From the Guidelines
Implementing nurse-led physical activity interventions is a highly effective evidence-based nursing approach to prevent falls in people with dementia. This approach involves nurses delivering physical activity interventions in nursing homes, which can help maintain and promote physical functioning and activities of daily living in people with dementia 1. The interventions can include a range of physical activities, such as walking, exercise, and mobility training, which can be tailored to the individual needs and abilities of people with dementia.
Some key considerations for implementing nurse-led physical activity interventions include:
- Ensuring that the interventions are tailored to the individual needs and abilities of people with dementia
- Providing ongoing support and supervision to people with dementia as they participate in physical activity interventions
- Encouraging people with dementia to participate in physical activities that they enjoy, which can help to increase motivation and adherence
- Monitoring the effects of physical activity interventions on physical functioning and activities of daily living in people with dementia, and making adjustments as needed.
The evidence suggests that physical activity interventions can improve physical outcomes for people with dementia living in nursing homes 1. Additionally, nurses are in a key position to offer and implement physical activity interventions for people with dementia, as they are the primary carers in nursing homes 1.
Overall, nurse-led physical activity interventions are a promising approach to preventing falls in people with dementia, and can be implemented in a range of settings, including nursing homes. By tailoring interventions to the individual needs and abilities of people with dementia, and providing ongoing support and supervision, nurses can help to promote physical functioning and activities of daily living, and reduce the risk of falls.
From the Research
Evidence-Based Nursing Intervention
- One evidence-based nursing intervention to prevent falls in people with dementia is the use of a knowledge translation intervention, which involves collating existing evidence into a usable format, identifying individual issues, understanding context, and evaluating change over time 2.
- This intervention can be guided by the Knowledge to Action framework and may include goal setting and action planning using a discussion tool to drive implementation.
- The intervention can also involve engagement with the person with dementia and their caregiver, through identification of their needs and preferences, and enabling choice, which can result in high adoption of falls prevention strategies 2.
Key Components of the Intervention
- The intervention should include a comprehensive assessment of the person with dementia, including demographic details, functional status, dementia severity, activity level, self-efficacy, falls risk, and readiness to change behavior 2.
- The intervention should also involve regular reassessment of fall risk and fall prevention programs to ensure a proactive approach to reducing falls 3.
- Additionally, the intervention can include strategies such as education provision about falls risk, pain assessment, using a clock or calendar to reorient to time and place, and bowel care, although these activities may have lower adherence rates 4.
Effectiveness of the Intervention
- The effectiveness of the intervention in reducing falls among people with dementia is still uncertain, with some studies showing a non-significant trend towards reduced falls risk 2 and others finding insufficient evidence to endorse any intervention to reduce falls for people living with dementia in any setting 5.
- However, the use of a knowledge translation intervention has been shown to increase readiness to change behavior for falls risk and adoption of falls prevention strategies 2.