Best practice in fall prevention: roles of informal caregivers, health care providers and the community

Abstract

Falls are an important public health problem for older adults, resulting in significant morbidity and mortality, as well as healthcare costs. Evidence supports the assessment of older adults' fall risks and implementation of interventions to reduce these risks. Older adults are the key stakeholder in preventing falls, but need the support of their informal caregivers, healthcare providers, and community groups. This article addresses the roles of these additional stakeholders in providing and supporting best practices in fall prevention. Together these stakeholders can assist older adults in self-management of fall prevention, based on the preferences of the individual, local resources, and available programmes and healthcare services.

Home modifications for older people with cognitive impairments: Mediation analysis of caregivers’ information needs and perceptions of fall risks

“…This growth in home modification could indicate that older people and their families are paying more attention now than they did before to keeping their homes safe. Such modifications enable older people to stay in their homes for longer and reduce the cost and disruption incurred by moving into long‐term care facilities (Joint Center for Housing Studies of Harvard University, ; Lach et al, ). This suggests that healthcare providers should be prepared to meet the increasing and diverse needs of both older people and their family members by carefully considering the benefits and daily challenges that homebound older people and their caregivers encounter in terms of concerns, risk factors, roles and responsibilities (Fjordside & Morville, ; Ryan et al, ; Tong et al, ).…”

“…We found that caregivers’ information needs related to fall management were significantly associated with home modification, partially mediating the relationship between older people's impaired ADLs and home modification. This suggests that it is crucial for nursing providers to work closely with multidisciplinary healthcare professionals such as occupational therapists, physical therapists and construction professionals to provide relevant resources and information to caregivers regarding both home modification and fall prevention (Lach et al, ). A multidisciplinary team plays an important role in helping caregivers understand the importance of home modification in fall prevention as part of both health care and community well‐being, as caregivers are more likely to initiate home modifications after discussing their options with healthcare professionals (Marquardt et al, ).…”

“…Informal caregivers play an important role in the provision of a wide range of information regarding fall risks for older people. Researchers have shown that caregivers are able to subjectively identify which older people are at high risk for both falls (Ryan, McCann, & McKenna, ) and fall‐associated injuries (Lach, Krampe, & Phongphanngam, ; Shimada et al, ). Family caregivers can provide unique perspectives regarding the physical, spatial and interpersonal issues related to home safety, many of which differ from those of their care recipients (Tong, Sims‐Gould, & Martin‐Matthews, ).…”

“…Family caregivers can provide unique perspectives regarding the physical, spatial and interpersonal issues related to home safety, many of which differ from those of their care recipients (Tong, Sims‐Gould, & Martin‐Matthews, ). Informal caregivers such as family members can encourage older people to participate in preventive interventions or to use external resources (Boltz, ; Lach et al, ; Marquardt et al, ; Suttanon, Hill, Said, Byrne, & Dodd, ). With their caregivers’ support, older people are thus more likely to seek external resources regarding home modifications that promote home safety (Marquardt et al, ).…”

“…Despite the fact that home modifications are effective interventions for fall prevention among older people, they are often not implemented due to a lack of knowledge and/or resources on this topic among the older people concerned (Marquardt et al, ). There is also limited information that focuses specifically on how caregivers’ perceptions of fall risk are associated with the caregivers’ information needs and home modifications (Lach et al, ) for older people with cognitive impairments. This gap in the literature is significant because caregivers play an essential role in fall‐risk assessment and related interventions for older people with cognitive and functional impairments (Wilkinson et al, ).…”