‘Believe the positive’ aggregation of fall risk assessment methods reduces the detection of risk of falling in older adults

Menezes, Michele Duarte de; Meziat‐Filho, Ney; Lemos, Thiago; Ferreira, Arthur de Sá

doi:10.1016/j.archger.2020.104228

Cited by 6 publications

(4 citation statements)

References 64 publications

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“…Furthermore, HCPs have different definitions of living at risk [ 7 ]. Current risk assessments often focus narrowly on specific safety issues like falls [ 8 ] or generate a decontextualized risk score [ 9 – 11 ]. They often fail to consider patients’ perceptions or preferences regarding strategies to mitigate risk, consider older adult and caregiver risk tolerance [ 7 , 12 ] or consider how important risky activities are for the person.…”

Section: Introductionmentioning

confidence: 99%

Shifting the narrative from living at risk to living with risk: validating and pilot-testing a clinical decision support tool: a mixed methods study

MacLeod¹,

Veillette

Klein

et al. 2023

BMC Geriatr

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Background When there are safety concerns, healthcare professionals (HCPs) may disregard older adults’ wishes to return or remain at home. A paradigm shift is needed for HCPs to move from labelling older adults as living at risk to helping them live with risk. The Living with Risk: Decision Support Tool (LwR:DST) was developed to support older adults and HCPs with difficult decision-making regarding living with risk. The study objectives were to: (1) validate, and (2) pilot-test the LwR:DST in hospital and community settings. Methods The study was conducted across Canada during the pandemic. The LwR:DST’s content was validated with quantitative and qualitative data by: (1) 71 HCPs from hospital and community settings using the Delphi method, and (2) 17 older adults and caregivers using focus groups. HCPs provided feedback on the LwR:DST’s content, format and instruction manual while older adults provided feedback on the LwR:DST’s communication step. The revised LwR:DST was pilot-tested by 14 HCPs in one hospital and one community setting, and 17 older adults and caregivers described their experience of HCPs using this approach with them. Descriptive and thematic analysis were performed. Results The LwR:DST underwent two iterations incorporating qualitative and quantitative data provided by HCPs, older adults and caregivers. The quantitative Delphi method data validated the content and the process of the LwR:DST, while the qualitative data provided practical improvements. The pilot-testing results suggest that using the LwR:DST broadens HCPs’ clinical thinking, structures their decision-making, improves their communication and increases their competence and comfort with risk assessment and management. Our findings also suggest that the LwR:DST improves older adults’ healthcare experience by feeling heard, understood and involved. Conclusions This revised LwR:DST should help HCPs systematically identify frail older adults’ risks when they remain at or return home and find acceptable ways to mitigate these risks. The LwR:DST induces a paradigm shift by acknowledging that risks are inherent in everyday living and that risk-taking has positive and negative consequences. The challenges involved in integrating the LwR:DST into practice, i.e., when, how and with whom to use it, will be addressed in future research.

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Section: Introductionmentioning

confidence: 99%

Shifting the narrative from living at risk to living with risk: validating and pilot-testing a clinical decision support tool: a mixed methods study

MacLeod¹,

Veillette

Klein

et al. 2023

BMC Geriatr

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“…One in three people aged 65 years or older falls every year, with half of these people reporting falling more than once [ 10 ]. In addition, falls are also the leading cause of death in older people.…”

Section: Introductionmentioning

confidence: 99%

“…Injuries associated with falls among the older population are a major cause of pain, disability, loss of functional autonomy and institutionalization, negatively affecting the physical, psychological, and socioeconomic status of the individual [ 12 ], which, ultimately, exerts a great impact on their quality of life [ 13 ]. Falls, therefore, represent a public health problem in older adults with high associated costs both directly and indirectly [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…There is a need to monitor, manage, and promote screening programs for fall prevention in the older population, including personalized FR assessments. However, prediction of falls in older adults is a complicated clinical issue due to its multifactorial nature, and, therefore, several FR assessment methods are available [ 10 ]. Effective FR screening is still underutilized and not routinely integrated into clinical practice; consequently, many older adults do not undergo comprehensive FR screening, nor do they receive targeted prevention strategies [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Determining the Profile of People with Fall Risk in Community-Living Older People in Algarve Region: A Cross-Sectional, Population-Based Study

Guerreiro

Botelho

Fernández‐Martínez

et al. 2022

IJERPH

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One in three people aged 65 years or older falls every year. Injuries associated with this event among the older population are a major cause of pain, disability, loss of functional autonomy and institutionalization. This study aimed to assess mobility and fall risk (FR) in community-living older people and to determine reliable and independent measures (health, social, environmental and risk factors) that can predict the mobility loss and FR. In total, 192 participants were included, with a mean age of 77.93 ± 8.38. FR was assessed by EASY-Care (EC) Standard 2010, the Tinetti Test and the Modified Falls Efficacy Scale (MFES). An exploratory analysis was conducted using the divisive non-hierarchical cluster method, aiming to identify a differentiator and homogeneous group of subjects (optimal group of variables) and to verify if that group shows differences in fall risk. Individually, the health, social, environmental and risk factor categories were not found to be an optimal group; they do not predict FR. The most significant predictor variables were a mix of the different categories, namely, the presence of pain, osteoarthritis (OA), and female gender. The finding of a profile that allows health professionals to be able to quickly identify people at FR will enable a reduction in injuries and fractures resulting from falls and, consequently, the associated costs.

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Choisir et savoir combiner les outils d’évaluation du risque de chute d’une personne âgée

Barbier¹

2022

Soins Gérontologie

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‘Believe the positive’ aggregation of fall risk assessment methods reduces the detection of risk of falling in older adults

Cited by 6 publications

References 64 publications

Shifting the narrative from living at risk to living with risk: validating and pilot-testing a clinical decision support tool: a mixed methods study

Shifting the narrative from living at risk to living with risk: validating and pilot-testing a clinical decision support tool: a mixed methods study

Determining the Profile of People with Fall Risk in Community-Living Older People in Algarve Region: A Cross-Sectional, Population-Based Study

Choisir et savoir combiner les outils d’évaluation du risque de chute d’une personne âgée

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