FINDING BALANCE ALGORITHM
Education & Behavior Change
When communicating with the older adult, it is important to use plain language. Plain language is text that is easy and quick to read. It is intended for a broad group of people some of whom may not have high literacy and clarifies and explains information to non-medical professionals. It is not 'dumbing' down professional writing or underrating the complexities of medical care.
If providing written information, dark lettering on a light, non-glassy background with large font size (14) is recommended for older adults.
Brochures on falls prevention, bone health, diet, activity and other topics should be provided as appropriate.
Consider adult learning principles such as:
Information needs to relate to the seniors' own experiences and make sense to them.
Adults must actively participate in the learning experience to remember it.
Everyone learns at different rates and in different ways.
Educate older adults and their families that most falls are preventable and for those falls that are not preventable, educate on injury reduction strategies.
Research indicates that the language used with older adults can influence the uptake of information. Messages are better received if they are positive and focus on healthy aging, mobility and independence rather than falls and safety.
Most of the recommendations provided to older adults require a change in their behaviour. To be motivated to change behaviour, they must:
Believe that there is a problem
Believe that it is their problem
Believe that there is a solution
Believe that they can implement it and receive benefits
Individuals have to be ready to change. Prochaska outlines stages in his Transtheoretical Model of Stages of Readiness for Change. It is important for the healthcare provider to recognize the stage the client is at, as different approaches are necessary to engage individuals at different stages.
Motivational Interviewing is a tool for facilitating many different kinds of positive behaviour change. The basis for it is guiding individuals to evoke their own motivations for change. It has been defined as "... a client-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence."
To facilitate behaviour change, consider programs that emphasize social aspects and counter the belief that nothing can be done. Find out what the clients are willing to modify and address their concerns first. Fear of falling, activity avoidance and lack of ability may need to be addressed first.
Older adults are not a homogeneous group and will have differences in how they accept falls prevention strategies depending on their age, level of frailty, socioeconomic status and culture. One size does not fit all. When planning education or any interventions, the targeted group must be considered.