No abstract

This study aimed to evaluate the effectiveness of a multi-disciplinary, client-centered, fall prevention program on the experiences of participation and autonomy in everyday occupations among community-dwelling older adults. In total, 131 older adults (65+) were included and randomly allocated into two groups. Intention-to-treat analysis was used. Results of this pilot study showed that the program had a limited effect on the subjective experiences of participation and autonomy in everyday occupations among the participants. However, a trend of increased perceived participation and a decrease in the experience of perceived problems with participation among the participants in the intervention group was shown. Perceived participation and autonomy seem to be subjective experiences, and they seem to vary depending on the individual. To properly understand the impact of fall prevention interventions on participation and autonomy, measurements that capture both subjective and objective experiences are essential to use.

This paper gives a brief description of the service delivery system for assistive technology used in daily life (AT) in Sweden, and includes discussion on present changes and trends. In Sweden the responsibility for provision of AT is shared between counties/regions and municipalities. The greater part of the cost for prescribed AT is paid by taxes. Each county/region and municipality decides on its fees and assortment of AT; there are no national guidelines or coordination. The prescription process is part of the rehabilitation process, where assessment of needs precedes prescription. In 2007 the Swedish government commissioned a programme in which trials with a voucher system were conducted in three counties and eight municipalities. The trials were evaluated and interviewed users expressed that the voucher system increased their participation in the process and that they experienced more satisfaction when they had purchased the AT on their own. The voucher system has been criticized by some users; notably by the main user organisation for persons with hearing impairments. During the past ten years, the range of AT that can be prescribed has been reduced and users have to buy some types of AT as consumer products on the private market.

Introduction: A major threat to healthy aging is accidental falls causing individual suffering as well as increasing costs for society. The aim of this study was to compare and evaluate a multifactorial fall prevention program, with ordinary falls prevention in primary health care. Method: Eligible patients were community dwelling older adults (+65) who had fallen within the last six month or were concerned about falling. Participants (n=131) were randomized to an intervention or control group. Primary outcome was measure of falls and the secondary was fear of falling. Results/Findings: There was a significant decrease of the risk for falls and fear of falling at 12 months in favour to the intervention group. When comparing groups over time including baseline measures only fear of falling remained significant. Discussion and implications: Small group learning environments in combination with learning by doing, could be an effective approach for the translation of knowledge into everyday life and valued activities leading to a decrease in falls and fear of falling. Conclusion: Multifactorial and multidisciplinary approaches against falls in a small group learning environment could be effective in preventing falls and reducing fear of falling among older adults at risk.

The employer has attended to some suggested short-term solutions and the follow-up study showed that the working conditions had been improved. A reduction of cardiovascular load, as well as self-rated physical exertion, was noted and the work was perceived as substantially less stressful.