Lessons learned from a multidisciplinary fall-prevention programme: The occupational-therapy element

Abstract

Objective: To gain insight into the contribution of the occupational-therapy part of a multidisciplinary fall prevention programme towards the reduction of falls and functional decline. Design: A descriptive and exploratory study. Methods: Data were collected in the context of a randomized controlled trial that found no effect of a multidisciplinary fall prevention programme. The study population comprised 166 participants, two occupational therapists (OTs), and one official from each of the five participating municipalities. Data were collected on the recommendations arising from the OT part of the programme, the extent to which those recommendations were implemented and what OTs did to stimulate implementation of behaviour change. Results: The occupational-therapy programme resulted in 457 recommendations; 65% of the recommendations regarding services and assistive devices were implemented. It took on average six months to implement recommended home modifications. Advice on behaviour change predominantly comprised recommendations to reduce risky behaviour. Conclusion: To improve the occupational-therapy programme more rapid implementation of recommendations is suggested. Second, participants should be supported to achieve recommended changes. Furthermore, occupational therapists should use theory-based techniques to stimulate behaviour change and use follow-up visits to promote maintenance of the desired behaviour.

Key words::

• Elderly
• fall prevention
• home modifications

Acknowledgements

The authors would like to thank the Faculty of Health, Medicine and Life Sciences of Maastricht University, the Care and Public Health Research Institute, and the Netherlands Organisation for Health Research and Development (ZonMw), Committee on Health Care Efficiency Research Programme, grant 945-02-053, for funding this study. In addition, we would like to thank Charlotte H. Mom-Schuurman for her contribution (CIZ Centre healthcare indications in the Netherlands).