Date Presented 03/27/20
This mixed-method study examines fall prevention from the perspective of caregivers of community-dwelling older adults. Both qualitative and quantitative questions were used to explore the caregivers’ unique perspectives on home safety, number of recent falls, and hospitalizations. A high correlation was found between caregivers’ perceptions of safety and the number of falls. The study suggests ideas for OTs to increase safety for older adults aging in place at home.
Primary Author and Speaker: Debora Oliveira
Additional Authors and Speakers: Erika Frisby, Carly Sapp, Whitney McKnight, Calvin Bryant
PURPOSE: Falls are the leading cause of injury, disability, and even death among people aged 65 years or older in the U.S. according to the Center for Disease Control (CDC, 2018). This research sought information directly from the caregivers of older adults regarding the varying success of fall prevention. The hypothesis of the study was that there is a relationship between the number of falls older persons have had and their caregivers’ perceptions of whether or not they were safe. The objectives were to explain how caregivers’ perception of safety correlates with injury rates for the older adults for whom they care as well as to compare the number of falls with feelings of safety according to caregivers.
DESIGN: The CDC checklist Check for Safety: A Home Fall Prevention Checklist for Older Adults. Additional qualitative questions explored the caregivers’ unique perspective. This survey was uploaded to Qualtrics. Implied consent was acknowledged by the consent form on the welcome screen of the survey. The survey sought to collect both qualitative and quantitative data through 37 closed-ended questions and two open-ended. A mixed method design was used in order to combine the benefits of both the qualitative and quantitative information regarding fall prevention for older adults.
METHOD: Following approval from the Florida A&M University IRB, participants for this study were recruited from two closed Facebook communities. The recruitment message provided participants with a link to a survey housed in Qualtrics. Word of mouth and snowball sampling was used for recruitment as well as Twitter with the following tweet: “Are you a #caregiver of an older adult? Please do our survey on #fallprevention”. Inclusion criteria were adults 18 years or older and who self-identified as a caregiver of an older adult who is 65+ years of age. Participants had to be able to read and understand the English language and live in the United States or Canada.
RESULTS: A chi-square analysis was performed using SPSS 24 to analyze both how many times the person they care for has fallen in the last three months and whether or not they perceived the person they care for as being safe. The sample included a total of 33 respondents. The frequencies of falls were significantly different, X2= (3, N=33) = 14.39, p=.002. A sample size of 28 respondents reported whether or not they perceived the person they care for as being safe. These frequencies were significantly different, X2= (2, N=28) = 34.79, p=.000. The researchers received several data themes for the two open-ended questions were that were asked of participants. An open-ended question was “Describe other factors that you believe may be safety issues in the home for the person you care for.” Main themes were unclear pathways. Other themes included medical and environmental concerns. The second open-ended question asked, “what steps have you taken to try to improve safety and to reduce the risk of falls for the person you care for”? The data from this question were categorized into several themes including making environmental adaptations and getting assistive devices.
CONCLUSION: Caregivers expressed concern about the people for whom they care. Several themes were raised to improve safety, including environmental hazards, use of adaptive equipment, and medical conditions.
IMPACT STATEMENT: The study suggests caregiver concerns for safety and risk for falls should be an important component of the initial assessment and the intervention plan. The use of the CDC checklist could be used to assess fall risks.
References
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Houry, D., Florence, C., Baldwin, G., Stevens, J., & McClure, R. (2015). The cdc injury center’s response to the growing public health problem of falls among older adults. American Journal of Lifestyle Medicine, 10, 74-77
Stevens, J. A. & Burns, E. (2015). A cdc compendium of effective fall interventions: What works for community-dwelling older adults (3rd ed.). Atlanta, GA: National Center for Injury Prevention and Control of the Centers for Disease Control and Prevention.
Stevens, J., Smith, M., Parker, E., Jiang, L., & Floyd, F. (2017). Implementing a clinically based fall prevention program. American Journal of Lifestyle Medicine, 20, 1-7.
