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Predictors of Bath Grab-Bar Use among Community-Living Older Adults

Published online by Cambridge University Press:  31 March 2010

Nancy Edwards ,
Donna Lockett ,
Faranak Aminzadeh  and
Rama C. Nair
Nancy Edwards
Affiliation:
Community Health Research Unit, Ottawa, Ontario School of Nursing, University of Ottawa, Ottawa, Ontario
Donna Lockett*
Affiliation:
Community Health Research Unit, Ottawa, Ontario
Faranak Aminzadeh
Affiliation:
Community Health Research Unit, Ottawa, Ontario Regional Geriatric Assessment Program of Ottawa-Carleton, Ottawa, Ontario
Rama C. Nair
Affiliation:
Dept of Epidemiology & Community Medicine, University of Ottawa, Ottawa, Ontario
*
Requests for offprints should be sent to: / Les demandes de tirés-a-part doivent être adressé e s à: Donna Lockett, Ph.D., Community Health Research Unit, University of Ottawa, 451 Smyth Rd, Ottawa, ONK1H 8M5. (dlockett@zeus.med.uottawa.ca)
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Abstract

Bathrooms are a common location for falls among older adults. Bath grab bars can assist in promoting safe bath transfers. The aim of this study was to identify predictors of bathroom safety-device use among community-living seniors. A two-stage sampling strategy was used to select, first, a random sample of non-universal apartment buildings and a matched sample of universal buildings, from among non-profit apartment buildings in two Canadian regions; and second, a random sample of participants within each building. A total of 550 seniors participated in face-to-face interviews in their apartments. Participants within each building type presented with similar profiles. A logistic regression was used to identify predictors of grab-bar use among participants who had grab bars and entered the bathtub on a regular basis (n = 478). Significant predictors, in order of odds ratios, were bathing difficulties, ease of grab-bar use, living in buildings with policies supporting universal access to grab bars, having a history of falls, and reporting few psychosocial consequences of grab-bar use. Findings of this study emphasize the importance of promoting access as a key strategy for increasing use and have important implications for policy planning and falls-prevention initiatives.

Résumé

Les salles de bains sont des endroits où les adultes plus âgés font souvent des chutes. Les barres d'appui pour baignoire peuvent toutefois contribuer à promouvoir une façon sécuritaire d'entrer dans la baignoire et d'en sortir. La présente étude avait pour but de cerner les prédicteurs de l'utilisation des accessoires de sécurité dans les salles de bains chez les personnes âgées vivant dans la communauté. Dans le cadre de cette étude, 550 personnes âgées habitant dans des immeubles d'habitation sans but lucratif, dans deux régions canadiennes, ont participé à des entrevues de face à face dans leur appartement. Une évaluation de la salle de bains avait également lieu au cours de cette entrevue. Une régression logistique a servi à cerner les prédicteurs de l'utilisation des barres d'appui par les participants qui en possédaient et qui utilisaient leur baignoire de façon régulière (n = 478). Les prédicteurs significatifs étaient les suivants : antécédents de chutes, difficultés au moment du bain, telles que l'ont indiqué les participants, facilité d'utilisation des barres d'appui, appartements situés dans des édifices dont les politiques soutiennent l'accès universel aux barres d'appui, et l'indication du peu de conséquences, sur le plan psychosocial, de l'utilisation des barres d'appui par les participants. Les résultats de cette recherche ont des répercussions importantes sur la planification de politiques et la mise en place d'initiatives visant la prévention des chutes.

Keywords

agingfall preventionassistive-device usegrab barssafe bathingseniorsuniversal accessvieillissementprévention des chutesaccessoires de sécuritébarres d'appuifaçon sécuritaire d'entrer dans la baignoire et d'en sortirpersonnes âgéesaccès universel
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 22 , Issue 2 , Summer/L'été 2003 , pp. 217 - 227
Copyright
Copyright © Canadian Association on Gerontology 2003

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References

Connell, RB, Wolfe, SL, for the Atlanta FISCIT Group. Environmental and behavioral circumstances associated with falls at home among healthy elderly individuals. Arch Phys Med Rehabil 1997;78:179–186.Google Scholar
Northridge, ME, Nevitt, MC, Kelsey, JL. Non-syncopal falls in the elderly in relation to home environments. Osteoporos Int 1996;6:249–255.Google Scholar
Sattin, RW, Rodriguez, JG, De Vito, CA, Wingo, PA, and the study to assess falls among the elderly (SAFE) Group. Home environmental hazards and the risk of fall injury events among community-dwelling older persons. J Am Geriatr Soc 1998;46:669–676.Google Scholar
Tinetti, ME, Doucette, J, Claus, E, Marottoli, R. Risk factors for serious injury during falls by older persons in the community. J Am Geriatr Soc 1995;43(11):1214–1221.Google Scholar
Devito, CA, Lambert, DA, Sattin, RW, Bacchelli, S, Ros, A, Rodriguez, JG. Fall injuries among the elderly: community-based surveillance. J Am Geriatr Soc 1988;36(11):1029–1035.Google Scholar
Iliffe, S, Haines, A, Gallivan, S, Booroff, A, Goldenberg, E, Morgan, P. Assessment of elderly people in general practice. 2 Functional abilities and medical problems. Br J Gen Pract 1991;41:13–15.Google ScholarPubMed
Gill, TM, Williams, CS, Tinetti, ME. Assessing risk for the onset of functional dependence among older adults: the role of physical performance. J Am Geriatr Soc 1995;43:603–609.CrossRefGoogle ScholarPubMed
Lockett, D, Aminzadeh, F, Edwards, N, Nair, R, Robitaille, Y. Patterns of bathing and prevalence of bathroom hazards among community dwelling seniors: environmental hazards and fall prevention—A multidisciplinary challenge for the next millenium. Pre-conference workshop, Canadian Association on Gerontology 28th Annual Scientific and Educational Meeting; 1999 Oct; Ottawa, ON.Google Scholar
Gooptu, C, Mulley, GP. Survey of elderly people who get stuck in the bath. Br Med J 1994;308:762.Google Scholar
Lundgren-Lindquist, B, Grimby, G, Landah, S. Functional studies in 79-year-olds. Scand J Rehabil Med 1983;15:109–115.Google Scholar
Zimmer, A, Chappell, NL. Mobility restrictions and the use of devices among seniors. J Aging Health 1994;6(2):185–208.CrossRefGoogle Scholar
Axtell, LA, Yasuda, YL. Assistive devices and home modifications in geriatric rehabilitation. Clin Geriatr Med 1993;9(4):803–821.CrossRefGoogle ScholarPubMed
Tideiksaar, R. Falling in old age: prevention and management. 2nd ed. New York: Springer; 1997.Google Scholar
Aminzadeh, F, Edwards, N. Exploring seniors views on the use of assistive devices in fall prevention. Public Health Nurs 1998;15(4):297–304.Google Scholar
Canada Mortgage and Housing Corporation (CMHC). Focus groups to examine barrier-free and adaptable housing design. Ottawa, ON: Hichling Corporation RBO Architecture; 1994.Google Scholar
Gilderbloom, JI, Markham, JP. Housing modification needs of the disabled elderly: what really matters? Environ Behav 1996;28(4):512–535.CrossRefGoogle Scholar
Mann, WC, Karuza, J, Hurren, MD, Tomita, M. Needs of home-based older persons for assistive devices. Technology and Disability 1993;2(1):1–11.Google Scholar
Plautz, B, Beck, D, Selmar, C, Radersky, M. Modifying the environment: a community-based injury-reduction program for elderly residents. Am J Prev Med 1996;12(4):33–38.CrossRefGoogle ScholarPubMed
Trickey, F, Maltais, D, Gosselin, MA, Robitaille, Y. Adapting older persons homes to promote independence. Phys Occup Ther Geriatr 1993;12(1):1–14.CrossRefGoogle Scholar
Edwards, NI, Jones, DA. Ownership and use of assistive devices amongst older people in the community. Age Ageing 1998;27:463–468.Google Scholar
George, L, Binns, VE, Clayden, AD, Mulley, GP. Aids and adaptations for the elderly at home: underprovided, underused, and undermaintained. Br Med J 1988;296:1365–1366.CrossRefGoogle ScholarPubMed
Gill, TM, Robinson, JT, Williams, CS, Tinetti, ME. Mismatches between the home environment and physical capabilities among community-living older persons. J Am Geriatr Soc 1999a;47:88–92.CrossRefGoogle ScholarPubMed
Gill, TM, Williams, CS, Robinson, JT, Tinetti, ME. A population-based study of environmental hazards in the homes of older persons. Am J Public Health 1999b;89(4):553–556.CrossRefGoogle ScholarPubMed
Gitlin, LN. Why older people accept or reject assistive technology. Generations 1995b;19(1):41–46.Google Scholar
Gitlin, LN, Schemm, RL, Landsberg, L, Burgh, D. Factors predicting assistive device use in the home by older people following rehabilitation. J Aging Health 1996;8:554–575.CrossRefGoogle ScholarPubMed
Norburn, JE, Bernard, SL, Konard, TR, Woomert, A, DeFriese, GH, Kalsbeek, WD. Self-care and assistance from others in coping with functional status limitations among a national sample of older adults. J Gerontol Soc Sci 1995;50(2):S101–S109.Google Scholar
Sonn, U, Grimby, G. Assistive devices in an elderly population studied at 70 and 76 years of age. Disabil Rehabil 1994;16(2):85–92.Google Scholar
Mann, WC, Granger, C, Hurren, K, Tomita, M, Charvat, B. An analysis of problems with canes encountered by elderly persons. Phys Occup Ther Geriatr 1995;13:25–48.Google Scholar
Gitlin, LN, Levine, R, Geiger, C. Adaptive device use by older adults with mixed disabilities. Arch Phys Med Rehabil 1993;74:149–152.Google Scholar
Edwards, N. Population strategies for fall prevention. Paper presented at the Ontario Ministry of Health, Public Health Branch, Eastern Ontario Health Units conference, Population Health: From Theory to Action; 1994; Kingston, ON.Google Scholar
Phillips, B, Zhao, H. Predictors of assistive technology abandonment. Assist Technol 1993;(1):36–45.CrossRefGoogle ScholarPubMed
Hsieh, F. Sample size tables for logistic regression. Stat Med 1989;8:795–802.Google Scholar
Cohen, J. Statistical power analysis for the behavioural sciences. Rev. ed. Toronto Academic; 1977.Google Scholar
Zimmer, A, Segall, A. CARNET needs assessment survey methodology [Technical report, no. 1]. Manitoba: Center on Aging, University of Manitoba; 1992.Google Scholar
Cumming, RG, Kelsey, JL, Nevitt, MC. Methodological issues in the study of frequent and recurrent health problems: falls in the elderly. Ann Epidemiol 1990;1:49–56.Google Scholar
Cummings, SR, Nevitt, MC, Kidd, S. Forgetting falls: the limited accuracy of recall of falls in the elderly. J Am Geriatr Soc 1988;36(7):613–616.Google Scholar
Nevitt, MC. Ascertainment and description of falls among older persons by self-report. In: Weindruch, R, Hadley, EC, Ory, MG, Badinelli, J, editors. Reducing frailty and falls in older persons. Springfield MA: Charles C. Thomas; 1991. p. 476–495.Google Scholar
U.S. National Center for Health Statistics, Fitti, JE, Kovar, MG. The supplement on aging to the 1984 National Health Interview Survey [Vital and health statistics, series 1, no. 21]. Hyattsville, MD: U.S. Department of Health and Human Services.Google Scholar
Edwards, N LeBlond, D, Goodick, S, Roberge, G, Fortin, D, Asselin, G. Intervention strategies to prevent falls among seniors residing in apartment buildings. Paper presented at the International Community Health Nursing Research Conference; 1993; Edmonton, AB.Google Scholar
SPSS for Windows, Version 6.1.4 [Computer Software]. (1995). Chicago, IL: SPSS.Google Scholar
Graafmans, WC, Ooms, ME, Hofstee, MA, Bezemer, PD, Bouter, LM, Lips, P. Falls in the elderly: a prospective study of risk factors and risk profiles. Am J Epidemiol 1996;143(11):1129–1136.Google Scholar
Nevitt, MC, Cummings, SR, Hudes, ES. Risk factors forinjurious falls: a prospective study. J Gerontol 1991;46(5):M164–M170.Google Scholar
O'Loughlin, J, Robitaille, Y, Bovin, JF, Suissa, S. Incidence and risk factors for falls and injurious falls among the community living elderly. Am J Epidemiol 1993;137:342–354.CrossRefGoogle Scholar
Ashe, C, Gallagher, E, Coyte, P. The cost of falls among older Canadians. Victoria, BC: University of Victoria; 1995.Google Scholar
Cooper, BA, Stewart, D. The effect of a transfer device in the homes of elderly women. Phys Occup Ther Geriatr 1997;15(2):61–77.Google Scholar
Edwards, N, Céré, M, Leblond, D. A community-based intervention to prevent falls among seniors. Fam Community Health 1993b;15(4):57–65.Google Scholar
Ploeg, J, Black, ME, Hutchison, BG, Walter, SD, Scott, F, Chambers, LW. Personal, home and community safety promotion with community-dwelling elderly persons: response to a public health nurse intervention. Can J Public Health 1994;85(3):188–191.Google Scholar
Tinetti, ME, Baker, DI, McAvay, G, Claus, EB, Garrett, P, Gottschalk, M, Koch, ML, Trainor, K, Horwitz, RI. A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N Engl J Med 1994a;331(13):821–827.CrossRefGoogle ScholarPubMed