Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-11T08:05:23.560Z Has data issue: false hasContentIssue false

Maintaining independence after a fall

Published online by Cambridge University Press:  22 July 2009

AB Spinks*
Affiliation:
Griffith University, School of Medicine
J Wasiak
Affiliation:
Monash University, School of Public Health and Preventive Medicine
*
Address for correspondence: Anneliese Spinks, Griffith University, School of Medicine, University Drive, Meadowbrook, Queensland, 4131, Australia. Email: a.spinks@griffith.edu.au

Summary

Falls have a significant impact upon independent living ability in older people, with fall-related fractures one of the leading predictors of having to move into assisted living facilities. The loss of independence associated with a severe fall is often accompanied by a decline in physical, social, emotional and economic well-being. Rehabilitation programmes to restore functional ability following a fall have a greater chance of success if they adopt a multi-disciplinary approach and, if appropriate, are conducted in the patient's own home. Additional multi-component interventions that improve confidence and reduce the risk of subsequent falls may confer benefits by assisting individuals independently to perform activities of daily living.

Type
Psychological and social gerontology
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Quine, S, Morrell, S. Fear of loss of independence and nursing home admission in older Australians. Health Soc Care Comm 2007; 15: 212–20.CrossRefGoogle ScholarPubMed
2Magaziner, J, Fredman, L, Hawkes, W et al. Changes in functional status attributable to hip fracture: a comparison of hip fracture patients to community dwelling-aged. Am J Epidemiol 2003; 157: 1023–31.CrossRefGoogle ScholarPubMed
3Katz, S, Ford, AB, Moskowitz, RW, Jackson, BA, Jaffe, MW. Studies of illness in the aged. The index of ADL: A standardized measure of biological and psychological function. JAMA 1963; 185: 914–19.CrossRefGoogle Scholar
4Lawton, MP, Brody, E. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1979; 9: 179–86.CrossRefGoogle Scholar
5Gibson, MJ, Andres, RO, Isaacs, B, Radebaugh, T, Worm-Petersen, J. The prevention of falls in later life. A report of the Kellogg International Work Group on the prevention of falls by the elderly. Dan Med Bull 1987; 34 (suppl 4): S124.Google Scholar
6Centre for Disease Control and Prevention (CDC). Self-reported falls and fall related injuries among persons aged > or = 65 years – United States, 2006. MMWR Morb Mortal Wkly Report 2008; 57: 225–29.+or+=+65+years+–+United+States,+2006.+MMWR+Morb+Mortal+Wkly+Report2008;+57:+225–29.>Google Scholar
7Bialoszewski, D, Slupik, A, Lewczuk, E, Gotlib, J, Mosiolek, A, Mierzwinska, A. Incidence of falls and their effect on mobility of individuals over 65 years of age relative to their place of residence. Ortop Traumatol Rehabil 2008; 10: 441–48.Google ScholarPubMed
8Schiller, JS, Kramarow, EA, Dev, AN. Fall injury episodes among non-institutionalized older adults: United States, 2001–2003. Adv Data 2007; 21 (392): 116.Google Scholar
9Tinetti, ME, Williams, CS. Falls, injuries due to falls, and the risk of admission to a nursing home. N Engl J Med 1997; 337: 1279–84.CrossRefGoogle ScholarPubMed
10Rubenstein, LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing 2006; 35: ii3741.CrossRefGoogle ScholarPubMed
11Yardley, L, Smith, H. A prospective study of the relationship between feared consequences of falling and avoidance of activity in community-dwelling older people. Gerontologist 2002; 42: 1723.CrossRefGoogle Scholar
12Gosain, A, DiPietrio, LA. Aging and wound healing. World J Surg 2004; 28: 321–26.CrossRefGoogle ScholarPubMed
13Adelsberg, S, Pitman, M, Alexander, H. Lower extremity fractures: relationship to reaction time and coordination time. Arch Phys Med Rehabil 1989; 70: 737–39.Google ScholarPubMed
14Nevitt, MC, Cummings, SR. Type of fall and risk of hip and wrist fractures: the study of osteoporotic fractures. The Study of Osteoporotic Fractures Research Group. J Am Geriatr Soc 1993; 41: 1226–34.CrossRefGoogle Scholar
15Faulkner, KA, Cauley, JA, Studenski, SA. Lifestyle predicts falls independent of physical risk factors. Osteoporosis Int 2009 [Epub].CrossRefGoogle Scholar
16Bertera, EM, Bertera, RL. Fear of falling and activity avoidance in a national sample of older adults in the United States. Health Soc Work 2008; 33: 5462.CrossRefGoogle Scholar
17Moore, DS, Ellis, R. Measurement of fall-related psychological constructs among independent-living older adults: a review of the research literature. Aging Ment Health 2008; 12: 684–99.CrossRefGoogle ScholarPubMed
18Burker, EJ, Wong, H, Sloane, PD, Mattingly, D, Preisser, J, Mitchell, CM. Predictors of fear of falling in dizzy and non-dizzy elderly. Psychol Aging 1995; 10: 104–10.CrossRefGoogle Scholar
19Kressig, RW, Wolf, SL, Sattin, RW et al. Associations of demographic, functional, and behavioural characteristics with activity-related fear of falling among older adults transitioning to frailty. J Am Geriatr Soc 2001; 49: 1456–62.CrossRefGoogle ScholarPubMed
20Lach, HW. Incidence and risk factors for developing fear of falling in older adults. Public Health Nurs 2005; 22: 4552.CrossRefGoogle ScholarPubMed
21Tinetti, ME, Baker, DI, Gottschalk, M et al. Home-based multicomponent rehabilitation for older person after hip fracture: a randomized trial. Arch Phys Med Rehabil 1999; 80: 916–22.CrossRefGoogle ScholarPubMed
22Chung, MC, McKee, KJ, Austin, C et al. Post-traumatic stress disorder in older people after a fall. Int J Geriatr Psychiatry 2009 [Epub].CrossRefGoogle Scholar
23Deshpandne, N, Metter, EJ, Lauretani, F, Bandinelli, S, Guralnik, J, Ferruci, L. Activity restriction induced by fear of falling and objective and subjective measures of physical function: a prospective cohort study. J Am Geriatr Soc 2008; 56: 615–20.CrossRefGoogle Scholar
24Cumming, RG, Sakeld, G, Thomas, M, Szonyi, G. Prospective study of the impact of fear of falling on activities of daily living, sf-36 scores, and nursing home admission. J Gerontol: Med Sci 2000; 55 (a): M299305.CrossRefGoogle ScholarPubMed
25Egol, KA, Koval, KJ, Zuckerman, JD. Functional recovery following hip fracture in the elderly. J Orthop Trauma 1997; 11: 594–99.CrossRefGoogle ScholarPubMed
26Koval, KJ, Skovron, ML, Aharanoff, GB, Zuckerman, JD. Predictors of functional recovery after hip fracture in the elderly. Clin Orthop 1998; 348: 2228.Google Scholar
27Folden, S, Tappen, R. Factors influencing function and recovery following hip repair surgery. Orthop Nurs 2007; 26: 234–41.CrossRefGoogle ScholarPubMed
28Cameron, ID. Coordinated multidisciplinary rehabilitation after a hip fracture. Disabil Rehabil 2005; 27: 1081–90.CrossRefGoogle Scholar
29Curry, LC, Hogstel, MO, Davis, GC. Functional status in older women following hip fracture. J Adv Nurs 2003; 42: 347–54.CrossRefGoogle ScholarPubMed
30Dionyssiotis, Y, Dontas, IA, Economopoulos, D, Lyritis, GP. Rehabilitation after falls and fractures. J Musculoskelet Neuronal Interact 2008; 8: 244–50.Google ScholarPubMed
31Oldmeadow, LB, Edwards, ER, Kimmel, LA, Kipen, E, Robertson, VJ, Bailey, MJ. No rest for the wounded: early ambulation after hip surgery accelerates recovery. ANZ J Surg 2006; 76: 607–11.CrossRefGoogle ScholarPubMed
32Handoll, HH, Sherington, C. Mobilisation strategies after hip fracture in adults. Cochrane Database Syst Rev 2007: CD001704.CrossRefGoogle Scholar
33Chilov, M, Cameron, ID, March, LM. Evidence-based guidelines for fixing broken hips: an update. Med J Aust 2003; 179: 489–92.CrossRefGoogle ScholarPubMed
34Stenvall, M, Oloffson, B, Nyberg, L, Lundstrom, M, Gustafson, Y. Improved performance in activities of daily living and mobility after a multidisciplinary postoperative rehabilitation in older people with femoral neck fracture: a randomized controlled trial with 1-year follow-up. J Rehabil Med 2007; 39: 232–38.CrossRefGoogle ScholarPubMed
35Munin, MC, Seligman, K, Drew, MA et al. Effect of rehabilitation site on functional recovery after hip fracture. Arch Phys Med Rehabil 2005; 86: 367–72.CrossRefGoogle ScholarPubMed
36Kane, RL, Chen, Q, Finch, M, Blewett, L, Burns, R, Moskowitz, M. The optimal outcomes of post-hospital care under Medicare. Health Serv Res 2000; 35: 615–61.Google ScholarPubMed
37Ziden, L, Frandin, K, Kreuter, M. Home rehabilitation after hip fracture: a randomized controlled study on balance confidence, physical function and everyday activities. Clin Rehabil 2008; 22: 1019–33.CrossRefGoogle Scholar
38Crotty, M, Whitehead, CH, Gray, S, Finucane, PM. Early discharge and home rehabilitation after hip fracture achieves functional improvements: a randomized controlled trial. Clin Rehabil 2002; 16: 406–13.CrossRefGoogle ScholarPubMed
39Giusti, A, Barone, A, Oliveri, M, Pizzonia, M, Razzano, M, Palummeri, E, Pioli, G. An analysis of the feasibility of home rehabilitation among elderly people with proximal femoral fractures. Arch Phys Med Reahbil 2006; 87: 826–31.CrossRefGoogle ScholarPubMed
40Crotty, M, Whitehead, C, Miller, M, Gray, S. Patient and caregiver outcomes 12 months after home-based therapy for hip fracture: a randomized controlled trial. Arch Phys Med Rehabil 2003; 84: 1237–39.CrossRefGoogle ScholarPubMed
41Krichbaum, K. GAPM Postacute care coordination improves hip fracture outcomes. West J Nurs Res 2007; 29: 523–44.CrossRefGoogle Scholar
42Gitlin, LN, Winter, L, Dennis, MP, Corcoran, M, Schinfeld, S, Hauck, WW. A randomized trial of a multicomponent home intervention to reduce functional difficulties in older adults. J Am Geriatr Soc 2006; 54: 809–16.CrossRefGoogle ScholarPubMed
43Rucker, D, Rowe, BH, Johnson, JA et al. Educational intervention to reduce falls and fear of falling in patients after fragility fractures: results of a controlled pilot study. Prev Med 2006; 42: 316–19.CrossRefGoogle ScholarPubMed
44Tennstedt, S, Howland, J, Lachman, M, Peterson, E, Kasten, L, Jette, A. A randomized, controlled trial of a group intervention to reduce fear of falling and associated activity restriction in older adults. J Gerontol B Psychol Sci Soc Sci 1998; 53: P38492.CrossRefGoogle ScholarPubMed
45Brouwer, BJ, Walker, C, Rydahl, SJ, Culham, EG. Reducing fear of falling in seniors through education and activity programs: a randomized trial. J Am Geriatr Soc 2003; 51: 829–34.CrossRefGoogle ScholarPubMed
46Sattin, RW, Easley, KA, Wolf, SL, Chen, Y, Kutner, MH. Reduction in fear of falling through intense Tai chi exercise training in older, transitionally frail adults. J Am Geriatr Soc 2005; 53: 1168–78.CrossRefGoogle ScholarPubMed
47Di Monaco, M, Vallero, F, Tappero, R, De Lauso, L, De Toma, E, Cavanna, A. Incident falls impair ability to function in hip-fracture survivors: a prospective study of 95 elderly women. Arch Gerenol Geriatr 2008; [Epub].CrossRefGoogle Scholar
48Lightbody, E, Watkins, C, Leathley, M, Sharma, A, Lye, M. Evaluation of a nurse-led falls prevention programme versus usual care: a randomized controlled trial. Age Ageing 2002; 31: 203–10.CrossRefGoogle ScholarPubMed
49Coutinho, ES, Fletcher, A, Bloch, KV, Rodrigues, LC. Risk factors for falls with severe fractures in elderly people living in a middle income country: a case control study. BMC Geriatr 2008; 8: 21.CrossRefGoogle Scholar
50Landi, F, Onder, G, Cesari, M et al. Psychotropic medications and risk for falls among community-dwelling frail older people: an observational study. J Gerontol A Biol Sci Med Sci 2005; 60: 622–26.CrossRefGoogle ScholarPubMed
51Vestergaard, P. Skeletal effects of central nervous system active drugs: anxiolytics, sedatives, antidepressants, lithium and neuroleptics. Curr Drug Saf 2008; 3: 185–89.CrossRefGoogle ScholarPubMed
52Van Der Welde, N, Meerding, WJ, Looman, CW, Pols, HA, Van Der Cammen, TJ. Cost effectiveness of withdrawal of fall-risk-increasing drugs in geriatric outpatients. Drugs Aging 2008; 25: 521–29.CrossRefGoogle Scholar
53Weber, V, White, A, McIlvried, R. An electronic medical record (EMR)-based intervention to reduce polypharmacy and falls in an ambulatory rural elderly population. J Gen Intern Med 2008; 23: 399404.CrossRefGoogle Scholar
54Campbell, AJ, Robertson, MC, Gardner, MM, Norton, RN, Buchner, DM. Psychotropic medication withdrawal and a home-based exercise program to prevent falls: a randomized, controlled trial. J Am Geriatr Soc 1999; 47: 850–53.CrossRefGoogle Scholar
55Cumming, RG, Thomas, M, Szonyi, G. Home visits by an occupational therapist for assessment and modification of environmental hazards: a randomized trial for falls prevention. J Am Geriatr Soc 1999; 47: 1471–72.CrossRefGoogle ScholarPubMed
56Keysor, JJ, Jette, AM, Coster, W, Pvru Bettger, J, Haley, SM. Association of environmental factors with levels of home and community participation in an adult rehabilitation cohort. Arch Phys Med Rehabil 2006; 87: 1566–75.CrossRefGoogle Scholar
57Cranny, A, Horsley, T, O'Donnell, S. Effectiveness and safety of Vitamin D in relation to bone health. Evid Rep Technol Assess (Full Rep) 2007; 158: 1235.Google Scholar
58Melzer, I, Benjuya, N, Kaplanski, J.Effect of physical training on postural control of elderly. Harefuah 2005; 144: 839–44.Google ScholarPubMed
59Sohng, KY, Moon, JS, Song, HH, Lee, KS, Kim, YS. Fall prevention exercise program for fall risk factor reduction of the community-dwelling elderly in Korea. Yonset Med J 2003; 44: 883–91.CrossRefGoogle ScholarPubMed
60Binder, EF, Brown, M, Sinacore, DR, Steger-May, K, Yarasheki, KE, Scechtman, KB. Effects of extended outpatient rehabilitation after hip fracture: a randomized controlled trial. JAMA 2004; 18: 837–46.CrossRefGoogle Scholar
61Faber, MJ, Bosscher, RJ, Chin, A, Paw, MJ, van Wieringen, PC. Effects of exercise programs on falls and mobility in frail and pre-frail older adults: a multicenter randomized controlled trial. Arch Phys Med Rehabil 2006; 87; 885–96.CrossRefGoogle ScholarPubMed
62Weerdesteyn, V, Rijken, H, Geurts, AC, Smite-Engelsman, BC, Mulder, T, Duysens, J. A five-week exercise program can reduce falls and improve obstacle avoidance in the elderly. Gerontology 2006; 52: 131–41.CrossRefGoogle ScholarPubMed
63Cameron, ID, Stafford, B, Cumming, RG et al. Hip protectors improve falls self-efficacy. Age Ageing 2000; 29: 5762.CrossRefGoogle ScholarPubMed
64Parker, MJ, Gillespie, WJ, Gillespie, LD. Hip protectors for preventing hip fractures in older people. Cochrane Database of Systematic Reviews 2005, issue 3, art no: CD001255. DOI: 10.1002/14651858.CD001255.pub3.CrossRefGoogle Scholar
65Day, L, Fildes, B, Gordon, I, Fitzharris, M, Flamer, H, Lord, S. Randomised factorial trial of falls prevention among older people living in their own homes. BMJ 2002; 325: 1177.CrossRefGoogle ScholarPubMed
66Clemson, L, Cumming, RG, Kendig, H, Swann, M, Heard, R, Taylor, K. The effectiveness of a community-based program for reducing the incidence of falls in the elderly: a randomized trial. J Am Geriatr Soc 2004; 52: 1487–94.CrossRefGoogle ScholarPubMed
67Rizzo, JA, Baker, DI, McAvay, G, Tinetti, ME. The cost-effectiveness of a multifactorial targeted prevention program for falls among community dwelling elderly persons. Med Care 1996; 34: 954–69.CrossRefGoogle Scholar