Why should clinical practitioners ask about their patients’ concerns about falling?

Abstract Concerns (or ‘fears’) about falling (CaF) are common in older adults. As part of the ‘World Falls Guidelines Working Group on Concerns about Falling’, we recommended that clinicians working in falls prevention services should regularly assess CaF. Here, we expand upon these recommendations...

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Veröffentlicht in:Age and ageing 2023-04, Vol.52 (4)
Hauptverfasser: Ellmers, Toby Jack, Freiberger, Ellen, Hauer, Klaus, Hogan, David B, McGarrigle, Lisa, Lim, Mae Ling, Todd, Chris, Martin, Finbarr, Delbaere, Kim
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container_end_page
container_issue 4
container_start_page
container_title Age and ageing
container_volume 52
creator Ellmers, Toby Jack
Freiberger, Ellen
Hauer, Klaus
Hogan, David B
McGarrigle, Lisa
Lim, Mae Ling
Todd, Chris
Martin, Finbarr
Delbaere, Kim
description Abstract Concerns (or ‘fears’) about falling (CaF) are common in older adults. As part of the ‘World Falls Guidelines Working Group on Concerns about Falling’, we recommended that clinicians working in falls prevention services should regularly assess CaF. Here, we expand upon these recommendations and argue that CaF can be both ‘adaptive’ and ‘maladaptive’ with respect to falls risk. On the one hand, high CaF can lead to overly cautious or hypervigilant behaviours that increase the risk of falling, and may also cause undue activity restriction (‘maladaptive CaF’). But concerns can also encourage individuals to make appropriate modifications to their behaviour to maximise safety (‘adaptive CaF’). We discuss this paradox and argue that high CaF—irrespective of whether ‘adaptive’ or ‘maladaptive’—should be considered an indication that ‘something is not right’, and that is represents an opportunity for clinical engagement. We also highlight how CaF can be maladaptive in terms of inappropriately high confidence about one’s balance. We present different routes for clinical intervention based on the types of concerns disclosed.
doi_str_mv 10.1093/ageing/afad057
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As part of the ‘World Falls Guidelines Working Group on Concerns about Falling’, we recommended that clinicians working in falls prevention services should regularly assess CaF. Here, we expand upon these recommendations and argue that CaF can be both ‘adaptive’ and ‘maladaptive’ with respect to falls risk. On the one hand, high CaF can lead to overly cautious or hypervigilant behaviours that increase the risk of falling, and may also cause undue activity restriction (‘maladaptive CaF’). But concerns can also encourage individuals to make appropriate modifications to their behaviour to maximise safety (‘adaptive CaF’). We discuss this paradox and argue that high CaF—irrespective of whether ‘adaptive’ or ‘maladaptive’—should be considered an indication that ‘something is not right’, and that is represents an opportunity for clinical engagement. We also highlight how CaF can be maladaptive in terms of inappropriately high confidence about one’s balance. 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source Applied Social Sciences Index & Abstracts (ASSIA); Oxford University Press Journals All Titles (1996-Current); MEDLINE; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection
subjects Accidental Falls
Aged
Falls
Fear
Humans
Older people
Prevention programs
Risk Assessment
Safety behaviour
title Why should clinical practitioners ask about their patients’ concerns about falling?
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