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“People are Getting Lost a Little Bit”: Systemic Factors that Contribute to Falls in Community-Dwelling Octogenarians

Published online by Cambridge University Press:  09 June 2015

Dorothy Gotzmeister ,
Aleksandra A. Zecevic ,
Lisa Klinger  and
Alan Salmoni
Dorothy Gotzmeister*
Affiliation:
The School of Graduate and Postdoctoral Studies, Western University
Aleksandra A. Zecevic
Affiliation:
School of Health Studies, Faculty of Health Sciences, Western University
Lisa Klinger
Affiliation:
School of Occupational Therapy, Faculty of Health Sciences, Western University
Alan Salmoni
Affiliation:
School of Kinesiology, Western University
*
*La correspondance et les demandes de tirés-à-part doivent être adressées à: / Correspondence and requests for offprints should be sent to: Dorothy Gotzmeister, OT Reg. (Ont.), MSc, The School of Graduate and Postdoctoral Studies International and Graduate Affairs Building, Room 1N07 Western University 1151 Richmond Street London, ON N6A 3K7 ([email protected])
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Abstract

Octogenarians living in the community are the fastest-growing demographic in Canada. Simultaneously, they have the highest prevalence of falls and nine times greater risk of injury due to a fall. To understand how to improve the safety of octogenarians’ aging-in-place, a systems approach is essential. Understanding how societal factors interact and affect the older adult can help care custodians identify and remove safety deficiencies that bring about falls. The purpose of this study was to identify system-wide factors contributing to falls in community-dwelling octogenarians. Eight falls were investigated using the systemic falls investigative method. Participants ranged in age from 83–90 years. Across-case analyses identified 247 contributing factors, grouped within four distinct themes: (a) everyday living has become risky; (b) supervision limitations; (c) health care system disconnects; and (d) poor fall risk identification and follow-up. This qualitative study provides systemic insights into how and why falls occur in community-dwelling octogenarians.

Résumé

Les octogénaires qui habitent aux communautés sont la caractéristique la plus croissante dans la démographie du Canada. Au même temps, ils ont la plus forte prévalence des chutes et neuf fois plus de risques de blessures dues à une chute [par rapport a qui]? Une approche systématique est essentielle pour améliorer la sécurité des octogenaires qui vieillissent en place (chez soi). Comprendre comment les facteurs sociaux interagissent et affectent les aînés peuvent aider à identifier et éliminer les carences en matière de sécurité qui provoquent des chutes. Le but de cette étude était d'identifier les facteurs dans l'ensemble du système qui contribuent aux chutes chez les octogénaires qui habitent aux communautés. Huit chutes ont été étudiées en utilisant une méthode systématique d'examiner les chutes (MSEC). Les participants étaient âgés de 83 à 90 ans. Les analyses à travers des cas ont identifiées 247 facteurs contributifs, regroupés au sein de quatre thèmes distincts: (a) la vie quotidienne est devenu plein de risque; (B) la surveillance est limitée; (C) le système de soins de santé montre la déconnexion; et (d) l'identification et le suivi des chutes est défectueux. Cette étude qualitative permet des apércus systématiques sur comment et pourquoi les chutes se produisent chez les octogénaires dans les communautés.

Keywords

agingaging-in-placecase studiescauses of fallscommunity carehealth-related safetyinvestigative methodvieillissmentvieillissant chez-soiétudes de cascauses de chutessoins communautairessécurité liée à santéméthode systématique d'enquête
Type
Canadian Institutes of Health Research–Institute of Aging: Profile/Instituts de recherche en santé du Canada–Institut du vieillissement : Profil
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 34 , Special Issue 3 , September 2015 , pp. 397 - 410
Copyright
Copyright © Canadian Association on Gerontology 2015 

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