Clinical trial examines care strategies for preventing falls at home

September 19, 2017, University of York
Clinical trial examines care strategies for preventing falls at home
Almost 50% of those over the age of 80 experience a fall each year. Credit: University of York

A new large-scale clinical trial is testing the effectiveness of NHS home assessment strategies in preventing elderly people from falling unnecessarily.

Falling in is a common problem, with almost 50% of those over the age of 80 experiencing a fall each year. People fall for a variety of reasons, including diseases that affect the muscle and nervous system, poor eyesight, and weakening muscle strength, but it is thought that many in the home can be prevented with the proper assessment methods.

The cost of falls to the NHS is estimated to be £2.3 billion each year, but a previous small-scale study conducted by the University of York, suggests that falls could be reduced by 12% or more if home assessment strategies played a core part of care packages for the elderly.

The York team are now conducting a larger-scale clinical trial to provide further evidence on how effective home assessments, delivered by Occupational Therapists, are in preventing falls and what the cost implications might be to the NHS.

Adjustments

Sarah Cockayne, research fellow at the York Clinical Trials Unit, Department of Health Sciences, said: "People often think that falls are part of getting older and that little can be done to stop them, but there are actually many ways to reduce falls.

"A GP may advise on adjusting footwear to improve your balance and making sure you have your eyesight tested regularly, but there are also important environmental changes that can be made, such as improving home lighting and where domestic appliances are placed within easy reach."

The trial, which is now recruiting participants aged over 70 who have fallen in the last 12 months or who are concerned about falls, involves two study groups that will either receive a home assessment by an occupational therapist or guidance literature on how to prevent falls in the home.

Overlooked

Shelley Crossland, Occupational Therapist and one of the study authors from Leicestershire Partnership NHS Trust said: "Individuals may not be aware of their risk of falling, and consequently opportunities for prevention of falls are often overlooked, with risk factors becoming evident only after injury.

"As part of this new project, an Occupational Therapist will explore how an individual engages with their home environment looking at the potential risk areas and the performance of tasks ranging from making a hot drink, to getting in and out of the shower and other tasks completed on a daily basis.

"This visit will enable participants, with the help from an Occupational Therapist, to identify the areas of potential risks and solutions to reduce them."

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Infophage
not rated yet Sep 19, 2017
"People fall for a variety of reasons, including diseases that affect the muscle and nervous system, poor eyesight, and weakening muscle strength, but it is thought that many falls in the home can be prevented with the proper assessment methods."

Statins affect the muscles and nervous system; tamoxifen, seroquel and antidepressants affect the eyes; statins weaken muscle strength.

Look in the medicine cabinet to prevent falls. Nearly every drug a senior citizen takes causes hypotension, and if it causes hypertension, they also take a few drugs to address that.

Many of the drugs are not for a disease the person has that requires drug treatment. For example, statins and antihypertensives are supposed to reduce cardiovascular events. These drugs are not tested on the very old so there is no way to say whether they help or hurt.

In the USA, fatal falls in the elderly have shot up in the last twenty years, as has polypharmacy. Non-fatal but disabling falls must be up, too.

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