Development of a behavioural framework for dementia care partners’ fall risk management

BMC Geriatrics

Research

Tracy M. Mroz¹  Elizabeth A. Phelan²  Tatiana Sadak³  Clara Berridge⁴  Nancy R. Hooyman⁴  Yuanjin Zhou⁵ 

[1] Department of Rehabilitation Medicine, University of Washington, Seattle, USA;School of Medicine, Division of Gerontology and Geriatric Medicine, School of Public Health, Department of Health Systems and Population Health, University of Washington, Seattle, USA;School of Nursing, University of Washington, Seattle, USA;School of Social Work, University of Washington, Seattle, USA;Steve Hicks School of Social Work, University of Texas at Austin, Austin, USA;

关键词: Cognitive impairment;    Dementia;    Fall prevention;    Caregiving;    Fall risk;    Health behaviours;   

DOI  :  10.1186/s12877-022-03620-4

 received in 2022-04-04, accepted in 2022-11-14,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundAlthough older adults living with dementia (OLWD) are at high risk for falls, few strategies that effectively reduce falls among OLWD have been identified. Dementia care partners (hereinafter referred to as “care partners”) may have a critical role in fall risk management (FRM). However, little is known about the ways care partners behave that may be relevant to FRM and how to effectively engage them in FRM.MethodsSemi-structured, in-depth interviews were conducted with 14 primary care partners (age: 48–87; 79% women; 50% spouses/partners; 64% completed college; 21% people of colour) of community-dwelling OLWD to examine their FRM behaviours, and their observations of behaviours adopted by other care partners who were secondary in the caring role.ResultsThe analysis of interview data suggested a novel behavioural framework that consisted of eight domains of FRM behaviours adopted across four stages. The domains of FRM behaviours were 1. functional mobility assistance, 2. assessing and addressing health conditions, 3. health promotion support, 4. safety supervision, 5. modification of the physical environment, 6. receiving, seeking, and coordinating care, 7. learning, and 8. self-adjustment. Four stages of FRM included 1. supporting before dementia onset, 2. preventing falls, 3. preparing to respond to falls, and 4. responding to falls. FRM behaviours varied by the care partners’ caring responsibilities. Primary care partners engaged in behaviours from all eight behavioural domains; they often provided functional mobility assistance, safety supervision, and modification of the physical environment for managing fall risk. They also adopted behaviours of assessing and addressing health conditions, health promotion support, and receiving, seeking and coordinating care without realizing their relevance to FRM. Secondary care partners were reported to assist in health promotion support, safety supervision, modification of the physical environment, and receiving, seeking, and coordinating care.ConclusionsThe multi-domain and multi-stage framework derived from this study can inform the development of tools and interventions to effectively engage care partners in managing fall risk for community-dwelling OLWD.

【 授权许可】

CC BY   
© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2022

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