Improving Policy for the Prevention of Falls Among Community-Dwelling Older People—A Scoping Review and Quality Assessment of International National and State Level Public Policies

Abstract

Objectives: Effective public policy to prevent falls among independent community-dwelling older adults is needed to address this global public health issue. This paper aimed to identify gaps and opportunities for improvement of future policies to increase their likelihood of success.Methods: A systematic scoping review was conducted to identify policies published between 2005–2020. Policy quality was assessed using a novel framework and content criteria adapted from the World Health Organization’s guideline for Developing policies to prevent injuries and violence and the New Zealand Government’s Policy Quality Framework.Results: A total of 107 articles were identified from 14 countries. Content evaluation of 25 policies revealed that only 54% of policies met the WHO criteria, and only 59% of policies met the NZ criteria. Areas for improvement included quantified objectives, prioritised interventions, budget, ministerial approval, and monitoring and evaluation.Conclusion: The findings suggest deficiencies in a substantial number of policies may contribute to a disconnect between policy intent and implementation. A clear and evidence-based model falls prevention policy is warranted to enhance future government efforts to reduce the global burden of falls.

Perspectives and experiences of community-dwelling older adults who experience falling: A qualitative meta-synthesis

“…There is, therefore, an urgent need for community policymakers to take heed of these findings and to prioritize creating age-friendly environments that minimize fall risks. This includes ensuring adequate lighting in public spaces, maintaining accessible sidewalks, and promoting home safety assessments to identify and address hazards within individuals’ residences [ 26 ]. As revealed in this study, diverse perceptions and attitudes can significantly influence behavior and decisions concerning fall prevention and safety measures in older adults.…”

“…This collaborative approach will ensure that physical, psychological, and social aspects of post-fall management are addressed and that greater independence is prolonged. However, many policies and programs on falls appear to have been designed with little capacity to be evaluated [ 26 ]. Therefore, the content criteria of monitoring and evaluation mechanisms need to be established, especially for the reliable monitoring of falls among older people in the community setting.…”

Mortality Trends due to Falls in the Group of People in Early (65–74 Years) and Late (75+) Old Age in Poland in the Years 2000–2020

“…The key is to identify people at risk of falling and to refer them to local programs or resources. Prevention of falls must span the spectrum of ages and health states within the older population and address the diversity of causes of falls without unnecessarily compromising quality of life and independence [ 39 ]. Preventive actions usually involve improving safety in the home environment and the immediate environment of the elderly person, making a proper diagnosis and implementing an appropriate therapy of current diseases, monitoring pharmacotherapy, initiating exercises to improve balance and motor coordination, providing assistive equipment, and educating the patient and his/her relatives [ 40 , 41 ].…”

The risk of falls in patients with cerebrovascular disease

“…Many studies report that health professionals are responsible for protective and preventive measures to eliminate and reduce the risk of falls and that it is of great importance to comprehensively understand and systematically apply the principles of fall prevention (39).…”