Page 122 - Encyclopedia of Nursing Research

ConTInUInG CARE RETIREMEnT CoMMUnITIES n 89

primary health care provider, (2) not wanting having an injurious fall. Individuals who had
to do anything even if the tests were abnor- atrial fibrillation or neurological problems,
mal, (3) feeling they were too old, and (4) a were not married, and did not adhere to a C
desire to contract the known problem so as to regular exercise program were more likely
facilitate death. to have multiple falls. In addition, it was
The impact of the CCRC environment noted that the falls were less likely to occur in
(i.e., access to services and physical environ- residents who exercised regularly (Crowley,
ment) on healthy behaviors has also been 1996). A CCRC setting was also used to test a
considered. Increased access to services in Post-Fall Index with the goal of using this tool
“all-inclusive” settings (Young, Inamdar, & for secondary prevention of falls in future
Hannan, 2010) increases the opportunities research (Gray-Miceli, Strumpf, Johnson,
for health promotion. In addition, the phys- Draganescu, & Ratcliffe, 2006).
ical environment, particularly the many CCRCs continue to be a viable liv-
opportunities for walking and other types ing environment for older adults. In order
of physical activity (Resnick & D’Adamo, for these facilities to keep costs down and
2011; Zalewski et al., 2009), is associated remain lucrative, it is imperative that there
with increased function and physical activ- be a focus on maintaining health and func-
ity regardless of the residents’ underlying tion and in helping individuals remain in the
capability. Conversely, with regard to life least invasive level of care (i.e., independent
prolonging interventions such as availabil- living). Continued research needs to build on
ity of automated external defibrillators, as the preliminary findings from exploratory
per the wishes of residents, these devices studies and begin to develop and test inter-
are not easily available for use in the facil- ventions that will help older adults in CCRCs
ity (Woodley, Medvene, Kellerman, Base, & maintain their health and function, prevent
Mosack, 2006). There is also no overwhelm- injuries, address end-of-life care preferences,
ing support of smart home technologies and optimize use of health care resources.
among CCRC residents because of concerns Examples of this include consideration of the
about privacy (Courtney, Demiris, Rantz, & increasing number of CCRCs with wellness
Skubic, 2008). There tends to be a philosophy programs and the outcomes of these pro-
among residents of optimizing health but grams from a health and fiscal perspective.
avoiding aggressive interventions that will other important areas of research within
sustain life in the face of illness (nahm & CCRCs need to address smart home tech-
Resnick, 2001). nologies and use of technology in general to
Falls, which are a common problem for promote health and safety, for example, use
older adults in any setting, is another area of smart phones to detect a fall among older
that has been studied in CCRCs. For exam- individuals or medication management tech-
ple, predictors of falls in a CCRC was stud- nology. Testing of the impact of electronic
ied (Resnick, 1999), and findings supported medical records to optimize transitions
the need to evaluate predictors of falls within within settings and between CCRC settings
each specific community as environmental and acute care facilities should also be the
risks and activity patterns may be very differ- focus of future research. CCRCs have been
ent. In the community studied, falls generally and will continue to be a wonderful housing
occurred between noon and midnight, within alternative for older adults, and consideration
the residents’ apartments, and when walking needs to be given to how to make these sites
(63%) or transferring (19%). only 16 (10%) of affordable for all.
the falls resulted in a fracture. The number
of falls was the only variable associated with Barbara Resnick