BACKGROUND AND PURPOSE: Falls and immobility are common among community-living elderly persons and result from the accumulated effect of multiple impairments and disabilities as well as environmental hazards. We developed and tested a simple assessment and intervention protocol for use in prevention and treatment programs among community-living elderly persons. This article presents the components of the assessment; the criteria for intervening on diagnosed impairments contributing to falls and immobility; and the recommended treatments, environmental adaptations, training, and exercise programs targeting the diagnosed problems. SUBJECTS: A convenience sample of 11 residents of a senior housing complex who were cognitively intact and ambulatory were chosen for reliability testing of the assessment protocol. A random sample of 20 of the 153 elderly subjects involved in a multiple risk factor trial for fall prevention then were chosen to test the reliability of the intervention recommendations. METHODS: The assessment and intervention protocol was developed by a consensus approach among a group consisting of a geriatric physician, two nurses, and three physical therapists. The interrater reliability of both the assessment and the intervention components of the protocol was determined by comparing the results of two of the study physical therapists. RESULTS: There was excellent agreement in assessment and intervention results by the two physical therapists. The assessment required approximately 45 minutes to complete, suggesting it is feasible for use in clinical practice. CONCLUSION AND DISCUSSION: A simple, standardized assessment and intervention protocol, such as the one described, could aid physical therapists in evaluating and treating community-living elderly persons by improving communication among care providers, providing better documentation for reimbursers, and ensuring a direct linkage between assessment and intervention, thus simplifying the development of a treatment plan for elderly persons with complicated or multiple impairments. The ultimate test of this assessment and intervention protocol will be ascertainment of the goal of the protocol, namely a reduction in falls and improvement in mobility among multiply and chronically ill elderly persons.
BACKGROUND AND PURPOSE: Falls and immobility are common among community-living elderly persons and result from the accumulated effect of multiple impairments and disabilities as well as environmental hazards. We developed and tested a simple assessment and intervention protocol for use in prevention and treatment programs among community-living elderly persons. This article presents the components of the assessment; the criteria for intervening on diagnosed impairments contributing to falls and immobility; and the recommended treatments, environmental adaptations, training, and exercise programs targeting the diagnosed problems. SUBJECTS: A convenience sample of 11 residents of a senior housing complex who were cognitively intact and ambulatory were chosen for reliability testing of the assessment protocol. A random sample of 20 of the 153 elderly subjects involved in a multiple risk factor trial for fall prevention then were chosen to test the reliability of the intervention recommendations. METHODS: The assessment and intervention protocol was developed by a consensus approach among a group consisting of a geriatric physician, two nurses, and three physical therapists. The interrater reliability of both the assessment and the intervention components of the protocol was determined by comparing the results of two of the study physical therapists. RESULTS: There was excellent agreement in assessment and intervention results by the two physical therapists. The assessment required approximately 45 minutes to complete, suggesting it is feasible for use in clinical practice. CONCLUSION AND DISCUSSION: A simple, standardized assessment and intervention protocol, such as the one described, could aid physical therapists in evaluating and treating community-living elderly persons by improving communication among care providers, providing better documentation for reimbursers, and ensuring a direct linkage between assessment and intervention, thus simplifying the development of a treatment plan for elderly persons with complicated or multiple impairments. The ultimate test of this assessment and intervention protocol will be ascertainment of the goal of the protocol, namely a reduction in falls and improvement in mobility among multiply and chronically ill elderly persons.
Authors: Amy L Byers; Thomas Sheeran; Amy E Mlodzianowski; Barnett S Meyers; Pamella Nassisi; Martha L Bruce Journal: Res Gerontol Nurs Date: 2008-10 Impact factor: 1.571
Authors: Julie Bruce; Anower Hossain; Ranjit Lall; Emma J Withers; Susanne Finnegan; Martin Underwood; Chen Ji; Chris Bojke; Roberta Longo; Claire Hulme; Susie Hennings; Ray Sheridan; Katharine Westacott; Shvaita Ralhan; Finbarr Martin; John Davison; Fiona Shaw; Dawn A Skelton; Jonathan Treml; Keith Willett; Sarah E Lamb Journal: Health Technol Assess Date: 2021-05 Impact factor: 4.014
Authors: Lesley D Gillespie; M Clare Robertson; William J Gillespie; Catherine Sherrington; Simon Gates; Lindy M Clemson; Sarah E Lamb Journal: Cochrane Database Syst Rev Date: 2012-09-12