Mobility Decline Prevention
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Modules - Mobility Decline Prevention
Safety Assessment for the Frail Elderly: A Comparison of Restrained and Unrestrained Nursing Home Residents
John F. Schnelle, Priscilla G. MacRae, Sandra F. Simmons, Gwen Uman, Joseph G. Ouslander, Lori L. Rosenquist, and Betty Chang, 1994, in Journal of the American Geriatrics Society;42:586-592.
This paper describes a safety assessment for the frail elderly (SAFE) that measures behavioral factors associated with falls. The authors used the assessment to evaluate the walking and transitioning performance of 108 physically restrained and 111 unrestrained nursing home residents. Results showed that the assessment identifies potentially remediable problems that increase with a frail older person's risk for injury. It also identifies factors that differentiate restrained and unrestrained nursing home residents that should be assessed and targeted for intervention by restraint reduction programs. One surprising conclusion is that restraint removal would not necessarily enhance freedom of movement for at least 50% of the restrained residents who cannot walk. This is because these non-ambulatory residents also lack the ability to propel their wheelchairs. The authors contend that restraint reduction programs are not sufficient to increase mobility in many residents; specific interventions are also needed to restore walking skills or increase wheelchair mobility.
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