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Results for 'falls'

Results 1 - 10 of 13

Effectiveness of complex falls prevention interventions in residential aged care settings: a systematic review

FRANCIS-COAD Jacqueline, et al
2018

Objective: The objective of this review was to synthesize the best available evidence for the effectiveness of complex falls prevention interventions delivered at two or more of the following levels: resident, facility or organization, on fall rates in the residential aged care (RAC) population. Introduction: Preventing falls in the high risk RAC population is a common global goal with acknowledged complexity. Previous meta-analyses have not specifically addressed complexity, described as falls prevention intervention delivery at multiple levels of a RAC organization, to determine its effect on fall outcomes. Inclusion criteria: The current review considered studies that included participants who were aged 65 years and over residing in long-term care settings providing 24-hour supervision and/or care assistance. Studies that evaluated complex falls prevention interventions delivered by single discipline or multidisciplinary teams across at least two or all of the following levels: residents, RAC facility and RAC organization were eligible. Experimental study designs including randomized controlled trials, controlled clinical trials and quasi-experimental trials that reported on measures related to fall incidence were considered, namely, rate of falls (expressed as the number of falls per 1000 occupied bed days), the number of participants who became fallers (expressed as the number of participants who fell once or more) and the rate of injurious falls (expressed as the number of falls with injury per 1000 occupied bed days). Methods: A three-step search strategy was undertaken, commencing with an initial scoping search of MEDLINE and CINAHL databases prior to an extensive search of all relevant published literature, clinical trial registries and gray literature. Two independent reviewers assessed selected studies for methodological validity using the standardized critical appraisal instrument from the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI SUMARI). Data were extracted from the selected studies using the standardized data extraction tool from JBI SUMARI. Quantitative data were pooled in statistical meta-analysis for rate of falls, the number of participants who became fallers and the rate of injurious falls. Meta-analysis was conducted using a random-effect model with heterogeneity assessed using the standard Chi-squared and I2 index. Where statistical pooling was not possible, study findings were presented in narrative form. Results: Twelve studies were included in this review with seven being eligible for meta-analysis. Complex falls prevention interventions delivered at multiple levels in RAC populations did not show a significant effect in reducing fall rates (MD = −1.29; 95% CI [−3.01, 0.43]), or the proportion of residents who fell (OR = 0.76; 95% CI [0.42, 1.38]). However, a sensitivity analysis suggested complex falls prevention interventions delivered with additional resources at multiple levels had a significant positive effect in reducing fall rates (MD = −2.26; 95% CI [−3.72, −0.80]). Conclusions: Complex falls prevention interventions delivered at multiple levels in the RAC population may reduce fall rates when additional staffing, expertise or resources are provided. Organizations may need to determine how resources can be allocated to best address falls prevention management. Future research should continue to investigate which combinations of multifactorial interventions are effective.

The association between physical activity and social isolation in community-dwelling older adults

ROBINS Lauren M., et al
2018

Objectives: Social isolation is an increasing concern in older community-dwelling adults. There is growing need to determine effective interventions addressing social isolation. This study aimed to determine whether a relationship exists between physical activity (recreational and/or household-based) and social isolation. An examination was conducted for whether group- or home-based falls prevention exercise was associated with social isolation. Methods: Cross-sectional analysis of telephone survey data was used to investigate relationships between physical activity, health, age, gender, living arrangements, ethnicity and participation in group- or home-based falls prevention exercise on social isolation. Univariable and multivariable ordered logistic regression analyses were conducted. Results: Factors found to be significantly associated with reduced social isolation in multivariable analysis included living with a partner/spouse, reporting better general health, higher levels of household-based physical activity (OR = 1.03, CI = 1.01–1.05) and feeling less downhearted/depressed. Being more socially isolated was associated with symptoms of depression and a diagnosis of congestive heart failure (pseudo R2 = 0.104). Discussion: Findings suggest that household-based physical activity is related to social isolation in community-dwelling older adults. Further research is required to determine the nature of this relationship and to investigate the impact of group physical activity interventions on social isolation.

Fall prevention for people with learning disabilities: key points and recommendations for practitioners and researchers

FINLAYSON Janet
2018

Purpose: The purpose of this paper is to provide a narrative review of what is currently known about the high rates of falls, and fall injuries, which are experienced by people with learning disabilities (LDs) throughout their lives. Design/methodology/approach: Narrative review. Current evidence is summarised as key points and recommendations for practitioners and researchers. Findings: People with LDs experience similar rates of falls as older adults in the wider population, but throughout their lives, or at an earlier age. Originality/value: Key points and recommendations are summarised for practitioners and researchers to promote fall prevention strategies and interventions for people with LDs.

A return on investment tool for the assessment of falls prevention programmes for older people living in the community

PUBLIC HEALTH ENGLAND
2018

This report presents results of a tool developed by York Health Economics Consortium to assess the potential return on investment (ROI) of falls prevention programmes targeted at older people living in the community. The tool pulls together evidence on the effectiveness and associated costs for four programmes where there was evidence of cost-effectiveness: Otago home exercise, Falls Management Exercise group programme, Tai Chi group exercise, and home assessment and modification. Based on an example analysis, all four interventions were found to be cost-effective, thus producing a positive societal ROI. One out of four interventions was also found to have a positive financial ROI (ie cost savings outweigh the cost of implementation). An accompanying Excel sheet allows for results to be tailored to the local situation based on the knowledge of the user.

Evaluation of a web-based app to assist home-hazard modification in falls prevention

WARD Gillian, WALKER-CLARKE Aimee, HOLLIDAY Nikki
2017

Introduction: Given the impact falls can have on older people and their families, many health and social care services are focused on preventing falls and implementing interventions to reduce future falls. FallCheck is a web app that supports identification of home-hazards and directs users towards self-management strategies to reduce risk of falling. Method: A survey by clinical experts of a beta version of FallCheck was conducted, producing quantitative and qualitative data including issues and attributes identified by respondents. Thirty-six individuals signed up to take part in the study, and 27 respondents took part in the final evaluation survey. Findings: Testing by health and social care professionals found there is scope for using the app as a digital self-assessment tool by people at risk of falls. It has further potential as an effective tool to support environmental/behavioural change to reduce risk of falls. Conclusion: FallCheck was developed from a sound evidence-base to support home-hazard modification as an effective intervention component within a multifactorial intervention to prevent falls. Health and social care professionals found it had good acceptability for use in practice, justifying further testing of the usability and effectiveness of the app in supporting behavioural changes and environmental modifications with people at risk of falling and carers.

Adding extra years to life and extra life to those years: local government guide to healthy ageing

LOCAL GOVERNMENT ASSOCIATION
2018

Guide that sets out priority areas for partnership working to improve later life health. The guide focuses on taking a life course approach and developing healthy behaviours and includes practice examples. The eight case studies in the guide provide examples about what can work to reduce the impact of long-term conditions. The case examples cover tackling loneliness and isolation; preventing falls; getting older people active; using lottery funding to boost healthy ageing; an Olympic legacy for older people; extending the NHS Health Checks programme; getting people talking about their health and reshaping the strategy on health ageing.

A structured literature review to identify cost-effective interventions to prevent falls in older people living in the community

PUBLIC HEALTH ENGLAND
2018

Summarises the findings from a literature review to identify cost-effective interventions in preventing falls in older people living in the community in England. The review was conducted to inform an economic model to estimate the return on investment of the cost effective interventions across communities in England. The review identified 26 studies, of which 12 were judged to be directly applicable. These included 6 types of interventions: exercise, home assessment and modifications, multifactorial programmes; medicines review and modification to drugs; cardiac pacing and expedited cataract surgery. Based on the evidence, the review recommends interventions to be included in the economic model.

Dance to Health: evaluation of the pilot programme

AESOP
2017

Outlines the results of Aesop's falls prevention dance programme for older people, Dance to Health. This arts based intervention address older people's falls and problems with some current falls prevention exercise programmes, by incorporating evidence-based exercise programmes into creative, social and engaging dance activity. The programme was developed using the Aesop 7-item checklist, which lists the features an arts programme should have for it to be taken up by the health system and made available to every patient who could benefit. The report outlines the rationale for creating the programme, the outcomes achieved - in addition to reduced falls, cost effectiveness, and the wider impact of the programme. It reports that the pilot successfully brought people from the worlds of dance and older people's exercise together, was able to train dance artists in the evidence-based falls programme, and also developed six evidence-based falls prevention programmes with 196 participants. A total of 73 per cent of participants achieved the target of 50 hours’ attendance over the six months, compared with a national average for completing standard falls prevention exercise programmes of 31 per cent for primary prevention and 46 per cent for secondary prevention. Additional outcomes identified included increases in group identification, relationships and reduced loneliness, functional health and wellbeing, and mental health and wellbeing.

Stockton Borough Council's Multi-Disciplinary Service

Stockton-on-Tees Borough Council

Stockton Borough Council established a Multi-Disciplinary Service (MDS) in October 2015, as part of their Better Care Fund plan. The process of designing and implementing the service was through creating a partnership with all key stakeholders in across health, social care and the voluntary sector: Hartlepool and Stockton-on-Tees CCG - Health Commissioners; Stockton-on-Tees Borough Council - Social Care; North Tees and Hartlepool FT - Acute and Community Health; Tees Esk and Wear Valleys FT - Mental Health Trust; and the Voluntary Community and Social Enterprise sector. The executive management teams of all partner organisations signed up to the MDS and have continued to support its development though regular updates at the Joint Health and Wellbeing Board.

ExtraCare's Wellbeing Programme

The ExtraCare Charitable Trust

ExtraCare’s Wellbeing Programme was developed in 2002, in partnership with older people who live at ExtraCare’s Schemes and Villages. The concept was launched following a survey, which highlighted that 75% of residents at one location had not accessed any health screening via their GPs or the NHS. A pilot screening scheme subsequently identified 122 previously undetected conditions amongst a population of just 136, highlighting a clear need for the Programme.

Results 1 - 10 of 13

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