Home care worker-supported exercise program to address falls: a feasibility study
Willeke Walsh A B , Claudia Meyer B C D E * and Elizabeth V. Cyarto C F GA At Home Support, Bolton Clarke, Melbourne, Vic. 3023, Australia.
B Rehabilitation, Ageing and Independent Living Research Centre, Monash University, Melbourne, Vic. 3199, Australia.
C Bolton Clarke Research Institute, Bolton Clarke, Melbourne, Vic. 3131, Australia.
D College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5042, Australia.
E Centre for Health Communication and Participation, La Trobe University, Melbourne, Vic. 3086, Australia.
F Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Qld 4059, Australia.
G Faculty of Health and Behavioural Sciences, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Qld 4067, Australia.
Australian Journal of Primary Health - https://doi.org/10.1071/PY22248
Submitted: 28 October 2022 Accepted: 16 May 2023 Published online: 16 June 2023
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University
Abstract
Background: Falls are a major concern for community-dwelling older adults. The Otago Exercise Program (OEP) is an evidence-based home program that reduces risk of falls. Exercise participation and program adherence can be challenging. Home care workers (HCWs) are well positioned to provide support for older adults.
Methods: This feasibility study included: HCW training; HCW in-home support of a physiotherapist-tailored OEP; online physiotherapy consultations; older participant questionnaires and functional outcome measures; and HCW and older participant interviews.
Results: Twelve older adults, eight HCWs and one physiotherapist participated. A small falls risk reduction, and improvement in falls efficacy, quality of life and functional improvement were noted. Thematic analysis showed formal and informal support was valued by older adults and HCWs. A role-ordered matrix synthesis highlighted variable ongoing independent program participation.
Conclusions: By Your Side, a physiotherapist-led and home care worker-supported modified OEP provides a feasible and acceptable option for falls prevention in home care services. Collaborative teamwork, and both formal and informal support, are key aspects to optimising engagement and benefits.
Keywords: acceptability, community, engagement, exercise, fall prevention, falls, feasibility, home care worker, older adult, Otago Exercise Program, physiotherapist.
References
Australian Institute of Health and Welfare (2021) People using aged care. GEN Aged Care Data. Available at https://www.gen-agedcaredata.gov.au/Topics/People-using-aged-care [Accessed 9 September 2021]Burns ER, Stevens JA, Lee R (2016) The direct costs of fatal and non-fatal falls among older adults – United States. Journal of Safety Research 58, 99–103.
| The direct costs of fatal and non-fatal falls among older adults – United States.Crossref | GoogleScholarGoogle Scholar |
Burton E, Lewin G, Clemson L, Boldy D (2013) Effectiveness of a lifestyle exercise program for older people receiving a restorative home care service: a pragmatic randomized controlled trial. Clinical Interventions in Aging 8, 1591–1601.
| Effectiveness of a lifestyle exercise program for older people receiving a restorative home care service: a pragmatic randomized controlled trial.Crossref | GoogleScholarGoogle Scholar |
Burton E, Lewin G, O’Connell H, Hill KD (2018a) Falls prevention in community care: ten years on. Clinical Interventions in Aging 13, 261–269.
| Falls prevention in community care: ten years on.Crossref | GoogleScholarGoogle Scholar |
Burton E, Lewin G, O’Connell H, Petrich M, Boyle E, Hill KD (2018b) Can community care workers deliver a falls prevention exercise program? A feasibility study. Clinical Interventions in Aging 13, 485–495.
| Can community care workers deliver a falls prevention exercise program? A feasibility study.Crossref | GoogleScholarGoogle Scholar |
Campbell AJ, Robertson MC, Gardner MM, Norton RN, Tilyard MW, Buchner DM (1997) Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women. BMJ 315, 1065–1069.
| Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women.Crossref | GoogleScholarGoogle Scholar |
Creswell JW, Plano Clark VL (2011) ‘Designing and conducting mixed methods research.’ (SAGE publications: California)
Fisk M, Livingstone A, Pit SW (2020) Telehealth in the context of COVID-19: changing perspectives in Australia, the United Kingdom, and the United States. Journal of Medical Internet Research 22, e19264
| Telehealth in the context of COVID-19: changing perspectives in Australia, the United Kingdom, and the United States.Crossref | GoogleScholarGoogle Scholar |
Hawthorne G, Richardson J, Osborne R (1999) The Assessment of Quality of life (AQoL) instrument: a psychometric measure of health-related quality of life. Quality of Life Research 8, 209–224.
| The Assessment of Quality of life (AQoL) instrument: a psychometric measure of health-related quality of life.Crossref | GoogleScholarGoogle Scholar |
Henwood T, Hetherington S, Purss M, Rouse K, Morrow J, Smith M (2019) active@home: investigating the value of a home care worker–led exercise program for older adults with complex care needs. Journal of Aging and Physical Activity 27, 284–289.
| active@home: investigating the value of a home care worker–led exercise program for older adults with complex care needs.Crossref | GoogleScholarGoogle Scholar |
Hill K, Bernhardt J, McGann A, Maltese D, Berkovits D (1996a) A new test of dynamic standing balance for stroke patients: reliability, validity and comparison with healthy elderly. Physiotherapy Canada 48, 257–262.
| A new test of dynamic standing balance for stroke patients: reliability, validity and comparison with healthy elderly.Crossref | GoogleScholarGoogle Scholar |
Hill KD, Schwarz JA, Kalogeropoulos AJ, Gibson SJ (1996b) Fear of falling revisited. Archives of Physical Medicine and Rehabilitation 77, 1025–1029.
| Fear of falling revisited.Crossref | GoogleScholarGoogle Scholar |
Kreisfeld R, Pointer S, Bradley C (2017) Trends in hospitalisations due to falls by older people, Australia 2002-03 to 2012-13. Australian Institute of Health and Welfare: Canberra, ACT, Australia.
Martins AC, Santos C, Silva C, Baltazar D, Moreira J, Tavares N (2018) Does modified Otago Exercise Program improves balance in older people? A systematic review. Preventive Medicine Reports 11, 231–239.
| Does modified Otago Exercise Program improves balance in older people? A systematic review.Crossref | GoogleScholarGoogle Scholar |
Miles MB, Huberman AM, Saldana J (2014) ‘Qualitative data analysis: a methods sourcebook.’ (SAGE Publications: Thousand Oaks, CA, USA)
Olanrewaju O, Kelly S, Cowan A, Brayne C, Lafortune L (2016) Physical activity in community dwelling older people: a systematic review of reviews of interventions and context. PLoS ONE 11, e0168614
| Physical activity in community dwelling older people: a systematic review of reviews of interventions and context.Crossref | GoogleScholarGoogle Scholar |
Podsiadlo D, Richardson S (1991) The timed “Up and Go”: a test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society 39, 142–148.
| The timed “Up and Go”: a test of basic functional mobility for frail elderly persons.Crossref | GoogleScholarGoogle Scholar |
Robertson MC, Campbell AJ, Gardner MM, Devlin N (2002) Preventing injuries in older people by preventing falls: a meta-analysis of individual-level data. Journal of the American Geriatrics Society 50, 905–911.
| Preventing injuries in older people by preventing falls: a meta-analysis of individual-level data.Crossref | GoogleScholarGoogle Scholar |
Rossiter-Fornoff JE, Wolf SL, Wolfson LI, Buchner DM, FICSIT Group (1995) A cross-sectional validation study of the FICSIT common data base static balance measures. The Journals of Gerontology: Series A 50A, M291–M297.
| A cross-sectional validation study of the FICSIT common data base static balance measures.Crossref | GoogleScholarGoogle Scholar |
Russell MA, Hill KD, Blackberry I, Day LM, Dharmage SC (2008) The reliability and predictive accuracy of the falls risk for older people in the community assessment (FROP-Com) tool. Age and Ageing 37, 634–639.
| The reliability and predictive accuracy of the falls risk for older people in the community assessment (FROP-Com) tool.Crossref | GoogleScholarGoogle Scholar |
Sherrington C, Fairhall N, Wallbank G, Tiedemann A, Michaleff ZA, Howard K, Clemson L, Hopewell S, Lamb S (2020) Exercise for preventing falls in older people living in the community: an abridged Cochrane systematic review. British Journal of Sports Medicine 54, 885–891.
| Exercise for preventing falls in older people living in the community: an abridged Cochrane systematic review.Crossref | GoogleScholarGoogle Scholar |
Somerville L, Davis A, Elliott AL, Terrill D, Austin N, Philip K (2015) Building allied health workforce capacity: a strategic approach to workforce innovation. Australian Health Review 39, 264–270.
| Building allied health workforce capacity: a strategic approach to workforce innovation.Crossref | GoogleScholarGoogle Scholar |
Stone RI, Bryant NS (2019) The future of the home care workforce: training and supporting aides as members of home-based care teams. Journal of the American Geriatrics Society 67, S444–S448.
| The future of the home care workforce: training and supporting aides as members of home-based care teams.Crossref | GoogleScholarGoogle Scholar |
Whitney SL, Wrisley DM, Marchetti GF, Gee MA, Redfern MS, Furman JM (2005) Clinical measurement of sit-to-stand performance in people with balance disorders: validity of data for the Five-Times-Sit-to-Stand Test. Physical Therapy 85, 1034–1045.
| Clinical measurement of sit-to-stand performance in people with balance disorders: validity of data for the Five-Times-Sit-to-Stand Test.Crossref | GoogleScholarGoogle Scholar |
Zubala A, MacGillivray S, Frost H, Kroll T, Skelton DA, Gavine A, Gray NM, Toma M, Morris J (2017) Promotion of physical activity interventions for community dwelling older adults: a systematic review of reviews. PLoS ONE 12, e0180902
| Promotion of physical activity interventions for community dwelling older adults: a systematic review of reviews.Crossref | GoogleScholarGoogle Scholar |
