people falling and accessing emergency services. The Crisis Response Falls Service in Northamptonshire (UK) was designed to identify health and social care needs, promote independence and limit the impact of falls. This paper presents the findings of an evaluation of the service. A mixed-method approach was applied, drawing on the views of service users (via a survey and telephone interviews) and reviewing existing East Midlands Ambulance Service (EMAS) data with routinely collected data from the service.A decrease in the numbers of patients conveyed to hospital following a fall was observed. Best estimates of financial calculations suggest savings. High levels of patient satisfaction were achieved; patients felt treated with dignity and staff were considered friendly, approachable and well-informed. First responder services can provide positive impacts for those who fall in the community. The development and impact of the CRS shows the importance of evidence-based client centred training to inform the approaches taken to supporting those who fall, and the impact of a strong values based approach on the experiences of patients. KeywordsParamedic, falls, elderly, patient experience, patient satisfaction, allied health personnel. Key points1) The elderly population of the world is growing with increasing trends of older people falling and accessing emergency services.2) Falls have a range of impacts for communities and individuals, including fractures, traumatic brain injury, hospitalisation or premature death.3) Having an understanding of falls and the circumstances leading to them is invaluable for identifying a targeted, proactive response from commissioners and front line staff.4) It is important that the views of older people are taken into account and that they are afforded choices in interventions, ensuring that they maintain independence and competence.5) This study has begun to illustrate the range of impacts that interagency collaboration can have in supporting older people who fall, alongside the importance of effective training and a values based approach.3

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“…First, as part of a population health management approach to FRIs, it may be appropriate for policy makers to place greater emphasis on removing barriers associated with economic deprivation and social norms, such as an emphasis on physical activity and safe health practices to change the culture of awareness and engagement around falls and FRIs. This may be useful, as many older adults express lack of understanding about the causes of such events 93 or are unwilling to engage in prevention activities. 94 Older adults sometimes do not realize that FRIs can lead to rapid decline in health and functional independence, or even death.…”

Section: Fall-related Injuries Among Older Adultsmentioning

confidence: 99%

Examining Contextual Influences on Fall-Related Injuries Among Older Adults for Population Health Management

Hoffman

Rodríguez

2015

Population Health Management

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The objectives were to assess the associations between fall-related injuries (FRIs) treated in the emergency department (ED) among older adults in California and contextual county-level physical, social, and economic characteristics, and to assess how county-level economic conditions are associated with FRIs when controlling for other county-level factors. Data from 2008 California ED discharge, Medicare Impact File, and County Health Rankings were used. Random effects logistic regression models estimated contextual associations between county-level factors representing economic conditions, the built environment, community safety, access to care, and obesity with patient-level FRI treatment among 1,712,409 older adults, controlling for patient-level and hospital-level characteristics. Patient-level predictors of FRI treatment were consistent with previous studies not accounting for contextual associations. Larger and rural hospitals had higher odds of FRI treatment, while teaching and safety net hospitals had lower odds. Better county economic conditions were associated with greater odds (ß = 0.73, P = 0.001) and higher county-level obesity were associated with lower odds (ß = -0.37, P = 0.004), but safer built environments (ß = -0.31, P = 0.38) were not associated with FRI treatment. The magnitude of association between county-level economic conditions and FRI treatment attenuated with the inclusion of countylevel obesity rates. FRI treatment was most strongly and consistently related to more favorable county economic conditions, suggesting differences in treatment or preferences for treatment for FRIs among older individuals in communities of varying resource levels. Using population health data on FRIs, policy makers may be able to remove barriers unique to local contexts when implementing falls prevention educational programs and built environment modifications. (Population Health Management 2015;18:437-448)

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Older people’s experience of falls: understanding, interpretation and autonomy

Abstract: Assisting people to reflect on their falls and to understand why they happened could help with preventing future falls, allay fear, boost confidence and aid rehabilitation relating to their activities of daily living.

Cited by 65 publications

References 47 publications

Qualitative study on the impact of falling in frail older persons and family caregivers: Foundations for an intervention to prevent falls

Qualitative study on the impact of falling in frail older persons and family caregivers: Foundations for an intervention to prevent falls

Falls assessment and prevention in older people: an evaluation of the Crisis Response Service

Examining Contextual Influences on Fall-Related Injuries Among Older Adults for Population Health Management

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