Older men’s falls risk and confidence in completing activities of daily living: A retrospective cohort study
Author: Kimberley Burr
Supervisors: Yvonne Thomas Laura Hogue
Burr, K. (2022). Older men’s falls risk and confidence in completing activities of daily living: A retrospective cohort study (Unpublished document submitted in partial fulfilment of the requirements for the degree of Master of Occupational Therapy). Otago Polytechnic | Te Pūkenga - New Zealand Institute of Skills and Technology https://doi.org/10.34074/thes.6044
Abstract
RESEARCH QUESTION Is there a relationship between the clinician-assessed falls risk for older men compared to their self-assessed confidence in completing activities of daily living without falling?
BACKGROUND AND AIM Falls are a common event that occur with ageing, with roughly one in three persons over 65 experiencing at least one fall annually. Differences in gender experiences have highlighted older women fall indoors more often and experience higher rates of injury following a fall, while older men were more likely to fall outdoors and have higher mortality rates following hospitalisation from a fall. Nevertheless, older men continue to engage in ADLs if they feel a fall is inevitable, or if they are unaware of their risk and overconfident in their ability to complete the ADLs. Additionally, older men remain underrepresented in research. The aim of this study is to understand if there is a relationship between the clinician-assessed falls risk for older men compared to their self-assessed confidence in completing activities of daily living without falling.
METHODS A retrospective cohort study was conducted using data from 68 men aged 65 to 74. Three clinician-assessed falls risk assessments and one self-rated assessment tool were completed by participants. The data collected from client files was analysed using descriptive statistics and Spearman’s correlation to determine the degree of the relationship. The data collected was assessed at two time points to provide more comprehensive results.
FINDINGS The study found more than half of older men were at risk of falls at both time points, and they rated themselves as being fairly confident when completing 14 ADLs without falling. At time point one, there was a -.419 low negative correlation between clinician-assessed falls risk and self-assessed falls risk for older men. At time point two, there was a -.599 moderate negative relationship.
DISCUSSIONS The study findings suggest there is a relationship between older men’s ADL confidence compared to their risk of falls. Furthermore, older men were more aware of this relationship when completing complex ADLs compared to basic ADLs. With occupational therapists providing support more directed towards complex ADLs, or environmental and equipment changes to activities, this study suggests that specific activity and falls risk education should first be directed to completing basic ADLs. Further research is recommended into developing a New Zealand self-rated falls assessment as current self-rated assessment tools are not as gender specific or culturally appropriate for older men.
Keywords: New Zealand, older men, fall risk, assessment, activities of daily living (ADL)
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