Mae is a PhD student at School of Public Health and Community Medicine (UNSW) and Neuroscience Research Australia (NeuRA). Her research focuses on falls prevention and health literacy in older people. She is particularly interested in understanding how health literacy can empower older adults to take care of their own health and increase the uptake and efficacy of evidence-based fall prevention programs.
Research investigating the impacts of cognitive behavioural therapy and balance programs on fear of falling, funded by Mindgardens.
Falls and fear of falling affect many older people and can impose limitations upon daily activities. Over one third of community dwelling older people fall each year with about 15% of falls being injurious. However, two thirds of older people express a fear of falling during common daily activities, making it more common than falls itself. Fear of falling has been associated with needless restriction in physical and social activities, and subsequent deterioration of health and wellbeing.
Previous research has suggested that fear of falling can be reduced through cognitive behavioural therapy (CBT) and balance exercise programs. However, these face-to-face treatments are resource intensive and not readily accessible to people. Furthermore, the effects of these treatments on fear of falling are small and often do not last beyond the duration of the program.
By utilising technology and providing tailored physical activity guidance we are aiming to reduce a fear of falling in an accessible, efficient and lasting way.
A thee-arm randomised clinical trial will be conducted in 189 community-dwelling older adults with a substantial concern of falling. Participants will be randomly allocated into one of three groups in order to test whether a self-managed CBT intervention, alone or in combination with a graded balance activity program, can reduce concerns about falling in older adults when compared to usual care.
We are collaborating with the Black Dog institute to provide a home-based cognitive behavioural therapy program that addresses a fear of falling. We will also be utilising our cutting-edge balance program StandingTall to provide a graded balance program.
Catastrophizing thoughts about falls can trip people up. We are now looking for programs that can help reduce concern about falling in older people.
Falls and fear of falling affect many older adults and can impose limitations upon daily activities. Over one third of community dwelling older adults fall each year with about 15% of falls being injurious. However, over two thirds of older adults express fear of falling during common daily activities, making it more common than falls itself. Fear of falling has been associated with needless restriction in physical and social activities with consequent negative impacts on lower quality of life.
Previous research has suggested that fear of falling can be reduced through cognitive behavioural therapy and balance exercise programs. We are collaborating with Black Dog Institute to investigate the effectiveness of an online cognitive behavioural program (myCompass) versus a health education program for 6 weeks at reducing concerns about falling in community-dwelling older people. The intervention consists of a fully-automated cognitive behavioural therapy program (myCompass) delivered through a tablet or computer in people’s homes with no therapist input, including evidence-based and interactive psychological modules that users can complete via the internet on a tablet or computer in their homes.
An informed and engaged older adult who values health promotion, protection, and preparedness is vital to promote uptake and adherence to any health and fall prevention programs.
According to the Australian Bureau of Statistics, about 60 per cent of Australians (15-74 years old) have less than adequate levels of health literacy and only 6% of the population have high health literacy. Health literacy was also found to be lower in old age. The majority of Australians with inadequate health literacy were aged 65 to 74 years. Similarly, in another Australian survey, only 8% of 1454 older adults were aware that balance training can prevent falls, or that falls could be prevented at all. This is indicative of poor health literacy among older Australians related to fall risk and fall prevention. With the increasing complexity of health information and services, health literacy is an issue for older Australians. Health literacy may affect individuals’ understanding of health information and in turn influence their health decisions and uptake of health preventive interventions such as engaging in physical activities to prevent falls.
This project will address a crucial gap in empowering older adults to take care of their own health and increase the uptake and efficacy of evidence-based fall prevention programs. An informed and engaged older adult who values health promotion, protection, and preparedness is vital to promote uptake and adherence to any health and fall prevention programs.
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CARLY CHAPLIN Research Assistant : firstname.lastname@example.org
LILLIAN MILES Research Assistant
Older patients are poor at recognizing their fall risks. Both patients' perceived and actual fall risks should be evaluated in the inpatient setting in order to inform individualized fall prevention education and strategies.
To explore the experiences of community nurses and home carers, in caring for patients on home enteral nutrition. To facilitate a better transition of care for patients, adequate training for carers, standardising clinical practice in managing patients with home enteral nutrition and improving communication between home care services and the acute care hospitals are needed.
An exploratory descriptive study was conducted to explore the perspectives of patients who had fallen in the hospital; 100 patients were interviewed. An inductive content analysis approach was adopted. Six themes emerged: Apathetic toward falls, self-blame behavior, reluctance to impose on busy nurses, negative feelings toward nurses, overestimating own ability, and poor retention of information. Patients often downplayed the risks of falls and were reluctant to call for help.