Fall Risk, Supports and Services, and Falls Following a Nursing Home Discharge

Marwa Noureldin, Zachary Hass, Kathleen Abrahamson, Gregory Arling

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background and Objectives: Falls are a major source of morbidity and mortality among older adults; however, little is known regarding fall occurrence during a nursing home (NH) to community transition. This study sought to examine whether the presence of supports and services impacts the relationship between fall-related risk factors and fall occurrence post NH discharge. Research Design and Methods: Participants in the Minnesota Return to Community Initiative who were assisted in achieving a community discharge (N = 1459) comprised the study sample. The main outcome was fall occurrence within 30 days of discharge. Factor analyses were used to estimate latent models from variables of interest. A structural equation model (SEM) was estimated to determine the relationship between the emerging latent variables and falls. Results: Fifteen percent of participants fell within 30 days of NH discharge. Factor analysis of fall-related risk factors produced three latent variables: fall concerns/history; activities of daily living impairments; and use of high-risk medications. A supports/services latent variable also emerged that included caregiver support frequency, medication management assistance, durable medical equipment use, discharge location, and receipt of home health or skilled nursing services. In the SEM model, high-risk medications use and fall concerns/history had direct positive effects on falling. Receiving supports/services did not affect falling directly; however, it reduced the effect of high-risk medication use on falling (p < .05). Discussion and Implications: Within the context of a state-implemented transition program, findings highlight the importance of supports/services in mitigating against medication-related risk of falling post NH discharge.

Original languageEnglish (US)
Pages (from-to)1075-1084
Number of pages10
JournalThe Gerontologist
Volume58
Issue number6
DOIs
StatePublished - Nov 3 2018
Externally publishedYes

Fingerprint

Accidental Falls
Nursing Homes
Structural Models
Statistical Factor Analysis
Durable Medical Equipment
History
Nursing Services
Activities of Daily Living
Caregivers
Research Design
Morbidity
Mortality
Health

ASJC Scopus subject areas

  • Gerontology
  • Geriatrics and Gerontology

Cite this

Fall Risk, Supports and Services, and Falls Following a Nursing Home Discharge. / Noureldin, Marwa; Hass, Zachary; Abrahamson, Kathleen; Arling, Gregory.

In: The Gerontologist, Vol. 58, No. 6, 03.11.2018, p. 1075-1084.

Research output: Contribution to journalArticle

Noureldin, Marwa ; Hass, Zachary ; Abrahamson, Kathleen ; Arling, Gregory. / Fall Risk, Supports and Services, and Falls Following a Nursing Home Discharge. In: The Gerontologist. 2018 ; Vol. 58, No. 6. pp. 1075-1084.
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