A qualitative study into the attitudes of people with mild cognitive impairment and early stages of dementia, and their carers, about falls interventions and risk

Peach, M.; Pollock, Kristian; Harwood, Rowan; Van Der Wardt, Veronika; Masud, Tahir

Abstract

Introduction: Falls are a common and serious problem for older people with cognitive impairment. Successful intervention to reduce falls risk could result in great benefit to patients and their families, and reduce costs. This study examines patients’ and family carers’ attitudes towards interventions to reduce falls risk and maintain independence.
Method: 20 semi-structured, audio-recorded interviews were completed with older people with early dementia (MMSE>20) or mild cognitive impairment and their carers, exploring attitudes to falls risk and prevention. A thematic analysis of the interview transcripts was undertaken using the constant comparison method.
Results: Participants acknowledged increasing caution and reduction or adaptation in activity to maintain safety. Changes were rationalised and absorbed into their lives but they asserted that ‘we’re doing OK’, and believed additional input unnecessary. Participants reported openness to interventions if needed in the future, and described taking things ‘a day at a time’, not thinking about the future or deteriorating abilities. Participants’ lacked awareness of the impact of falls and potential interventions to reduce risk. Engagement was also affected by practical constraints including transport, finance and time.
Conclusions: There is a dissonance between the patient and professional perspective around the need for preventative interventions to reduce risk of falls. Services should respect the fragile boundary between supporting people and undermining their sense of wellbeing. Presenting services in an individually tailored, relevant way which maintains a positive self-image is an integral part of effective uptake. Presenting interventions positively as maintaining activity and improving mental wellbeing should increase acceptance to patients and their carers.

Citation

Peach, M., Pollock, K., Harwood, R., Van Der Wardt, V., & Masud, T. (2014). A qualitative study into the attitudes of people with mild cognitive impairment and early stages of dementia, and their carers, about falls interventions and risk. European Geriatric Medicine, 5(S1), S169. https://doi.org/10.1016/S1878-7649%2814%2970440-1

• Journal Article Type: Article
• Acceptance Date: Sep 19, 2014
• Online Publication Date: Sep 28, 2014
• Publication Date: Sep 19, 2014
• Deposit Date: Apr 30, 2018
• Publicly Available Date: Jan 7, 2019
• Journal: European Geriatric Medicine
• Print ISSN: 1878-7649
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 5
• Issue: S1
• Article Number: P269
• Pages: S169
• DOI: https://doi.org/10.1016/S1878-7649%2814%2970440-1
• Public URL: https://nottingham-repository.worktribe.com/output/1104303