Online Program

Challenges of Reducing the Risk of Falls in Community-dwelling Elderly with dementia : The Double Jeopardy

Tuesday, November 3, 2015

Jane Bear-Lehman, PhD, OTR/L, FAOTA, College of Health Professions, Pace University, Pleasantville, NY
Victoria H. Raveis, PhD, Psychosocial Research Unit on Health, Aging and the Community, New York University, New York, NY
James Galvin, MD, Barlow Center for Memory Evaluation & Treatment, New York University, Langone School of Medicine
Valery Lanyi, MD, Department of Rehabilitation Medicine, New York University, Langone School of Medicine
Monique Carrero, MS, Psychosocial Research Unit on Health, Aging and the Community, New York University, New York, NY
Sharon Tepfer, MS, Private Practice, NY
Daniel G. Karus, MS, Psychosocial Research Unit on Health, Aging and the Community, New York University, New York, NY
Although persons with dementia, living in the community, have an increased fall risk, assessment and management of fall risk is not routinely part of standard clinical care.  A multi-disciplinary collaborative representing Public Health, Sociology, Occupational Therapy, Neurology and Rehabilitative Medicine, has adapted an evidence-based fall prevention program (PROFET) for delivery to community-dwelling elderly diagnosed with mild to moderate dementia who have not experienced a fall-related injury.  Program participants are enrolled through an outpatient neurology clinic. Intrinsic risk factors indicative of poor functionality (cognition, gait, balance, grip strength, polypharmacy) -- elders diagnosed with mild to moderate dementia,  and extrinsic risk factors (hazards in home environment) are identified through a comprehensive clinical assessment and home visit and an individualized fall risk reduction protocol developed for each participant (N=8). Implementing fall prevention programs prior to an injury-sustaining event can delay or prevent unintentional injuries among community-dwelling older adults. This becomes more complicated when there is a new diagnosis of dementia.  During the small window when learning new skills to prevent falls is opportune, the primary focus of the family is directed towards identifying longer term supported, safe living environment.  Expanding the reach of fall prevention efforts to include at-risk clinical populations, such as those with mild to moderate dementia, could substantially reduce healthcare costs and sustain the health and functioning, but will require other resources to attend to the pressing challenges of early diagnosis.

Learning Areas:

Other professions or practice related to public health
Public health or related research

Learning Objectives:
Describe a novel implementation of a fall prevention program for vulnerable community populations Discuss risk factors for falls in the elderly Discuss the challenges of double jeopardy of falls risk and newly diagnosis of dementia

Keyword(s): Behavioral Research, Aging

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Dr. Jane Bear-Lehman is an occupational therapist researcher whose work focuses on the cognitive and physical basis of disablement in community-dwelling elders. She publishes on the impact of the environment on falls in the elderly, adaptive and remedial approaches to enabling urban dwelling seniors to age-in-place, and adaptation to disablement in the elderly. She oversaw the overall coordination and delivery of the fall prevention and home safety components of this program.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.