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