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) |
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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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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.</description><identifier>ISSN: 0002-0729</identifier><identifier>EISSN: 1468-2834</identifier><identifier>DOI: 10.1093/ageing/afad057</identifier><identifier>PMID: 37097766</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Accidental Falls ; Aged ; Falls ; Fear ; Humans ; Older people ; Prevention programs ; Risk Assessment ; Safety behaviour</subject><ispartof>Age and ageing, 2023-04, Vol.52 (4)</ispartof><rights>The Author(s) 2023. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com 2023</rights><rights>The Author(s) 2023. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.</rights><rights>The Author(s) 2023. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c397t-3c1a3b513970e89ab39d60c78190320f9f7d7e354f18075a4f6c6a03880aeed43</citedby><cites>FETCH-LOGICAL-c397t-3c1a3b513970e89ab39d60c78190320f9f7d7e354f18075a4f6c6a03880aeed43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902,30976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37097766$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ellmers, Toby Jack</creatorcontrib><creatorcontrib>Freiberger, Ellen</creatorcontrib><creatorcontrib>Hauer, Klaus</creatorcontrib><creatorcontrib>Hogan, David B</creatorcontrib><creatorcontrib>McGarrigle, Lisa</creatorcontrib><creatorcontrib>Lim, Mae Ling</creatorcontrib><creatorcontrib>Todd, Chris</creatorcontrib><creatorcontrib>Martin, Finbarr</creatorcontrib><creatorcontrib>Delbaere, Kim</creatorcontrib><creatorcontrib>World Falls Guidelines Working Group on Concerns About Falling</creatorcontrib><creatorcontrib>The World Falls Guidelines Working Group on Concerns About Falling</creatorcontrib><title>Why should clinical practitioners ask about their patients’ concerns about falling?</title><title>Age and ageing</title><addtitle>Age Ageing</addtitle><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.</description><subject>Accidental Falls</subject><subject>Aged</subject><subject>Falls</subject><subject>Fear</subject><subject>Humans</subject><subject>Older people</subject><subject>Prevention programs</subject><subject>Risk Assessment</subject><subject>Safety behaviour</subject><issn>0002-0729</issn><issn>1468-2834</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNqFkL9OwzAQhy0EoqWwMqJILDCkPcdJbE8IVfyTkFioGCPXcVqXNA62M3TjNXg9ngSjBAYWpruTvvvu9EPoFMMUAyczsVK6Wc1EJUrI6B4a4zRnccJIuo_GAJDEQBM-QkfObcKIM5wcohGhwCnN8zFavKx3kVubri4jWetGS1FHrRXSa69No6yLhHuNxNJ0PvJrpW3UCq9V493n-0ckTSOVbdwAVKIOjtXVMToIrVMnQ52gxe3N8_w-fny6e5hfP8aScOpjIrEgywyHARTjYkl4mYOkDHMgCVS8oiVVJEsrzIBmIq1ymQsgjIFQqkzJBF303taat045X2y1k6quRaNM54qEQQ4UCGUBPf-Dbkxnm_BdkfAsIxBO8EBNe0pa45xVVdFavRV2V2AovgMv-sCLIfCwcDZou-VWlb_4T8IBuOwB07X_yb4ARsWMjg</recordid><startdate>20230401</startdate><enddate>20230401</enddate><creator>Ellmers, Toby Jack</creator><creator>Freiberger, Ellen</creator><creator>Hauer, Klaus</creator><creator>Hogan, David B</creator><creator>McGarrigle, Lisa</creator><creator>Lim, Mae Ling</creator><creator>Todd, Chris</creator><creator>Martin, Finbarr</creator><creator>Delbaere, Kim</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20230401</creationdate><title>Why should clinical practitioners ask about their patients’ concerns about falling?</title><author>Ellmers, Toby Jack ; Freiberger, Ellen ; Hauer, Klaus ; Hogan, David B ; McGarrigle, Lisa ; Lim, Mae Ling ; Todd, Chris ; Martin, Finbarr ; Delbaere, Kim</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c397t-3c1a3b513970e89ab39d60c78190320f9f7d7e354f18075a4f6c6a03880aeed43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Accidental Falls</topic><topic>Aged</topic><topic>Falls</topic><topic>Fear</topic><topic>Humans</topic><topic>Older people</topic><topic>Prevention programs</topic><topic>Risk Assessment</topic><topic>Safety behaviour</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ellmers, Toby Jack</creatorcontrib><creatorcontrib>Freiberger, Ellen</creatorcontrib><creatorcontrib>Hauer, Klaus</creatorcontrib><creatorcontrib>Hogan, David B</creatorcontrib><creatorcontrib>McGarrigle, Lisa</creatorcontrib><creatorcontrib>Lim, Mae Ling</creatorcontrib><creatorcontrib>Todd, Chris</creatorcontrib><creatorcontrib>Martin, Finbarr</creatorcontrib><creatorcontrib>Delbaere, Kim</creatorcontrib><creatorcontrib>World Falls Guidelines Working Group on Concerns About Falling</creatorcontrib><creatorcontrib>The World Falls Guidelines Working Group on Concerns About Falling</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Age and ageing</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ellmers, Toby Jack</au><au>Freiberger, Ellen</au><au>Hauer, Klaus</au><au>Hogan, David B</au><au>McGarrigle, Lisa</au><au>Lim, Mae Ling</au><au>Todd, Chris</au><au>Martin, Finbarr</au><au>Delbaere, Kim</au><aucorp>World Falls Guidelines Working Group on Concerns About Falling</aucorp><aucorp>The World Falls Guidelines Working Group on Concerns About Falling</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Why should clinical practitioners ask about their patients’ concerns about falling?</atitle><jtitle>Age and ageing</jtitle><addtitle>Age Ageing</addtitle><date>2023-04-01</date><risdate>2023</risdate><volume>52</volume><issue>4</issue><issn>0002-0729</issn><eissn>1468-2834</eissn><abstract>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.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>37097766</pmid><doi>10.1093/ageing/afad057</doi><oa>free_for_read</oa></addata></record> |
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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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