Dr. Susan Hunter is the Primary Investigator on a research study exploring the use of mobility aids for older adults with dementia and its relation to the risk of falls.
What has been the focus of your research and what prompted you to explore dementia and fall prevention?
Over the last 14 years I have been focused on risk of falls in older adults. My clinical background is what sparked my interest in the risk of falls for older adults with cognitive impairment. I began exploring dementia during my post-doc as an evolution of my 20-year clinical practice as a physiotherapist. I was often working with older patients, many of whom were rehabilitating from an acute illness in hospital; my greatest challenge was always rehabilitating patients with cognitive impairment, specifically dementia. There was just not enough research that looked at the causation and risk of falls in older adults with cognitive impairment.
I endeavoured to know the degree to which cognition impacted the risk of falls – knowing that the findings would greatly influence clinical practice and the success of rehabilitation techniques.
What are the best possible outcomes of this study?
The goal is to develop an assessment tool that measures the risk of falls in older adults with dementia who use a mobility aid, and also establish standardized guidelines to support the assessment process. The tool will help clinicians determine whether there is increased risk with the use of a mobility aid; this will help them make recommendations that are best suited for the individual. Seeing as clinicians are the end user, the best possible outcome is that they find the tool easy to use and integrate into their regular practice.
What are the key elements of the tool?
The tool was developed with the support and input of clinicians who work in geriatric medicine, they informed the depth and scope of the tool. There are two components that must be considered with the use of a mobility aid, physical function and safety. There are other tools that assess function of the tool but currently there are no standardized means to measure whether the use of an aid promotes or obstructs the user’s safety.
The assessment involves guiding individuals through nine functional tasks – for example walking around an obstacle or opening and closing a door. Depending on the area of concern, a specific care plan can be devised and implemented. Within the nine tasks there are performance measures that assess both the physical function and safety of the task while using the aid.
Can you highlight activities that you consider to be a breakthrough in fall prevention strategy?
I think there has been notable development in fall prevention strategy within the scope of cognitive impairment. When I started exploring standards of care for people with dementia, resources were extremely limited; more recently individuals living with dementia have become recognized as a unique population with specific needs and we are seeing that significant improvements can be made through rehab. We have also seen a rise in advocacy groups which furthers the conversation of care plan development for this demographic.
How has ONF facilitated your work thus far?
I have been involved with ONF for the past five years – initially I was recruited to support the Falls and Memory Impairment Network here in Ontario. The presence of the network fostered a collaborative approach, which is something I think ONF has always done well. I have greatly benefitted from the exposure to various networks which ONF has facilitated. The Ontario Neurotrauma Foundation has been a quintessential knowledge broker responsible for building networks and communities of practice that have successfully advanced research into sustained practice, I look forward to our continued collaboration.