Home modifications for older people with cognitive impairments: Mediation analysis of caregivers' information needs and perceptions of fall risks

Nursing Interventions to Empower Family Caregivers to Manage the Risk of Falling in Older Adults: A Scoping Review

Falls pose a significant risk to older adults, resulting in injuries and declining quality of life. The psychological impact, particularly the fear of falling, impairs their well-being. This pervasive fear affects daily activities, leading to self-imposed limitations and reduced engagement. This review aimed to identify nursing interventions to empower family caregivers to manage the risk of falling in older adults. A scoping review was developed following the JBI framework. We searched the CINAHL, MEDLINE, Nursing & Allied Health Collection, Cochrane Central Register of Controlled Trials, MedicLatina, and Cochrane Database of Systematic Reviews. The findings of this review revealed that out of 460 initially identified records, nine articles met the eligibility criteria and were retained for further in-depth analysis. These articles provided insights into nine distinct categories of nurse interventions: Therapeutic Relationships, Family Involvement, Personalized Care, Health Education, Multifactorial Falls Risk Assessment, Home Modifications, Referral, Transition Between Healthcare Services, and Health Care Consultants. The findings of this review have significant implications for clinical practice, particularly in emphasizing the crucial role of nurses in empowering family caregivers and older adults to manage the risk of falling at home. Healthcare professionals, policymakers, and researchers can benefit from this informative resource to develop strategies and guidelines.

Comparing Older Parents' and Adult Children's Fear of Falling and Perceptions of Age-Friendly Home Modification: An Integration of the Theories of Planned Behavior and Protection Motivation

This study investigated how a fear of falling affects perceptions and behavioral intentions toward age-friendly home modification (AFHM) in older parents and adult children by integrating the theory of planned behavior (TPB) to explain AFHM decision-making processes and the protection motivation theory to explain the impact of a fear of falling on AFHM intention. The target population comprised older parents (≥75 years old) and adult children (45-64 years old) in Busan, South Korea (N = 600). The participants completed a self-administered questionnaire in March 2022. Independent t-test and path model analyses were conducted to compare primary constructs between older parents and adult children and analyze the relationships among a fear of falling, TPB components, and AFHM intention. Results showed that both groups had positive attitudes toward AFHM. However, adult children showed significantly higher rates of having a fear of falling, lower perceived behavioral control, and higher AFHM intention than older parents. The proposed research models were partially supported in the older-parent group and fully supported in the adult-children group. Adult children play a critical role in AFHM, along with older adults who are directly involved in an aging society. AFHM-supporting programs, including monetary and human-force assistance, education, related public advertisements, and an active AFHM market, should be expanded.

Who uses technical aids in old age? Exploring the implementation of technology-based home modifications in Europe

Introduction

Home modifications and features, e.g., handrails or ramps for people using wheelchairs, should allow residents with functional limitations to maintain social participation, health, and wellbeing for aging in place. However, there is little evidence in relation to the individual characteristics shaping this implementation of technology-based home modifications. Current studies often focus on describing the distribution of certain implementations in households but do not provide information on factors predicting the implementation or detailed and multifaceted data on associations with characteristics of the older user. This article, therefore, examines the use of well-established technological aids and home modifications (e.g., ramps, handrails, automatic doors, bathroom or kitchen modifications, chair lifts, and alerting devices) in the households of older adults in Europe. We refer to Lawton's and Nahemow's concept of personal-environment fit and describe the use of technical aids across 18 countries, analyze associations with individual characteristics and social resources, and compare those associations and variance explanation between older adults in their third age ("young-old", 65-79 years) and older adults in their fourth age ("old-old", 80+).

Methods

Drawing on representative data from the Survey of Health, Ageing, and Retirement in Europe (SHARE), wave 6, a total of N = 38,553 older adults aged 65-105 years (M = 74.4 years, SD = 7.1; 55% women) were analyzed by performing hierarchical logistic regression analyses.

Results

Indicators of functioning explained the highest proportion of variance, followed by social resources, and variance explanation was higher for the fourth age than for the third age. In particular, older adults with physical limitations, a larger social network, and those who received care from a child outside the household were more likely to have home modifications installed.

Discussion

The study provides an overview of associations of diverse variables with assistive devices and modifications in the home and can serve as a starting point for public health activities concerning the heterogeneity of people aged 65 years and older.

What influences informal caregivers' risk perceptions and responses to home care safety of older adults with disabilities: A qualitative study

Objective

This study aimed to explore the factors that influence risk perceptions and responses by informal caregivers of older adults with disabilities.

Methods

A descriptive qualitative study was performed, and the socio-ecological framework was applied to interpret the complex influences on individual risk perceptions and responses. Semistructured interviews were conducted with 16 informal caregivers of older adults with disabilities. The interviews were transcribed verbatim and analyzed using content analysis.

Results

The four levels of the socio-ecological framework successfully allowed for the analysis of influences on the risk perceptions and responses of informal caregivers as follows: at the individual level: previous experiences, personality characteristics, health literacy, and care burden; at the familial level: economic status, emotional connection, informational and decisional support; at the community level: health service accessibility and neighbor communication; and at the social level: responsibility-driven culture, media advocacy, and aging policies.

Conclusions

The establishment of risk perceptions and coping behaviors by informal caregivers was affected by many factors. Using the framework to interpret our findings provided insight into the influence of these varying factors. Comprehensive, realistic, and achievable strategies are needed for improving the risk perceptions of informal caregivers in home care by addressing personal, familial, and social environmental factors.