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Incontinence is another condition not frequently intimated to their doctor. Less than a third of them actually report falls despite the availability of initiatives and measures, which can address falls. These include home-based exercises, home environment assessment, cataract surgery, medication review and Vitamin D and calcium supplements (CFA).
Falls Prevention Intervention
Studies reveal the importance of physical activity in preventing or reducing the risk of falls among older persons in the community and at home (Rose 2007). There is, however, limited evidence at present that physical activity benefits very weak ones in care facilities. Physical activity promises benefit to healthy older adults against the risk of falls. Those at moderate risk, on the other hand, will gain more from structured exercise programs aimed at risk factors, which can be manipulated or changed. They can be adjusted to progress according to the individual's capabilities and earlier physical activity experience. And those at high risk will profit from individually-tailored exercise program drawn from a larger, multifactor intervention approach. It is more resource-intensive. It determines key risk factors, which can be adjusted. These include the type and number of medications, cardiovascular abnormalities, environmental medication, depression, and risk-taking behavior (Rose).
Physical activity programs should be designed to appeal to older adults from various cultural and socio-economic classes or groups (Rose 2007). These programs have a built-in behavioral aspect, which helps older adults in self-regulation and self-monitoring of their own progress skills. These skills are needed to incorporate physical activity into their daily routine (Rose).
An illustrative example is a home program conducted by an occupational therapist at the homes of the participants (Steven and Sogolow 2008). The participants were aged 65 years and older, residing in Sydney. The occupational therapist identified relevant hazards at the participants' homes and their unsafe behaviors, using the Westmead Home Safety Assessment. The hazards identified were slippery floors, poor lightning and rugs and curled edges. The unsafe behaviors were wearing loose shoes, leaving clutter in high-traffic areas, and using furniture to get or reach out for objects in high places. The occupational therapist then recommended changes in their home setup and behaviors, using occupational therapy principles. The home visits took an average of 2 hours each (Steven and Sogolow).
Telephone follow-ups made two weeks later revealed a decrease in fall rates to a third among those who followed the recommended changes but only among those who had one or more previous falls during the year of the study. (Steven and Sogolow 2008). The level of experience of the occupational therapist was critical in the success of the program. Researchers emphasized that this should not be used by those without the appropriate skills in conducting untargeted home modification programs for older persons (Stevens and Sogolow).
A Matter of Balance/Volunteer Lay Leader Model
This is a statewide evidence-based fall prevention program for older adults to prevent falls and promote active aging among them (Ory et al. 2009). Its goal is to reduce the fear of falling among community-dwelling older adults and to increase physical activity among them, at the same time. Researchers analyzed two secondary databases. One was a centralized administrative data set to document implementation processes and structures for conducting the program. The other was a common set of outcome measures for assessing the effect of the program on older adults in a particular area. Multivariate analyses were used to investigate changes on key outcome variables (Ory et al.).
Method and Samples
The search conducted from 2007 to 2009 reached 3,092 older residents (Ory et al. 2009). The program certified and utilized 98 master trainers and 402 lay leaders. They conducted the program in 227 classes through the Area Agency on Aging network. They obtained immediate and positive results, indicating and establishing an appropriate direction to promote safe and productive aging. These results were increases in falls efficacy, improvements in their overall physical activity levels, and reduced interferences in their everyday normal routines (Ory et al.).
These findings show the importance of training and delivery structures for the wide dissemination of evidence-based programs (Ory et al. 2009). These programs not only have to be manualized for easy adoption but must also be adequate to meet increased delivery demand faithfully. Research outcomes also reinforced those of earlier and original randomized clinical trial and study. They confirmed that evidence-based fall prevention programs are the route to healthier aging. They prevent falls by altering risk factors associated with the cycle of fear and inactivity. They also suggest the influence of a low-intensity fall-prevention program aimed at reducing interference to daily life activities and unhealthy times. Overall, the widespread conduct of a falls prevention program among older adults at-risk for a cycle of health and functionality can promote active aging. Programs like this can form partnerships with various delivery sectors, which can help build community infrastructure that will enhance the health of older adults (Ory et al.).
The program, A Matter of Balance/Volunteer Lay Leader Model, can be implemented in two ways or versions (Ory et al. 2009). One can be a four-week activity, consisting of weekly classes. Another can be for 8 weeks with weekly classes. Early sessions can discuss tackling and reducing the fear of falling and encouraging the participants to modify their mindset that falls are preventable. Later in the session, they can modify their environments in order to reduce falls-related risk factors. They can also be taught exercises that will increase strength and balance. Certified master trainers teach lay leaders to conduct the program strictly and efficiently (Ory et al.).
This program model uses sites where they live, such as senior housing, retirement communities, or assisted-living facilities and senior centers served by pertinent organizations (Ory et al. 2009). Many similar programs coordinate with non-traditional aging partners for program delivery needed to broadly disseminate these programs. These partners include parks, recreation departments and general community centers. Evidence-based programs of this kind should continue to be implemented where older adults reside, where they engage in amusement, and pray in order to achieve program goals of healthy aging and building healthy communities. A broader perception of falls prevention best practices, however, should go beyond evidence-based programming in order to better appreciate the role and support of surrounding communities (Ory et al.).
Cripps, R. 2001, 'Deaths from falls in the elderly top 1,000-year,' Australian Institute of Health and Welfare [Online] Available at http://www.aihw.gov.au/media-release=detail/?id=6442464404
CFA 2011, 'Fall rates need to fall further,' Continence Foundation of Australia [Online]
Available at http://www.continence.org.au/news.php/38/fall-rates-need-to-fall-further
Ory, M.G. et al. 2009, 'Implementing and disseminating on evidence-based program to prevent falls in older adults, Texas, 2007-2009,' Preventing Chronic Disease [Online]
Available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2995605
Rose, D.J. 2005, 'The role of physical activity in the prevention of falls in older age,'
California State University [Online] Available at http://www.who.int/ageing/projects/6.Roleofphysicalactivitiesinfallsprevention.pdf
Stevens J.A. And Sogolow, E.D. 2008, 'Preventing falls: what works,' National
Center for Injury Prevention and Control [Online] Available at http://www.cdc.gov/HomeandRecreationalSafety/images/CDCCompendium_030508-a.pdf
Reuters 2011, 'Obesity tied to older adults' risk of falls, study says,' Fox News Network,
LLC [Online] Available at http://www.foxnews.com/health/2011/12/29/obesity-tied-to-older-adults-risk-falls-study-says
Rushworth N. 2009, 'Falls-related traumatic brain injury,' Australian Government Policy
Paper [Online] Available at http://www.bia.net.au/docs/BIApaper_FallsrelatedTBI.pdf
Wagner, La. M. et al. 2009, 'Falls among community-residing stroke survivors following inpatient rehabilitation,' BioMed Central Ltd. [Online] Available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2771071/?tool=pubmed
Watson, W. et al. 2010, 'The incidence and cost of falls injury among older people in New South Wales,' Centre for Health Advancement [Online] Available at http://www.health.new.gov.au/pubs/2010/pdf/incidence_cost_of_falls.pdf
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