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

• Verfasst von: Ellmers, Toby [VerfasserIn]
• Verfasst von: Freiberger, Ellen [VerfasserIn]
• Verfasst von: Hauer, Klaus [VerfasserIn]
• Verfasst von: Hogan, David B [VerfasserIn]
• Verfasst von: McGarrigle, Lisa [VerfasserIn]
• Verfasst von: Lim, Mae Ling [VerfasserIn]
• Verfasst von: Todd, Chris [VerfasserIn]
• Verfasst von: Martin, Finbarr [VerfasserIn]
• Verfasst von: Delbaere, Kim [VerfasserIn]
• Titel: Why should clinical practitioners ask about their patients’ concerns about falling?
• Verf.angabe: Toby Jack Ellmers, Ellen Freiberger, Klaus Hauer, David B Hogan, Lisa McGarrigle, Mae Ling Lim, Chris Todd, Finbarr Martin, Kim Delbaere, The World Falls Guidelines Working Group on Concerns About Falling
• E-Jahr: 2023
• Jahr: 23 April 2023
• Umfang: 4 S.
• Fussnoten: Gesehen am 23.06.2023
• Titel Quelle: Enthalten in: Age & ageing
• Ort Quelle: Oxford : Oxford Univ. Press, 1972
• Jahr Quelle: 2023
• Band/Heft Quelle: 52(2023), 4 vom: Apr., Artikel-ID afad057, Seite 1-4
• ISSN Quelle: 1468-2834
• DOI: doi:10.1093/ageing/afad057
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1850911533

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.