Attitudes of older people with mild dementia and mild cognitive impairment and their relatives about falls risk and prevention: a qualitative study

Objective: To explore the perceptions of older people with mild dementia and mild cognitive impairment, and their family carers, about falling, falls risk and the acceptability of falls prevention interventions. Design: Qualitative study involving thematic analysis of semi-structured interviews wit...

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Main Authors: Peach, Tamsin, Pollock, Kristian, van der Wardt, Veronika, das Nair, Roshan, Logan, Pip, Harwood, Rowan H.
Format: Article
Language:English
Published: Public Library of Science 2017
Online Access:https://eprints.nottingham.ac.uk/43765/
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author Peach, Tamsin
Pollock, Kristian
van der Wardt, Veronika
das Nair, Roshan
Logan, Pip
Harwood, Rowan H.
author_facet Peach, Tamsin
Pollock, Kristian
van der Wardt, Veronika
das Nair, Roshan
Logan, Pip
Harwood, Rowan H.
author_sort Peach, Tamsin
building Nottingham Research Data Repository
collection Online Access
description Objective: To explore the perceptions of older people with mild dementia and mild cognitive impairment, and their family carers, about falling, falls risk and the acceptability of falls prevention interventions. Design: Qualitative study involving thematic analysis of semi-structured interviews with patient and relative dyads. Participants and setting: 20 patient/ relative dyads recruited from Memory Assessment Services and Falls Prevention Services in the United Kingdom. Results: The findings are presented under four key themes: attitudes to falls, attitudes to falls prevention interventions, barriers and facilitators, and the role of relatives. Participants' attitudes to falls interventions were varied and sometimes conflicting. Some worried about falls, but many resisted identifying themselves as potential 'fallers', even despite having fallen, and rejected the idea of needing the help that structured interventions signify. Participants preferred to focus on coping in the present rather than anticipating, and preparing for, an uncertain future. Falls prevention interventions were acknowledged to be valuable in principle and if required in the future but often felt to be not necessary or appropriate at present. Conclusions: This study of how persons with cognitive impairment, and their relatives, view falls risk and prevention mirror findings relating to the wider population of older persons without dementia. Participants did not generally see falls prevention interventions as currently relevant to themselves. The challenge for clinicians is how to present interventions with understanding and respect for the older person's identity. They must identify and address goals that patients and relatives value. Simplistic or paternalistic approaches will likely fail. Individualised interventions which focus on maintaining independence and preserving quality of life are more likely to be acceptable by supporting a positive self-image for patients and their relatives.
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spelling nottingham-437652018-12-04T16:34:07Z https://eprints.nottingham.ac.uk/43765/ Attitudes of older people with mild dementia and mild cognitive impairment and their relatives about falls risk and prevention: a qualitative study Peach, Tamsin Pollock, Kristian van der Wardt, Veronika das Nair, Roshan Logan, Pip Harwood, Rowan H. Objective: To explore the perceptions of older people with mild dementia and mild cognitive impairment, and their family carers, about falling, falls risk and the acceptability of falls prevention interventions. Design: Qualitative study involving thematic analysis of semi-structured interviews with patient and relative dyads. Participants and setting: 20 patient/ relative dyads recruited from Memory Assessment Services and Falls Prevention Services in the United Kingdom. Results: The findings are presented under four key themes: attitudes to falls, attitudes to falls prevention interventions, barriers and facilitators, and the role of relatives. Participants' attitudes to falls interventions were varied and sometimes conflicting. Some worried about falls, but many resisted identifying themselves as potential 'fallers', even despite having fallen, and rejected the idea of needing the help that structured interventions signify. Participants preferred to focus on coping in the present rather than anticipating, and preparing for, an uncertain future. Falls prevention interventions were acknowledged to be valuable in principle and if required in the future but often felt to be not necessary or appropriate at present. Conclusions: This study of how persons with cognitive impairment, and their relatives, view falls risk and prevention mirror findings relating to the wider population of older persons without dementia. Participants did not generally see falls prevention interventions as currently relevant to themselves. The challenge for clinicians is how to present interventions with understanding and respect for the older person's identity. They must identify and address goals that patients and relatives value. Simplistic or paternalistic approaches will likely fail. Individualised interventions which focus on maintaining independence and preserving quality of life are more likely to be acceptable by supporting a positive self-image for patients and their relatives. Public Library of Science 2017-05-19 Article PeerReviewed application/pdf en cc_by https://eprints.nottingham.ac.uk/43765/1/28542315 Peach, Tamsin, Pollock, Kristian, van der Wardt, Veronika, das Nair, Roshan, Logan, Pip and Harwood, Rowan H. (2017) Attitudes of older people with mild dementia and mild cognitive impairment and their relatives about falls risk and prevention: a qualitative study. PLoS ONE, 12 (5). e0177530. ISSN 1932-6203 http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0177530 doi:10.1371/journal.pone.0177530 doi:10.1371/journal.pone.0177530
spellingShingle Peach, Tamsin
Pollock, Kristian
van der Wardt, Veronika
das Nair, Roshan
Logan, Pip
Harwood, Rowan H.
Attitudes of older people with mild dementia and mild cognitive impairment and their relatives about falls risk and prevention: a qualitative study
title Attitudes of older people with mild dementia and mild cognitive impairment and their relatives about falls risk and prevention: a qualitative study
title_full Attitudes of older people with mild dementia and mild cognitive impairment and their relatives about falls risk and prevention: a qualitative study
title_fullStr Attitudes of older people with mild dementia and mild cognitive impairment and their relatives about falls risk and prevention: a qualitative study
title_full_unstemmed Attitudes of older people with mild dementia and mild cognitive impairment and their relatives about falls risk and prevention: a qualitative study
title_short Attitudes of older people with mild dementia and mild cognitive impairment and their relatives about falls risk and prevention: a qualitative study
title_sort attitudes of older people with mild dementia and mild cognitive impairment and their relatives about falls risk and prevention: a qualitative study
url https://eprints.nottingham.ac.uk/43765/
https://eprints.nottingham.ac.uk/43765/
https://eprints.nottingham.ac.uk/43765/