Preventing Falls and Malnutrition among Older Adults in Municipal Residential Care in Sweden: A Registry Study

Abstract

Introduction Older adults in municipal residential care are among the most vulnerable and in need of most care. The prevalence of negative events, such as falls and malnutrition, is increased among these older adults. The need for strategies to prevent falls and malnutrition is emphasized in guidelines and systematic, individualized risk assessments are prerequisites for adequate interventions. Objectives The overall purpose of this study was to investigate the assessed risks of, and risk factors for, falling and malnutrition and the correlations between these assessed risks among older women and men in residential care. Further, the purpose was to investigate the consistency between planned and performed interventions among women and men assessed as at risk. Methods A cross-sectional registry study based on risk assessment data in the Swedish national quality registry, Senior Alert. Altogether, 5,919 older adults ≥65 in nursing homes and dementia care units in 19 municipalities in Sweden were included. Results Of the older adults, 77% were at risk of falls, and 59% were at risk of malnutrition. The most prevalent risk factors for falls were previous falls and not being cognitively oriented; and for malnutrition were having mild or severe dementia or depression. A significant positive correlation between the risk of falling and the risk of malnutrition was found. Less than half of the planned interventions for falls and malnutrition were performed. Care staff’s least common interventions to prevent falls were balance, muscular function, and strength training, which contrasts with the recommendations; interventions to prevent malnutrition were only partially adhering to recommendations. Conclusions This cross-sectional registry study points towards the importance of using an evidence-based approach, based on adherence to recommended guidelines, in the prevention of falling and malnutrition. Further, the implementation of clinical practice guidelines is needed, which requires educational training for care staff and supportive leadership.

Epidemiology of geriatric patients presenting to emergency departments in Europe: EGERS study

“…Infectious diseases are the third most common ED diagnosis, and this might be related to the coronavirus disease 2019 (COVID-19) pandemic during the study period. On the other hand, traumatic complaints and traumatic ED diagnoses were more common in the ≥85-year-old group compared to the other groups, which is also consistent with the previous studies [27][28][29]. The hospitalization rate was 52%, and of these patients, 83% were hospitalized in wards and 17% were in ICU in the present study.…”

“…Admissions to ED observation units for 85-year-old or older patients may be similar, but admissions to wards and ICUs may differ slightly depending on treatment protocols and hospitalization policies in the countries that participated in our study. Similar results were reported not only from Europe but also from the USA [27][28][29]. Falls are the leading cause of injury among adults over the age of 65, with home help service and having previously fallen being the most common risk factors [28].…”

Obstacles to and opportunities for care collaboration through the utilization of an effective preventive care process for frail older adults: A study protocol for a mixed methods study design.

“…Risks were identi ed in at least one of the four focus areas in 92% of cases in residential care facilities and home help care (34). However, not all identi ed risks led to an intervention, which is in line with previous research concluding that frail persons do not receive planned and performed interventions to the required degree, and SA is therefore not used to its full potential (35). A mismatch between identi ed risks and planned interventions has also been found suggesting that there are aws in how the PcP is implemented.…”

Older adults’ perceptions of oral health and its influence on general health: A deductive direct content analysis

“…Health behaviors, such as how often toothbrushing was performed, were described as having a strong link to oral health. Gusdal et al 29 support this by describing that poor oral health, such as lack of toothbrushing, is the most common cause of malnutrition among older adults living in nursing homes. A study by Moon et al 10 describes health behaviors such as continuously visiting the dentist as a factor that significantly impacts a person's oral health, which the Swedish older adults in this study also described.…”