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BMC Geriatrics
Published in: BMC Geriatrics 1/2019

Open Access 01-12-2019 | Dementia | Research article

Developing an Intervention for Fall-Related Injuries in Dementia (DIFRID): an integrated, mixed-methods approach

Authors: Alison Wheatley, Claire Bamford, Caroline Shaw, Elizabeth Flynn, Amy Smith, Fiona Beyer, Chris Fox, Robert Barber, Steve W. Parry, Denise Howel, Tara Homer, Louise Robinson, Louise M. Allan

Published in: BMC Geriatrics | Issue 1/2019

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Abstract

Background

Falls in people with dementia can result in a number of physical and psychosocial consequences. However, there is limited evidence to inform how best to deliver services to people with dementia following a fall. The aim of the DIFRID study was to determine the feasibility of developing and implementing a new intervention to improve outcomes for people with dementia with fall-related injuries; this encompasses both short-term recovery and reducing the likelihood of future falls. This paper details the development of the DIFRID intervention.

Methods

The intervention was designed using an integrated, mixed-methods approach. This involved a realist synthesis of the literature and qualitative data gathered through interviews and focus groups with health and social care professionals (n = 81). An effectiveness review and further interviews and observation were also conducted and are reported elsewhere. A modified Delphi panel approach with 24 experts was then used to establish a consensus on how the findings should translate into a new intervention. After feedback from key stakeholders (n = 15) on the proposed model, the intervention was manualised and training developed.

Results

We identified key components of a new intervention covering three broad areas:
• Ensuring that the circumstances of rehabilitation are optimised for people with dementia
• Compensating for the reduced ability of people with dementia to self-manage
• Equipping the workforce with the necessary skills and information to care for this patient group
Consensus was achieved on 54 of 69 statements over two rounds of the Delphi surveys. The statements were used to model the intervention and finalise the accompanying manual and protocol for a feasibility study. Stakeholder feedback was generally positive and the majority of suggested intervention components were approved. The proposed outcome was a 12-week complex multidisciplinary intervention primarily based at the patient’s home.

Conclusions

A new intervention has been developed to improve outcomes for people with dementia following a fall requiring healthcare attention. The feasibility of this intervention is currently being tested.

Trial registration

ISRCTN41760734 (16/11/2015).
Appendix
Available only for authorised users
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Metadata
Title
Developing an Intervention for Fall-Related Injuries in Dementia (DIFRID): an integrated, mixed-methods approach
Authors
Alison Wheatley
Claire Bamford
Caroline Shaw
Elizabeth Flynn
Amy Smith
Fiona Beyer
Chris Fox
Robert Barber
Steve W. Parry
Denise Howel
Tara Homer
Louise Robinson
Louise M. Allan
Publication date
01-12-2019
Publisher
BioMed Central
Keywords
Dementia
Dementia
Published in
BMC Geriatrics / Issue 1/2019
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-019-1066-6

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