ABSTRACT

Falls remain a major public health issue, particularly for frail older adults, such as those who receive home-delivered meals (HDMs). Social workers who assess the needs of HDM clients and routinely monitor their care are uniquely positioned to address fall prevention; however, the degree to which HDM social workers currently manage fall risk is unknown. To close this knowledge gap, we conducted a retrospective chart review and evaluated HDM social workers’ current practices relative to identifying clients at risk for falling and the client characteristics associated with social workers’ perceptions of fall risk. A total of 230 client charts were included in our analysis. Thirty-eight percent of HDM clients were determined to be at risk of falling. Advanced age, activity limitations, and specific health conditions (e.g., diabetes mellitus) were associated with social workers’ fall risk concerns. However, over 80% of our sample presented with well-established fall risk factors (e.g., mobility impairment) suggesting that HDM social workers might be under-identifying fall-risks. Though HDM social workers are well positioned to play a critical role in fall risk management, systematic efforts are needed to optimize social workers’ capacity for effectively identifying HDM clients at risk for falling.

摘要

跌倒仍然是一个主要的公共卫生问题，特别是对于体弱的老年人，例如那些接受家庭送餐 (HDM) 的人。评估 HDM 客户需求并定期监控他们的护理的社会工作者在解决跌倒预防方面具有独特的优势；然而，HDM 社会工作者目前管理跌倒风险的程度尚不清楚。为了弥补这一知识差距，我们进行了回顾性图表审查，并评估了 HDM 社工当前在识别有跌倒风险的案主方面的做法，以及与社工对跌倒风险的看法相关的案主特征。我们的分析共包含 230 个客户图表。38% 的 HDM 客户被确定有跌倒的风险。高龄、活动受限和特定的健康状况（例如，糖尿病）与社会工作者的跌倒风险相关。然而，我们的样本中有超过 80% 的人具有明确的跌倒风险因素（例如，行动不便），这表明 HDM 社会工作者可能对跌倒风险的识别不足。尽管 HDM 社工在跌倒风险管理中发挥了关键作用，但仍需要系统地努力优化社工有效识别面临跌倒风险的 HDM 客户的能力。