Fall Prevention Education Co-Designed and Evaluated with Community-Dwelling Older People Living with Dementia and Their Caregivers: A Feasibility Study

Abstract

Community-dwelling older people living with dementia are at increased risk of falls and injury that may impact their ability to remain at home. Fall prevention education programs have been effective in reducing falling risks in other older populations, but few studies have reported on programs specifically co-designed with this vulnerable cohort. This study partnered with community-dwelling older people living with dementia and their caregivers to co-design a fall prevention education program and evaluate its feasibility. A two-phase, mixed methods design using a community-based participatory research approach was conducted. A co-designed multimedia suite of 16 evidence-based safety messages (screened video, paper brochures), delivered by staff with support from caregivers, was evaluated using pre-and postprogram consumer engagement panels (clients, n = 4 and staff, n = 4), pre-and post-program client and caregiver (n = 18) surveys, and semi-structured educator staff interviews (n = 2). Quantitative data were analysed using Wilcoxon signed-rank tests and qualitative findings were subjected to deductive content analysis and were mapped to known feasibility criteria. Safety messages were positively received, card format delivery was preferred to video, and use of rhymes were fun and engaging. Following the program, older people felt they had a significantly clearer plan to help them prevent falling ( $p$  = 0.01). Caregivers who were invested in the program facilitated successful implementation and perceived that the program reduced their concerns about the person they cared for falling. Making the program available at an earlier stage (closer to diagnosis) was deemed preferable for a greater impact. Staff time for engagement and caregivers feeling uncomfortable with technology were two identified threats to implementation. Co-designing and evaluating a fall prevention education program with older people living with dementia, their caregivers, and staff were feasible. Safety messages clarified older peoples’ awareness of how to prevent falls and alleviated caregiver concerns. Education on falling may assist older people living with dementia to remain safe at home.