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Critique of Feasibility Study on Multidisciplinary Fall Prevention
Introduction
Falling among the elderly has been on the rise among the elderly people in developed worlds like Britain and the Netherlands. The Dutch health care system adopted a system that was being used by the British health care system as the intervention measure to prevent falls among the elderly. This paper will critique some of the elements of the feasibility study to ascertain whether it is effective or not.
Purpose and problem of the study
The study endeavored to develop some element of efficacy in fall prevention among the elderly who were at risk of falling by describing the adaptation of fall prevention program and its feasibility in the implementers and participants perspective. The study was prompted by rising cases of falling among the elderly which impacted negatively on their lives. The Netherlands in particular was pointed to as one country that badly needed measures to prevent falls among the elderly who were at risk of falling. To address this problem, a model British fall prevention program was used to assess the Dutch health care setting.
Examination of literature review
Close et al (1999 p.96) prevention of falls among the elderly is very relevant to this study as they do a randomized controlled study to look at the advantages of coming up with a structured assessment of people who sustained injuries after falling. They also focused on the possibilities of further falls. Close et al posit that studies that had been conducted on falling among the elderly majorly focused on the aspects of injury with little or no attention given to the systematic assessment of the causative factors, the consequences of the falls, and measures taken to ensure such falls never occur. However much relevant this study may be, its date of publication makes it difficult to cite as over the eleven years some more current studies had been undertaken about falling among the elderly. Current studies related to fall of adults are focused on how community falls can be prevented among people who can manage to call an ambulance after they have fallen. The study by Close et al involved the use of randomized controlled trials. Other researchers are currently perforating the ineffectiveness of multidisciplinary fall prevention programs and prevention of falling in patients who are at high risk of falling.
Speechley and Tinetti (1991 p.47) identified different types of falls encountered by elderly people and how the identification could be used in preventing further falls. The study is relevant but cannot be absolutely used to support any research because it is a study that was done almost two decades ago and maybe lack vital information that current researches have. Current studies in this area are looking at the impacts of risk of falling and how fear of falling affects movements senior citizens who are living independently who are just about to become frail. Other related studies also illuminate the prevention of falling among aged patients. Also related to this is how people respond to the prevention of injury occasioned by falls; contributions by individuals in falls prevention interventions; and how older people perceive implications of risks of falling.
Gillespie et al (2003 p. 340) assessed the effects of interventions that were geared towards reducing falling incidence among the elderly living in the hospital set up, community, or institutions that take care of the elderly. The study managed to come up with costs that were associated with the prevention of falls in the interventions that were administered. They did careful economic modeling in relation to the local health care system. However, the study did not unravel the effectiveness of some potential interventions that could be engaged in mitigating falling among elderly people. This study can be cited because it is current and administers some of the recent experimental techniques in this area of research. Some most of the current researches related to this study include the evaluation of effective training that emphasized balancing with people suffering from Alzheimer-related complications; prediction of fracture that happens on fragile hips; and what can be done to prevent falling of older people in hospitals and nursing homes.
Tinetti (1986 p.46) is appalled that falls account for 85 percent of the total injury-related hospital admissions among the elderly being admitted in health facilities. He reiterates that these falls strain health care system resources and the elderly often lose their independence and at times die. Previous studies showed that one out of three elderly people succumbed to fall-related injuries once a year. Some of the risk factors the study identified included problems with maintaining balance, weakness of the muscles, use of many drugs in treating a single infection, and heart-related problems. The study identified several ways of avoiding falls among the elderly as coming up with policies intended for fall prevention in long term; coming up with community-initiated strategies integrating aspects of exercise and education sessions to improve balance and strengthen muscles respectively. The study said this could be achieved by identification of people at risk and introducing them into these systems.
Abdelhafiz (2003 p.27) posit that older peoples major health problems emanate from falls and that 30 percent of them aged 65 and above fall at least once a year. They majorly used randomized trials in their study to come up with interventions to avoid falling. These falls are majorly attributed to poor vision.
Studies theoretical framework
Abdelhafizs (2003) study has an explicit framework as it clearly outlines the methods that were used to conduct the study. It is related to nursing as eye examinations are done by an optometrist who after giving out the eyeglasses recommended that the participants be visited by an occupational therapist in their homes. Some patients were subjected to cataract surgery. Abdelhafiz attributes falling among the elderly to poor eyesight.
Tinetti (1986) used Tinetti Assessment Tool which is very important in nursing. However, the study framework is so implicit and not easily seen. The framework is based on a scientific theory. The study framework is relevant is related to the subject of study as it attributes falling to lack of proper balancing among the women. The research tool used here relates the risk of falling among adults to scores below 19.
Gillespie et al (2003) theoretical framework is explicitly stated. They sourced their data from scientific records like the MEDLINE and EMBASE and the national research register. Their study was very relevant to the subject of study as intended to assess the effect of coming up with ways to prevent falls among the elderly.
Speechley and Tinettis (1981) study has got a relationship to the subject of study as it examines different types of falls and fallers witnessed among the elderly. Its framework is not explicitly stated as one has to go through the literature to come to deduce what the strategy is all about. Close et al (1991) study is related to the subject of study as it illuminates falls among the elderly just like the study does. Its study frame is explicitly stated as one does not have to go through the whole literature to be able to know the design.
The research objectives, questions, and objectives included a review of benefits of structured interdisciplinary assessment in respect to people who have fallen; assessment of efforts of intervention aimed at reducing fall incidences in elderly people; determination of the efficacy of vision to prevent falls among the frails. Some of the study variables used in the study included psychological, demographic, and physical variables that were used to assign patients to groups like the frail, vigorous, and transition group.
Conclusion
Most of the studies used in this feasibility study were relevant despite the fact that quite a number were not so current. More studies should be initiated into this area to cut the costs the elderly people incur in treating injuries sustained when they fall.
Reference List
Abdelhafiz, A.H., Austin, C.A. (2003). Visual factors should be assessed in older people presenting with falls or hip fracture. Age Ageing, 32:26-30.
Close, J., Ellis, M., Hooper, R., et al. (1999). Prevention of Falls in the Elderly Trial (PROFET): a randomized controlled trial. Lancet, 353:93-97.
Gillespie, L.D., Gillespie, W.J., Robertson, M.C., et al. (2003). Interventions for preventing fall in elderly people. Cochrane Database Syst Rev, CD000340.
Speechley, M., Tinetti, M. (1991). Falls and injuries in frail and vigorous community elderly persons. J Am Geriatr Soc, 39:46-52.
Tinetti, M.E. (1986). Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc, 34:119-26.
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