Improving acute care services for older people.
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Biomedical subjects
Publications and source records attributed to Susan E Kurrle.
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BACKGROUND: Hip protectors can prevent many hip fractures in older persons at high risk for falling. Few published studies have investigated the use of hip protectors in community-dwelling older persons, and the level of adherence with their use, and predictors of adherence in this setting, are not clear. The aim of this study was to report the predictors of adherence and the level of adherence with the use of hip protectors in frail community-dwelling older women. METHODS: This cohort study of the intervention group of a randomized, controlled trial recruited participants from aged care health services in urban areas of northern Sydney, Australia. Participants were 302 women who were 74 years or older (mean age, 83 years) and who had 2 or more falls or 1 fall requiring hospital admission in the previous year and who lived in their own homes. The main outcome measure was adherence with the use of hip protectors. RESULTS: Adherence was approximately 53% during the 2 years of the study, and hip protectors were worn at the time of 51% of falls. The significant independent predictors of nonadherence with hip protector use were lower self-efficacy for hip protector use (odds ratio [OR], 0.51; 95% confidence interval [CI],.33 to.79), higher number of perceived barriers to hip protector use (OR, 0.52; 95% CI, .38 to.72), and lower self-rated health (OR, 0.71; 95% CI, .55 to.93). CONCLUSIONS: Three easily measured factors independently predicted subsequent adherence with hip protector use. These findings may form the basis for strategies to improve adherence with the use of hip protectors and with other types of treatment or preventive strategies in older persons.
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Older people make up the majority of participants in general rehabilitation programs. Stroke and hip fracture are the major diagnostic groups. Most older people with significant disability of recent onset have the potential to benefit from rehabilitation. Assessing an older person's premorbid functional and cognitive status, which are strong determinants of rehabilitation outcome, is an important component of management. The major goals of rehabilitation for older people are mobility and self-care without the assistance of another person. Evidence suggests that rehabilitation for older people involving a coordinated multidisciplinary team of health professionals (including nurses and doctors) is effective. Contemporary rehabilitation practice is not confined to traditional inpatient rehabilitation units; it also occurs in the community and other non-hospital settings, and involves general practitioners.
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OBJECTIVE: To describe fall-related injuries due to pets in an older population. DESIGN: Case series. PARTICIPANTS AND SETTING: Patients aged 75 years and over presenting to the emergency department of a metropolitan hospital in northern Sydney over 18 months, with a fracture directly related to their pet. MAIN OUTCOME MEASURES: Type of fracture; circumstances of injury. RESULTS: 16 cases (mean patient age, 81 years) are described; 13 (81%) involved women. Animals of five species were involved, with cats and dogs being the most common pet hazard. CONCLUSIONS: Pets are a potential environmental hazard in the occurrence of fall-related injuries in older people, with dogs and cats most likely to be involved. Women appear more likely than men to be injured.