Fall Prevention Education For Home Bound Seniors

1532 words - 6 pages

The Centers for Disease Control and Prevention (2012) reports that each year in the United States, one in three people over the age of 65 falls at home. Falls are the most common cause of fractures and traumatic brain injuries as well as the leading cause of injury death in the elderly population. In a one-year study of 1529 home health patients, Lewis, Moutoux, Slaughter, and Bailey (2004) found that 57.6% of falls were caused by failure to use an assistive device properly and 11.3% were due to safety factors such as environmental hazards. Qualitative research has revealed that with regard to fall prevention, seniors prefer to have an active role; maintaining independence is a chief motivating factor; and fear of falling is a common barrier. Also of note are a perceived social stigma associated with use of assistive devices and a belief in some that falls are an unavoidable, normal part of aging (Vivrette, Rubenstein, Martin, Josephson, and Kramer, 2011; Faes et al., 2010; Horton, 2007).
As a health care setting, the home is an uncontrolled environment with very little professional supervision so that fall prevention measures are largely the responsibility of patients and their caregivers. While the most successful fall prevention efforts are multifaceted, effective measures for community-based elders include education, home modification, mobility aids, physical therapy and exercise training, and corrective changes to footwear, eye wear and medications (Chase, Mann, Wasek, & Arbesman 2012; Currie, 2008). Along with other measures, patient education through application of the Interaction Model of Client Health Behavior (IMCHB) could effectively close the gap between proven recommendations and adherence in order to decrease the incidence of falls in home health clients.
The Interaction Model of Client Health Behavior (Cox, 1982) proposes that health outcomes are the result of a dynamic relationship between unique client attributes and interactions between the client and health care provider. The elements of client singularity include background variables (demographic characteristics, social influence, previous health care experience and environmental resources) as well as more transient variables (intrinsic motivation, cognitive appraisal and affective response) that emerge during interactions with the health care provider. The elements of the client-professional interaction (health information, affective support, decisional control and professional competencies) are dynamic and reciprocal, and the emphasis the provider places on each is determined by the client singularity. The model assumes that “clients are capable of making informed, independent, and competent choices about their health care behavior” (p. 46). Mutual decisions made during client-provider interactions and subsequent client behaviors lead to health outcomes which include utilization of health care services, clinical health status indicators, severity of the health care...

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