The Great Balancing Act – perspectives from older people on falls risk

Dr Kristy Robson is a Lecturer in Podiatry at Charles Sturt University, a regional university in Australia. In this blog she shares a recent Age and Ageing publication that explores the behavioural decisions older people make when they knowingly and unknowingly undertake activities or tasks that pose a risk of falling. She tweets @KristyRobson2

Fall related injuries in older people constitute a significant public health issue in Australia and internationally. Falling represents the leading cause of unintentional injury in this population with approximately one third of older adults falling each year. Effective management of falls in older populations has proven to be challenging. Despite the substantial focus on falls prevention by the Australian government over the last decade the age standardised hospital admission rates attributed to falls continue to increase. The complexity of managing falls risk in the diverse populations found within Australia, coupled with an ageing population and finite resources, drives the need to better understand factors that can influence falling from the perspective of the older person.

Why it gets harder to prevent falls when older people leave hospital

Chiara Naseri is a physiotherapist and is currently completing her PhD at Western Australia’s Curtin University School of Physiotherapy and Exercise Science. She has recently published a review in Age and Ageing entitled “Reducing falls in older adults recently discharged from hospital: A systematic review and meta-analysis.”

The paper reveals the complexity of the discharge process for older people and that more support is required than is currently widely recognised. Her team found that falls prevention strategies, known to reduce falls for older people in general, were not as effective for older people following hospital discharge.

Evidence has shown 30% of the population of older people who live in the community fall at least once per year, 10% of these falls result in a serious injury. Whereas 40% of the population of older people who have recently been discharged home from hospital fall within 6 months of discharge, most of these falls occur in the first month and 54% result in a serious injury, particularly hip fractures.

“Please remember I’m still a person!” A carer’s solution to help hospital staff provide person-centred and holistic care

Zoe Harris cared for her husband at home before his dementia reached a stage where she was unable to cope, and he spent his final months in a care home. As a result of that experience, Zoe developed a range of communication tools to ensure that carers were aware of his needs and preferences, and which have subsequently been adopted by over 1,000 care homes and home care agencies. Her latest project is Mycarematters, an online platform where people, or someone on their behalf, can upload information to help hospital staff treat the whole person and not just their medical condition. @ZoeHarrisCCUK @Mycarematters @Care_Charts_UK

When I look back, I think Geoff had been showing signs of dementia for at least eight years before his diagnosis, and it was only a matter of months after he was finally told that he had what was probably a mix of Alzheimer’s Disease and Lewy Bodies, that his condition took a turn for the worse. I had to admit defeat and he moved first to a dementia assessment ward and, three months later, to a care home for what turned out to be the final 13 months of his life.

May issue of Age and Ageing out now

The May 2016 issue of Age and Ageing, the journal of the British Geriatrics Society is out now.

A full table of contents is available here, with editorials, research papers, reviews, short reports, case reports book reviews and more.

Hot topics this issue include:

• Electronic frailty index
• Exercise to reduce fear of falling
• Involving care home residents in research
• Patient knowledge of prescribed medicines
• C-reactive protein, frailty and multimorbidity

The Editor’s View can be read here.

Report from the BGS Falls and Postural Stability Meeting 2015

This year’s well attended Falls and Postural Stability Conference was held in Wembley, London. BGS member Mary Ni Lochlainn reports back.

The first session at this year’s BGS Falls and Postural Stability Conference was opened by Professor Alice Nieuwbower, from University of Leuven, Belgium, who discussed falls in the context of Parkinson’s Disease (PD).

Patients with PD are twice as likely to fall, compared to healthy older adults. It seems wobbling is a major factor here with ‘sway’ more predictive of falls than ‘gait speed’ in this population. Sway-metrics (probably not as much fun as they sound) show increased sway in patients taking levodopa, leading to a therapeutic challenge for clinicians.