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

项目摘要 福尔斯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生活在 老年痴呆症（OLWD）的安全老化。OLWD发生福尔斯跌倒的风险比 年龄匹配的同龄人没有痴呆症。然而，很少有有效的预防跌倒的策略 人口对于社区居住的老年痴呆症患者，他们接受他人、非正式护理伙伴的支持 （家庭，朋友，合作伙伴，邻居和其他无偿护理合作伙伴）在管理和 降低福尔斯的风险。到目前为止，还没有基于证据的协议来吸引痴呆症护理合作伙伴 秋季风险管理本研究的目的是1。制定并验证一项措施， 痴呆症护理伙伴-跌倒风险管理行为问卷（DCP-FRMBQ），旨在描述 老年痴呆症护理伙伴跌倒风险管理行为，2。探索这些行为之间的联系， OLWD的跌倒相关结局，以及3.研究可能塑造这些行为的因素和机制。 这项工作意义重大，因为它将促进对如何参与痴呆症护理的科学理解 秋季风险管理的合作伙伴。PI和Co-Is进行了成功的试点工作，提出了 痴呆症护理伙伴跌倒风险管理的多维行为框架。拟建项目 我将在这个有前途的试点研究的基础上创建DCP-FRMBQ措施，并使用该措施来检查 老年痴呆症护理伙伴跌倒风险管理行为和机制的影响，以及可能 塑造这些行为。为了制定综合措施，5名内容专家和15名痴呆症护理专家 来自不同背景的合作伙伴将参与评估内容的有效性和文化适应性， measure.然后，我们将向100名痴呆症护理合作伙伴管理更新的DCP-FRMBQ，以评估 结构效度和内部信度（Aim 1）。这些行为如何与较高或较低的风险相关联 将使用定量和定性数据探索社区居住的OLWD中的福尔斯下降率（目标2）。 我们还将从这100个痴呆症护理合作伙伴那里收集定量和定性数据， 其跌倒风险管理行为的潜在机制（目标3）。从中学到的知识 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。本研究是 响应国家老龄问题研究所关于改善老龄问题评估的优先领域， 过程及其对家庭和个人的影响（NOT-AG-18-057）。它对痴呆症有反应 《健康人2030》设定的关于减少OLWD可预防住院的目标，因为福尔斯 这是社区老年痴呆症住院的主要原因之一。它也符合联合国的目标， 国家计划解决阿尔茨海默病，以提高痴呆症护理质量和效率，并扩大 为痴呆症患者及其家人提供支持。

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.