Ellen Vlaeyen

Characteristics and Effectiveness of Fall Prevention Programs in Nursing Homes: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

To determine characteristics and effectiveness of prevention programs on fall‐related outcomes in a defined setting.

Camera-Based fall detection on real world data

Several new algorithms for camera-based fall detection have been proposed in the literature recently, with the aim to monitor older people at home so nurses or family members can be warned in case of a fall incident. However, these algorithms are evaluated almost exclusively on data captured in controlled environments, under optimal conditions (simple scenes, perfect illumination and setup of cameras), and with falls simulated by actors. In contrast, we collected a dataset based on real life data, recorded at the place of residence of four older persons over several months. We showed that this poses a significantly harder challenge than the datasets used earlier. The image quality is typically low. Falls are rare and vary a lot both in speed and nature. We investigated the variation in environment parameters and context during the fall incidents. We found that various complicating factors, such as moving furniture or the use of walking aids, are very common yet almost unaddressed in the literature. Under such circumstances and given the large variability of the data in combination with the limited number of examples available to train the system, we posit that simple yet robust methods incorporating, where available, domain knowledge (e.g. the fact that the background is static or that a fall usually involves a downward motion) seem to be most promising. Based on these observations, we propose a new fall detection system. It is based on background subtraction and simple measures extracted from the dominant foreground object such as aspect ratio, fall angle and head speed. We discuss the results obtained, with special emphasis on particular difficulties encountered under real world circumstances.

Camera Based Fall Detection Using Multiple Features Validated with Real Life Video

More than thirty percent of persons over 65 years fall at least once a year and are often not able to get up again unaided. The lack of timely aid can lead to severe complications such as dehydration, pressure ulcers and death. A camera based fall detection system can provide a solution. In this paper we compare four different fall features extracted from the dominant foreground object, as well as various combinations thereof. All tests are executed using real life data, which has been recorded at the home of 4 elderly, containing 24 falls. Experiments indicate that a fall detector based on a combination of aspect ratio, head speed and fall angle is preferred. The preliminary detector, which still has a substantial false alarm rate with a precision of 0.257(±0.073) and a promising recall of 0.896(±0.194), gives insights for further improvement as is discussed.

Falling and fall risk factors in adults with haemophilia: an exploratory study

Falls are a particular risk in persons with haemophilia (PWH) because of damaged joints, high risk of bleeding, possible impact on the musculoskeletal system and functioning and costs associated with treatment for these fall‐related injuries. In addition, fall risk increases with age and PWH are increasingly entering the over 65 age group. The aim of this study was to determine the occurrence of falls during the past year and to explore which fall risk factors are present in community‐dwelling PWH. Dutch speaking community‐dwelling adults were included from the age of 40 years with severe or moderate haemophilia A or B, independent in their mobility and registered at the University Hospitals Leuven. They were asked to come to the haemophilia centre; otherwise a telephone survey was conducted. Demographic and social variables, medical variables, fall evaluation and clinical variables were queried. From the 89 PWH, 74 (83.1%) participated in the study. Twenty‐four (32.4%) fell in the past year, and 10 of them (41.7%) more than once with an average of four falls. Living conditions, physical activity, avoidance of winter sports due to fear of falling, orthopaedic status, urinary incontinence and mobility impairments are potential fall risk factors in adult PWH. This exploratory study indicates that PWH are attentive to falling since they are at higher risk for falls and because of the serious consequences it might have. Screening and fall prevention should be stimulated in the daily practice of haemophilia care.

Implementation of fall prevention in residential care facilities: A systematic review of barriers and facilitators

OBJECTIVES To identify the barriers and facilitators for fall prevention implementation in residential care facilities. DESIGN Systematic review. Review registration number on PROSPERO: CRD42013004655. DATA SOURCES Two independent reviewers systematically searched five databases (i.e. MEDLINE, EMBASE, CINAHL, PsycINFO, and Web of Science) and the reference lists of relevant articles. REVIEW METHODS This systematic review was conducted in line with the Center for Reviews and Dissemination Handbook and reported according to the PRISMA guideline. Only original research focusing on determinants of fall prevention implementation in residential care facilities was included. We used the Mixed Method Appraisal Tool for quality appraisal. Thematic analysis was performed for qualitative data; quantitative data were analyzed descriptively. To synthesize the results, we used the framework of Grol and colleagues that describes six healthcare levels wherein implementation barriers and facilitators can be identified. RESULTS We found eight relevant studies, identifying 44 determinants that influence implementation. Of these, 17 were facilitators and 27 were barriers. Results indicated that the social and organizational levels have the greatest number of influencing factors (9 and 14, respectively), whereas resident and economical/political levels have the least (3 and 4, respectively). The most cited facilitators were good communication and facility equipment availability, while staff feeling overwhelmed, helpless, frustrated and concerned about their ability to control fall management, staffing issues, limited knowledge and skills (i.e., general clinical skill deficiencies, poor fall management skills or lack of computer skills); and poor communication were the most cited barriers. CONCLUSION Successful implementation of fall prevention depends on many factors across different healthcare levels. The focus of implementation interventions, however, should be on modifiable barriers and facilitators such as communication, knowledge, and skills. Effective fall prevention must consist of multifactorial interventions that target each residents fall risk profile, and should be tailored to overcome context-specific barriers and put into action the identified facilitators.

P-339: The use of fall prevention strategies in home care: a survey in Flanders (Belgium)

a Center of Expertise for Fall and Fracture Prevention Flanders, Belgium b Department of Public Health and Primary Care, Health Services and Nursing Research, KU Leuven, Leuven, Belgium c Division of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium d Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium e Unit for Osteoporosis and Metabolic Bone Disease, Department of Rheumatology and Endocrinology, Ghent University Hospital, Ghent, Belgium f Domus Medica, Society of Flemish General Practitioners, Antwerp, Belgium