DEVELOPING AN EDUCATIONAL PROGRAM FOR STAFF IN ASSISTED LIVING AND PERSONAL CARE HOMES ON RECOGNIZING FALL RISK AND FALLS PREVENTION

摘要

Assisted living facilities (ALFs) and personal care homes (PCHs) are becoming more common along the spectrum of living arrangements for older adults. These bridge the gap for those who can no longer live independently, but who do not require nursing home care. Federal regulations are established for nursing homes, however very few federal regulations govern ALFs/PCHs. These are primarily regulated by each state, and currently, there are few regulations regarding the training of the staff who primarily provide care to the residents. Falls are a common cause of both morbidity and mortality in older adults. The purpose of this study was to develop an educational program to be provided to non-professional staff in ALFs/PCHs to enhance their ability to recognize increased fall risk in residents, as well as develop an awareness of fall prevention techniques. Because there is very little in the literature regarding training staff in this setting, multiple steps were taken in the development of this program. The topics to be covered in the program were determined by a thorough review of the literature related to falls in older adults, the ALF/PCH setting, educational theory, and training of similar staff in the nursing home setting. Observations were completed on all three shifts (day, evening and night-time) at two local PCHs to identify problems that may be specific to this setting. To further refine content, a survey utilizing the Delphi Method was done, with geriatricians, occupational therapists, physical therapists and registered nurses, all of whom had experience in this setting and expertise in older adults. A pre-test and post-test was developed, utilizing cognitive interviewing to refine the test questions. The educational program was then presented at six local ALFs/PCHs. Based on pre-test/post-test scores, a statistically significant gain in knowledge occurred through the program. This statistically significant change from baseline understanding of fall risk/fall prevention was sustained over periods ranging from six weeks to three months, based on repeat testing. Based on feedback provided by participants, they generally found this program to be helpful useful in their day to day interactions with the residents.