Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-12T18:27:30.022Z Has data issue: false hasContentIssue false
  • English
  • Français

Older adults, falls and technologies for independent living: a life space approach

Published online by Cambridge University Press:  16 May 2011

CATHY BAILEY ,
TIMOTHY G. FORAN ,
CLIODHNA NI SCANAILL  and
BEN DROMEY
CATHY BAILEY*
Affiliation:
Technology Research for Independent Living (TRIL), National University Ireland, Galway, Ireland.
TIMOTHY G. FORAN
Affiliation:
Department of Medical Physics and Bioengineering, TRIL, St James's Hospital, Dublin, Ireland.
CLIODHNA NI SCANAILL
Affiliation:
TRIL, Digital Health Group, Intel, Dublin, Ireland.
BEN DROMEY
Affiliation:
School of Computer Science and Informatics, University College Dublin, Ireland.
*
Address for correspondence: Cathy Bailey, Ethnographic Research Unit, Irish Centre for Social Gerontology, National University of Ireland, Galway City, Ireland. E-mail: cathy.bailey@nuigalway.ie
Get access Rights & Permissions [Opens in a new window]

Abstract

This paper draws attention to the need for further understanding of the fine details of routine and taken-for-granted daily activities and mobility. It argues that such understanding is critical if technologies designed to mitigate the negative impacts of falls and fear-of-falling are to provide unobtrusive support for independent living. The reported research was part of a large, multidisciplinary, multi-site research programme into responses to population ageing in Ireland, Technologies for Independent Living (TRIL). A small, exploratory, qualitative life-space diary study was conducted. Working with eight community-dwelling older adults with different experiences of falls or of fear-of-falls, data were collected through weekly life-space diaries, daily-activity logs, two-dimensional house plans and a pedometer. For some participants, self-recording of their daily activities and movements revealed routine, potentially risky behaviour about which they had been unaware, which may have implications for falls-prevention advice. The findings are presented and discussed around four key themes: ‘being pragmatic’, ‘not just a faller’, ‘heightened awareness and blind spots’ and ‘working with technology’. The findings suggest a need to think creatively about how technological and other solutions best fit with people's everyday challenges and needs and of critical importance, that their installation does not reduce an older adult to ‘just a faller’ or a person with a fear-of-falls.

Keywords

fallsindependent livinglife spaceolder adultassistive technology
Type
Articles
Information
Ageing & Society , Volume 31 , Issue 5: Wellbeing, Independence and Mobility , July 2011 , pp. 829 - 848
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bailey, C., White, C. and Pain, R. 1999. Evaluating qualitative research: dealing with the tension between science and creativity. Area, 31, 4, 169–78.CrossRefGoogle Scholar
Ballinger, C. and Payne, S. 2002. The construction of the risk of falling among and by older people. Ageing & Society, 22, 3, 305–24.CrossRefGoogle Scholar
Berlin Hallrup, L., Albertsson, D., Bengtsson Tops, A., Dahlberg, K. and Grahn, B. 2009. Elderly women's experiences of living with fall risk in a fragile body: a reflective lifeworld approach. Health and Social Care in the Community, 17, 4, 379–87.CrossRefGoogle Scholar
Blythe, M. A., Monk, A. F. and Doughty, K. 2005. Socially dependable design: the challenge of ageing populations for HCI. Interacting with Computers, 17, 6, 672–89.CrossRefGoogle Scholar
Camarinha-Matos, L. M. and Afsarmanesh, H. A. 2004. TeleCARE: collaborative virtual elderly support communities. In Camarinha-Matos, L. M. (ed.), Proceedings of the 1st International Workshop on Tele-Care and Collaborative Virtual Communities in Elderly Care, Telecare 2004. In conjunction with ICEIS 2004 Porto, Portugal, April 2004. INSTICC Press, Setubal, Portugal.Google Scholar
Central Statistic Office 2007. Ageing in Ireland. Stationery Office, Dublin, Ireland.Google Scholar
Chang, J. T., Morton, S. C., Rubenstein, L. Z., Mojica, W. A., Maglione, M., Suttorp, M. J., Roth, E. A. and Shekelle, P. G. 2004. Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomized clinical trials. British Medical Journal, 328, 7441, 680–3.CrossRefGoogle Scholar
Cowan, D. and Turner-Smith, A. 1999. The role of assistive technology in alternative models of care for older people. In With Respect to Old Age-Research, Vol. (2), pp. 325–346.Google Scholar
Cumming, R. G., Salkeld, G., Thomas, M. and Szonyi, G. 2000. Prospective study of the impact of fear-of-falling on activities of daily living, SF-36 scores, and nursing home admission. Journal of Gerontology: Medical Sciences, 55, 5, M299–305.Google ScholarPubMed
Dewsbury, G., Rouncefield, M., Sommerville, M., Onditi, V. and Bagnall, P. 2007. Designing technology with older people. Universal Access in the Information Society, 6, 2, 207–17.CrossRefGoogle Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. 1975. Mini-mental state: a practical guide for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle Scholar
Gannon, B., O'Shea, E. and Hudson, E. 2008. Economic cost of falls and fractures among older people in Ireland. Irish Medical Journal, 101, 6, 170–3.Google Scholar
Gillespie, L. D., Robertson, M. C., Gillespie, W. J., Lamb, S. E., Gates, S., Cumming, R. G. and Rowe, B. H. 2003. Interventions for preventing falls in elderly people. Cochrane Database of Systematic Reviews, Issue 4: CD000340. Reissued as Cochrane Database of Systematic Reviews 2009, Issue 2: CD007146. doi: 10.1002/14651858.CD007146.pub2. Available online at http://onlinelibrary.wiley.com/o/cochrane/clsysrev/articles/CD007146/frame.html [Accessed 24 October 2010].CrossRefGoogle Scholar
Heywood, F. 2004. Money Well Spent: The Effectiveness and Value of Housing Adaptations. Policy Press, Bristol, UK.Google Scholar
Horton, K. and Arber, S. 2004. Gender and the negotiation between older people and their carers in the prevention of falls. Ageing & Society, 24, 1, 75–94.CrossRefGoogle Scholar
Kerse, N., Flickerm, L., Pfaff, J. J., Draper, B., Lautenschlager, N., Sim, M., Snowdon, J. and Almeida, O. 2008. Falls, depression and antidepressants in later life: a large primary care appraisal. PloS One, 3, 6, e2423. doi:10.1371/journal.pone.0002423.CrossRefGoogle ScholarPubMed
Kingston, P. 2000. Falls in later life: status passage and preferred identities as a new orientation. Health, 4, 2, 216–33.CrossRefGoogle Scholar
Lachman, M. E., Howland, J., Tennstedt, S., Jette, A., Assmann, S. and Peterson, E. W. 1998. Fear of falling and activity restriction: the survey of activities and fear of falling in the elderly (SAFE). Journals of Gerontology: Psychological Sciences, 53, 1, P43–50.CrossRefGoogle Scholar
Lawton, M. and Nahemov, L. 1973. Ecology and the ageing process. In Eisdorfer, V. and Lawton, M. P. (eds), The Psychology of Adult Development and Ageing. American Psychological Association, Washington DC, 619–74.CrossRefGoogle Scholar
Lebbon, C., Rouncefield, M. and Viller, S. 2003. Observation for innovation. In Clarkson, J., Keates, S., Coleman, R. and Lebbon, C. (eds), Inclusive Design: Design for the Whole Population. Helen Hamlyn Research Centre, Royal College of Art, London, 186–93.Google Scholar
Lewin, K. 1951. Organisation and Pathology of Thought: Selected Sources. Columbia University Press, New York.Google Scholar
Mahoney, D. F., Tallow, B. J. and Jones, R. N. 2003. Effects of an automated telephone support system on caregiver burden and anxiety: findings from the REACH for TLC intervention study. The Gerontologist, 43, 4, 556–67.CrossRefGoogle ScholarPubMed
Masud, T. and Morris, R. O. 2001. Epidemiology of falls. Age and Ageing, 30, supplement 4, 3–7.CrossRefGoogle ScholarPubMed
McCreadie, C. and Tinker, A. 2005. The acceptability of assistive technology to older people. Ageing & Society, 25, 1, 91–110.CrossRefGoogle Scholar
McKee, K. J. 1998. The body drop: a framework for understanding recovery from falls in older people. Generations Review (British Society of Gerontology), 8, 1, 11–4.Google Scholar
Milligan, C., Bingley, A. and Gatrell, T. 2005. Healing and feeling: the place of emotions for older people. In Davidson, J., Smith, M. and Bondi, L. (eds), Emotional Geographies. Ashgate, Aldershot, UK, 49–62.Google Scholar
Miskelly, F. G. 2001. Assistive technology in elderly care. Age and Ageing, 30, 6, 455–8.CrossRefGoogle ScholarPubMed
Monk, T., Reynolds, C., Machen, M. A. and Kupfer, D. 1992. Daily social rhythms in the elderly and their relationship to objectively recorded sleep. Sleep, 15, 4, 322–9.CrossRefGoogle Scholar
Morse, J. M. 1994. ‘Emerging from the data’: the cognitive processes of analysis in qualitative inquiry. In Morse, J. M. (ed.), Critical Issues in Qualitative Research Methods. Sage, Thousand Oaks, California, 23–43.Google Scholar
Peace, S., Kellaher, L. and Holland, C. 2006. Environment and Identity in Later Life. Open University Press, Maidenhead, UK.Google Scholar
Peel, C., Sawyer Baker, P., Roth, D., Brown, C., Bodne, E. and Allman, R. 2005. Assessing mobility in older adults: the UAB study of aging life-space assessment. Physical Therapy, 85, 10, 1008–19.CrossRefGoogle ScholarPubMed
Robertson, M. C., Devlin, N., Gardner, M. M., Devlin, N., McGee, R. and Campbell, A. J. 2001. Effectiveness and economic evaluation of a nurse delivered home exercise programme to prevent falls. 1: Randomised controlled trial. British Medical Journal, 322, 7288, 697–701.CrossRefGoogle ScholarPubMed
Rowles, G. 1978. Prisoners of Space? Exploring the Geographic Experience of Older People. Westview, Boulder, Colorado.Google Scholar
Scheffer, A. C., Schuurmans, M. J., van Dijk, N., van der Hooft,T. ,T. and de Rooij, S. E. 2008. Fear-of-falling: measurement strategy, prevalence, risk factors and consequences among older persons. Age and Ageing, 37, 1, 19–24.CrossRefGoogle ScholarPubMed
Stevens, M., Holman, C. D. J., Bennett, N. and de Klerk, N. 2001. Preventing falls in older people: outcome evaluation of a randomized controlled trial. Journal of the American Geriatrics Society, 49, 11, 1448–55.CrossRefGoogle ScholarPubMed
Thorne, S. 2000. Data analysis in qualitative research. Evidence Based Nursing, 3, 3, 68–70. doi:10.1136/ebn.3.3.68.CrossRefGoogle Scholar
Tinker, A., McCreadie, C., Stuchbury, R., Turner-Smith, A., Cowan, D. and Bialokoz, A. 2004. AT Home with AT. Introducing Assistive Technology into the Existing Homes of Older People: Feasibility, Acceptability, Costs and Outcomes. Institute of Gerontology, King's College London, UK. Available online at http://www.kcl.ac.uk/content/1/c6/02/96/45/KCLandReading2004IntroducingAssistiveTechnologyREKI.pdf [Accessed 24 October 2010].Google Scholar
Ward-Griffin, C., Hobson, S., Melles, P., Kloseck, M., Vandervoot, A. and Crilly, R. 2008. Falls and fear-of-falling among community-dwelling seniors: the dynamic tension between exercising precaution and striving for independence. Canadian Journal on Ageing, 23, 4, 307–18.CrossRefGoogle Scholar
World Health Organisation (WHO) 2007. WHO Global Report on Falls Prevention in Older Age. WHO, Geneva. Available online at http://www.who.int/ageing/publications/Falls_prevention7March.pdf [Accessed 24 October 2010].Google Scholar
Yardley, L. 2004. Fear-of-falling: links between imbalance and anxiety. Reviews in Clinical Gerontology, 13, 1, 1–7.Google Scholar
Yardley, L., Donovan-Hal, M., Francis, K. and Todd, C. 2006. Older people's views of advice about falls prevention: a qualitative study. Health Education Research, 21, 4, 508–17.CrossRefGoogle ScholarPubMed
Yardley, L. and Smith, H. 2002. A prospective study of the relationship between feared consequences of falling and avoidance of activity in community-living older people. The Gerontologist, 42, 1, 17–23.CrossRefGoogle ScholarPubMed