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Is there a role for gait aids to improve stability and reduce falls risk for older people with dementia?

Researchers: Angel Lee, Keith Hill, Elissa Burton, Claudia Meyer, Susan Hunter, Plaiwan Suttanon
Population: Home and Community Support
Funding support: Dementia Australia Research Foundation

Balance impairment and falls are common among people living with dementia. About 47% with certain types of dementia fall each year, with higher injury rates. Falls can have a dramatic negative impact on the independence, function, mobility, confidence, and quality of life for older people with dementia, and can also trigger residential care admission and increase carer burden. Hence, there is an imperative to identify approaches to improve gait stability and reduce falls risk in this group. Provision of a gait aid is frequently used to improve stability and reduce risk of falls for older people, shown in the literature to be beneficial for people with multiple sclerosis. However, there is confusion and inconsistency in the use of gait aids (e.g. for people recovering from a hip fracture) and why and how health professionals prescribe gait aids. Little is empirically known about gait aid use in people with dementia, with anecdotal concerns about safety and the person’s ability to learn new skills.

Rationale for the study is to understand current practice and factors influencing community care staff and informal carers’ approaches to gait aid use by older people with dementia and to improve practice in mobility care of older people with dementia through the development of an algorithm(s) to guide decision making among community care staff, and informal carers regarding prescription and safe use of gait aids by older people with dementia. Current practice and factors influencing community (and hospital) staff members’ approaches to gait aid use by older people with dementia and that of informal carers will be used by an expert panel as well as evidence in the literature to develop the algorithm(s).

This project involves teams from Western Australia (Sir Charles Gardiner Hospital and Curtin University) and Victoria (Bolton Clarke, Peninsula Health, Monash University). This study will contribute to the understanding of the role of gait aids in improving stability and mobility of older people living with dementia. The algorithm will likely assist Bolton Clarke At-Home Support staff in decision-making related to gait aid use for people with dementia, which impacts the person with dementia’s balance, mobility and falls risk.