References

Effects of guideline-based educational intervention on preventing falls in the elderly. 2016. http://www.academia.edu/33745822

Carnemolla P, Bridge C. A scoping review of home modification interventions–mapping the evidence base. Indoor Built Environ. 2018; 29:(3)299-310 https://doi.org/10.1177/1420326X18761112

Clemson L, Stark S, Pighills AC, Torgerson DJ, Sherrington C, Lamb SE. Environmental interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2019; 2 https://doi.org/10.1002/14651858.CD013258

dos Santos BW, Baixinho CL. Possibilities for nursing interventions in the prevention of falls in the elderly: a review. Cogitare Enfermagem. 2020; 25 https://doi.org/10.5380/ce.v25i0.71326

Fernando E, Fraser M, Hendriksen J, Kim CH, Muir-Hunter SW. Risk factors associated with falls in older adults with dementia: a systematic review. Physiother Can. 2017; 69:(2)161-170 https://doi.org/10.3138/ptc.2016-14

Gitlin LN, Corcoran MA. Managing dementia at home: the role of home environmental modifications. Top Geriatr Rehabil. 1996; 12:(2)28-39

Gitlin LN, Corcoran M, Winter L, Boyce A, Hauck WW. A randomized, controlled trial of a home environmental intervention: effect on efficacy and upset in caregivers and on daily function of persons with dementia. Gerontologist. 2001; 41:(1)4-14 https://doi.org/10.1093/geront/41.1.4

Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, Lamb SE. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012; 9 https://doi.org/10.1002/14651858.CD007146.pub3

System design for elderly falls. 2016. https://avesis.akdeniz.edu.tr/yayin/4f61b200-0ee7-4935-b800-127db8e34213/system-design-for-elderly-fall (accessed 12 January 2022)

Guo JL, Tsai YY, Liao JY, Tu HM, Huang CM. Interventions to reduce the number of falls among older adults with/without cognitive impairment: an exploratory meta-analysis. Int J Geriatr Psychiatry. 2014; 29:(7)661-669 https://doi.org/10.1002/gps.4056

Harvey L, Mitchell R, Brodaty H, Draper B, Close J. Differing trends in fall-related fracture and non-fracture injuries in older people with and without dementia. Arch Gerontol Geriatr. 2016; 67:61-67 https://doi.org/10.1016/j.archger.2016.06.014

Hopewell S, Adedire O, Copsey BJ, Boniface GJ, Sherrington C, Clemson L, Close JT, Lamb SE. Multifactorial and multiple component interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2018; 7 https://doi.org/10.1002/14651858.CD012221.pub2

Jørgensen TSH, Hansen AH, Sahlberg M, Gislason GH, Torp-Pedersen C, Andersson C, Holm E. Nationwide time trends and risk factors for in-hospital falls-related major injuries. Int J Clin Pract. 2015; 69:(6)703-709 https://doi.org/10.1111/ijcp.12624

Keall MD, Pierse N, Howden-Chapman P, Cunningham C, Cunningham M, Guria J, Baker MG. Home modifications to reduce injuries from falls in the home injury prevention intervention (HIPI) study: a cluster-randomised controlled trial. Lancet. 2015; 385:(9964)231-238 https://doi.org/10.1016/S0140-6736(14)61006-0

Leszczyńska A, Daniszewska B, Pruszyńska M, Przedborska A, Hadała M, Raczkowski JW. Effects of a health improvement programme on quality of life in elderly people after falls. Polish Ann Med. 2016; 23:(2)129-134 https://doi.org/10.1016/j.poamed.2016.01.008

Lök N, Akin B. Domestic environmental risk factors associated with falling in elderly. Iran J Public Health. 2013; 42:(2)120-128

Meuleners LB, Hobday MB. A population-based study examining injury in older adults with and without dementia. J Am Geriatr Soc. 2017; 5:(3)520-525 https://doi.org/10.1111/jgs.14523

Ness KK, Gurney JG, Ice GH. Screening, education, and associated behavioral responses to reduce risk for falls among people over age 65 years attending a community health fair. Phys Ther. 2003; 83:(7)631-637 https://doi.org/10.1093/ptj/83.7.631

Olij BF, Ophuis RH, Polinder S, Van Beeck EF, Burdorf A, Panneman MJ, Sterke CS. Economic evaluations of falls prevention programs for older adults: a systematic review. J Am Geriatr Soc. 2018; 66:(11)2197-2204 https://doi.org/10.1111/jgs.15578

World Alzheimer Report. 2018. https://apo.org.au/node/260056 (accessed 12 January 2022)

Pega F, Kvizhinadze G, Blakely T, Atkinson J, Wilson N. Home safety assessment and modification to reduce injurious falls in community-dwelling older adults: cost-utility and equity analysis. Inj Prev. 2016; 22:(6)420-426 https://doi.org/10.1136/injuryprev-2016-041999

Petersen JD, Siersma VD, dePont Christensen R, Storsveen MM, Nielsen CT, Waldorff FB. The risk of fall accidents for home dwellers with dementia—A register-and population-based case-control study. Alzheimer's & Dementia: DADM. 2018; 10:421-428 https://doi.org/10.1016/j.dadm.2018.05.004

Rimland JM, Abraha I, Dell'Aquila G Effectiveness of non-pharmacological interventions to prevent falls in older people: a systematic overview. The SENATOR Project ONTOP Series. PloS One. 2016; 11:(8) https://doi.org/10.1371/journal.pone.0161579

Sharma S, Mueller C, Stewart R Predictors of falls and fractures leading to hospitalisation in people with dementia: a representative cohort study. J Am Med Dir Assoc. 2018; 19:(7)607-612 https://doi.org/10.1016/j.jamda.2018.03.009

Shelkey M, Wallace M. Katz index of independence in activities of daily living. J Gerontol Nurs. 1999; 25:(3)8-9 https://doi.org/10.3928/0098-9134-19990301-05

Tekin DE, Kara N, Tan NU, Arkuran F. The Turkish adaptation of the fall risk assessment scale developed by the Delmarva Foundation: a reliability and validity study. J Ed Res Nurs. 2013; 10:(1)45-51

van Hoof J, Kort HS. Supportive living environments: a first concept of a dwelling designed for older adults with dementia. Dementia. 2009a; 8:(2)293-316 https://doi.org/10.1177/1471301209103276

van Hoof J, Kort HS, Van Waarde H. Housing and care for older adults with dementia: a European perspective. J Hous Built Environ. 2009b; 24:(3)369-390 https://doi.org/10.1007/s10901-009-9143-3

van Hoof J, Kort HS, van Waarde H, Blom MM. Environmental interventions and the design of homes for older adults with dementia: an overview. Am J Alzheimers Dis Other Demen. 2010; 25:(3)202-232 https://doi.org/10.1177/1533317509358885

Vitorino LM, Teixeira CAB, Boas ELV, Pereira RL, Santos NOD, Rozendo CA. Fear of falling in older adults living at home: associated factors. Rev Esc Enferm USP. 2017; https://doi.org/10.1590/S1980-220X2016223703215

Wilson N, Kvizhinadze G, Pega F, Nair N, Blakely T. Home modification to reduce falls at a health district level: modeling health gain, health inequalities and health costs. PloS One. 2017; 12:(9) https://doi.org/10.1371/journal.pone.0184538

Wu TY, Chie WC, Yang RS, Kuo KL, Wong WK, Liaw CK. Risk factors for single and recurrent falls: a prospective study of falls in community dwelling seniors without cognitive impairment. Prev Med. 2013; 57:(5)511-517 https://doi.org/10.1016/j.ypmed.2013.07.012

Uymaz PE, Nahcivan NO. Evaluation of a nurse-led fall prevention education program in Turkish nursing home residents. Educ Gerontol. 2016; 42:(5)299-309 https://doi.org/10.1080/03601277.2015.1109403

Care of the Older Person

Falls

Dementia

Home care

Nurse-led home modification interventions for community-dwelling older adults with dementia and their impact on falls prevention

02 February 2022

Care of the Older Person

02 February 2022

Volume 27 · Issue 2

ISSN (print): 1462-4753

ISSN (online): 2052-2215

Abstract

This quasi-experimental study aimed to investigate the effects of nurse-led home modification interventions on the family members of home-dwelling older adults with dementia. The sample consisted of 42 older adults diagnosed with dementia and their family members. A number of validated tools were used. Three home visits were undertaken, a training package with family members was instigated, and the patients were followed up for a 6-month period. It was determined that there was a decrease in falls in the first 3-month period (p=0.002). The number of falls in the second 3-month period was lower in the older adults who had their homes modified (p=0.000). Family-centred, nurse-led home-modification interventions can be effective in the prevention and reducing of falls in older adults with dementia.

Around 50 million people live with dementia worldwide, and this number is expected to double by 2030. It is anticipated that this condition will affect 152 million people by 2050 (Patterson, 2018). Dementia can impair balance, vision, attention and cognition, which can also lead to a greater risk of falls for the person living with this condition (Fernando et al, 2017). The risk of falling is 2–3 times higher in older adults with dementia in the community (Jørgensen et al, 2015; Meuleners and Hobday, 2017; Sharma et al, 2018). Older adults with dementia living at home had a 1.89–fold higher risk of falling (Petersen et al, 2018). Of the adults older than 65 years of age hospitalised due to falls, 58% had dementia (Harvey et al, 2016). The risk of hospitalisation due to injuries resulting from falls was 2.34 times higher in individuals with dementia (Jørgensen et al, 2015). Many older adults with dementia are living in the community and may not be offered environmental interventions to reduce falls. Memory loss also contributes to individuals forgetting measures that have been implemented to increase the safety of their home (van Hoof and Kort, 2009a).

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falls

prevention of falls

home modifications

dementia