Sharing knowledge of falls prevention for people with dementia: insights for community care practice
Claudia Meyer A B E , Sophie Hill A , Keith D. Hill C and Briony Dow DA Centre for Health Communication and Participation, School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University, Plenty Road, Bundoora, Vic. 3086, Australia.
B RDNS Institute, 31 Alma Road, St Kilda, Vic. 3182, Australia.
C School of Physiotherapy and Exercise Science, Curtin University, Kent Street, Perth, WA 6845, Australia.
D National Ageing Research Institute, PO Box 2127, Royal Melbourne Hospital, Vic. 3050, Australia.
E Corresponding author. Email: cmeyer@rdns.com.au
Australian Journal of Primary Health 23(5) 464-470 https://doi.org/10.1071/PY16142
Submitted: 18 January 2016 Accepted: 23 May 2017 Published: 21 July 2017
Abstract
People living with dementia (PLWD) fall more frequently, with more adverse consequences, than general community-dwelling older people; however, falls prevention evidence for PLWD is limited. Increased success of falls prevention strategies for PLWD may rely on tailored interventions to address dementia-specific risk factors. The Australian person-centred care environment highlights the need to better understand sharing of falls prevention knowledge between clients, carers and health professionals. This study aims to examine knowledge of falls prevention for PLWD among community care health professionals (CCHPs) and explore effectiveness of an action–research approach to enhance falls prevention practice. Consecutive action–research sessions were conducted with four groups of Australian multidisciplinary CCHPs (n = 18), including a knowledge survey of CCHPs, followed by implementation of action plans. Thematic analysis of the transcribed discussion was undertaken. Results showed limited knowledge and understanding of evidence-based falls prevention strategies, but small incremental changes made by CCHPs through action research offered insights into enhancing knowledge and awareness. Appropriate professional development for community care health professionals is needed to support falls prevention for PLWD, along with associated organisational changes, to ensure knowledge is adequate.
References
Allan LM, Ballard CG, Rowan EN, Kenny RA (2009) Incidence and prediction of falls in dementia: a prospective study in older people. PLoS One 4, e5521| Incidence and prediction of falls in dementia: a prospective study in older people.Crossref | GoogleScholarGoogle Scholar |
Australian Institute of Health and Welfare (2012) Dementia in Australia. Catalogue number AGE-70. AIHW, Canberra, ACT, Australia.
Bennett S, Shand S, Liddle J (2011) Occupational therapy practice in Australia with people with dementia: a profile in need of change. Australian Occupational Therapy Journal 58, 155–163.
| Occupational therapy practice in Australia with people with dementia: a profile in need of change.Crossref | GoogleScholarGoogle Scholar |
Bradley C (2012) Hospitalisations due to falls in older people, Australia 2008–09. (Australian Institute for Health and Welfare, Canberra: ACT, Australia). Available at http://www.aihw.gov.au/publication-detail/?id=10737421923 [Verified 19 October 2012]
Burton E, Cavalheri V, Adams R, Oakley-Browne C, Bovery-Spencer P, Fenton AM, Campbell BW, Hill KD (2015) Effectiveness of exercise programs to reduce falls in older people with dementia living in the community: a systematic review and meta-analysis. Clinical Interventions in Aging 10, 421–434.
| Effectiveness of exercise programs to reduce falls in older people with dementia living in the community: a systematic review and meta-analysis.Crossref | GoogleScholarGoogle Scholar |
Dupuis S, Gillies J, Carson J, Whyte C, Genoe R, Loiselle L, Sadler L (2012) Moving beyond patient and client approaches: mobilizing ‘authentic partnerships’ in dementia care, support and services. Dementia 11, 427–452.
| Moving beyond patient and client approaches: mobilizing ‘authentic partnerships’ in dementia care, support and services.Crossref | GoogleScholarGoogle Scholar |
Ganz DA, Yano EM, Saliba D, Shekelle PG (2009) Design of a continuous quality improvement program to prevent falls among community-dwelling older adults in an integrated healthcare system. BMC Health Services Research 9, 206
| Design of a continuous quality improvement program to prevent falls among community-dwelling older adults in an integrated healthcare system.Crossref | GoogleScholarGoogle Scholar |
Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, Lamb SE (2012) Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews 2012, CD007146
| Interventions for preventing falls in older people living in the community.Crossref | GoogleScholarGoogle Scholar |
Kirkpatrick D, Kirkpatrick J (2006) ‘Evaluating Training Programs: the Four Levels.’ (Berrett-Koehler Publishers: San Francisco, CA, USA)
Lamb SE, Jorstad-Stein EC, Hauer K, Becker C (2005) Development of a common outcome data set for fall injury prevention trials: the Prevention of Falls Network Europe consensus. Journal of the American Geriatrics Society 53, 1618–1622.
| Development of a common outcome data set for fall injury prevention trials: the Prevention of Falls Network Europe consensus.Crossref | GoogleScholarGoogle Scholar |
Liu-Ambrose T, Ahamed Y, Graf P, Feldman F, Robinovitch S (2008) Older fallers with poor working memory overestimate their postural limits. Archives of Physical Medicine and Rehabilitation 89, 1335–1340.
| Older fallers with poor working memory overestimate their postural limits.Crossref | GoogleScholarGoogle Scholar |
Low L-F, White F, Jeon Y-H, Gresham M, Brodaty H (2013) Desired characteristics and outcomes of community care services for persons with dementia: what is important according to clients, service providers and policy? Australasian Journal on Ageing 32, 91–96.
| Desired characteristics and outcomes of community care services for persons with dementia: what is important according to clients, service providers and policy?Crossref | GoogleScholarGoogle Scholar |
Meyer C, Hill K, Hill S, Dow B (2015a) Translating falls prevention knowledge for community-dwelling people living with dementia: design protocol for a mixed-method intervention. Journal of Alzheimer’s Disease & Parkinsonism 5, 185
| Translating falls prevention knowledge for community-dwelling people living with dementia: design protocol for a mixed-method intervention.Crossref | GoogleScholarGoogle Scholar |
Meyer C, Hill S, Dow B, Synnot A, Hill K (2015b) Translating falls prevention knowledge to community-dwelling older PLWD: a mixed-method systematic review. The Gerontologist 55, 560–574.
| Translating falls prevention knowledge to community-dwelling older PLWD: a mixed-method systematic review.Crossref | GoogleScholarGoogle Scholar |
Panel on Prevention of Falls in Older Persons, American Geriatrics Society and British Geriatrics Society (2011) Summary of the updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons. Journal of the American Geriatrics Society 59, 148–157.
| Summary of the updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons.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 |
Shaw FE, Bond J, Richardson DA, Dawson P, Steen IN, McKeith IG, Kenny RA (2003) Multifactorial intervention after a fall in older people with cognitive impairment and dementia presenting to the accident and emergency department: randomised controlled trial. British Medical Journal 326, 73
| Multifactorial intervention after a fall in older people with cognitive impairment and dementia presenting to the accident and emergency department: randomised controlled trial.Crossref | GoogleScholarGoogle Scholar |
Stringer E (2007) ‘Action Research.’ (SAGE Publications: Thousand Oaks, CA, USA)
Waldron N, Hill A, Barker A (2012) Falls prevention in older adults. Australian Family Physician 41, 930–935.
