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

项目总结 瀑布是一个巨大的公共卫生挑战，可能会阻止社区居住的老年人与 痴呆症(OLWD)来自安全老化的原地。OLWD体验到的跌倒风险是 年龄匹配的非痴呆症同龄人。然而，对此几乎没有有效的预防跌倒的策略 人口。对于接受他人支持的社区居住的OLWD，他们的非正式护理伙伴 (家人、朋友、伴侣、邻居和其他无偿护理伙伴)在管理和 降低他们跌倒的风险。到目前为止，还没有基于证据的协议来吸引痴呆症护理伙伴 在秋季风险管理方面。拟议研究的目标是：1.制定和验证一项措施， 痴呆症护理伙伴跌倒风险管理行为问卷(DCP-FRMBQ)旨在描述 痴呆症护理伙伴跌倒风险管理行为，2.探索这些行为与 与跌倒相关的OLWD结果，以及3.调查可能塑造这些行为的因素和机制。 这项工作意义重大，因为它将促进人们对如何进行痴呆症护理的科学理解 秋季风险管理方面的合作伙伴。国际和平研究所和联合信息系统成功地开展了试点工作，提出了一个 痴呆护理伙伴跌倒风险管理的多维行为框架。拟议中的项目 我将在这项有前景的试点研究的基础上创建DCP-FRMBQ措施，并使用该措施来检查 影响痴呆症护理伙伴跌倒风险管理行为及机制的影响因素 塑造这些行为。为了生成全面的衡量标准，5名内容专家和15名痴呆症护理人员 来自不同背景的合作伙伴将参与评估 测量。然后，我们将向100名痴呆症护理伙伴实施更新的DCP-FRMBQ，以评估 构建效度和内部信度(目标1)。这些行为如何与更高或更低的风险相关联 将利用定量和定性数据(目标2)探讨社区居住的OLWD下降的可能性。 我们还将从这100个痴呆症护理伙伴那里收集有关因素和 其跌倒风险管理行为的潜在机制(目标3)。从以下方面获得的知识： 拟议的研究将指导未来护理伙伴参与的降低跌倒风险干预措施的战略 社区居住的OLWD以及这些干预措施可能发挥作用的机制。这项研究是 响应国家老龄问题研究所关于改进护理评估的优先领域 过程及其对家庭和个人的影响(非-AG-18-057)。它对其中一种痴呆症有反应 2030年健康人制定的关于减少OLWD可预防住院的目标如下 这是社区居住的OLWD患者住院的主要原因之一。它还与 应对阿尔茨海默病国家计划，以提高痴呆症护理质量和效率并扩大 支持痴呆症患者及其家人。

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.