Engaging care partners in fall risk management for community-dwelling older adults living with dementia

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PROJECT SUMMARY Falls are an enormous public health challenge and may prevent community-dwelling older adults living with dementia (OLWD) from safely aging in place. OLWD experience a 2-10 times higher risk of falls compared to age-matched peers without dementia. However, there are few effective fall prevention strategies for this population. For community-dwelling OLWD who receive support from others, their informal care partners (family, friends, partners, neighbors, and other unpaid care partners) play an essential role in managing and reducing their risk of falls. To date, there are no evidence-based protocols for engaging dementia care partners in fall risk management. The objectives of the proposed study are to 1. develop and validate a measure, Dementia Care Partner – Fall Risk Management Behavior Questionnaire (DCP-FRMBQ) that aims to describe dementia care partner fall risk management behaviors, 2. explore associations between these behaviors and fall-related outcomes of OLWD, and 3. investigate factors and mechanisms that might shape these behaviors. This work is significant because it will advance scientific understanding of how to engage dementia care partners in fall risk management. The PI and Co-Is have conducted successful pilot work that proposed a multidimensional behavioral framework of dementia care partners’ fall risk management. The proposed project will build on this promising pilot study to create the measure, DCP-FRMBQ, and use the measure to examine the impact of dementia care partner fall risk management behaviors and mechanisms and factors that might shape these behaviors. To generate the comprehensive measure, 5 content experts and 15 dementia care partners from diverse backgrounds will participate in assessing the content validity and cultural suitability of the measure. We will then administer the updated DCP-FRMBQ to 100 dementia care partners to assess the construct validity and internal reliability (Aim 1). How these behaviors are associated with a higher or lower risk of falls among community-dwelling OLWD will be explored using both quantitative and qualitative data (Aim 2). We will also collect quantitative and qualitative data from these 100 dementia care partners about factors and mechanisms underlying their fall risk management behaviors (Aim 3). The knowledge acquired from the proposed study will direct strategies for future care partner-engaged fall risk reduction interventions for community-dwelling OLWD and the mechanisms by which these interventions may work. This research is responsive to the priority areas of the National Institute on Aging on improving assessment of caregiving processes and their impact on families and individuals (NOT-AG-18-057). It responds to one of the dementia objectives set by Healthy People 2030 regarding reducing preventable hospitalizations in OLWD, as falls are one of the main causes of community-dwelling OLWD’s hospitalizations. It also aligns with the goals of the National Plan to Address Alzheimer’s Disease to enhance dementia care quality and efficiency and expand support for people living with dementia and their families.