Falls prevention in persons with intellectual disabilities: development, implementation, and process evaluation of a tailored multifactorial fall risk assessment and intervention strategy.
A one-stop falls clinic for adults with ID is doable and welcome, yet smooth scheduling and carer logistics must be fixed before you scale.
01Research in Context
What this study did
Hanson et al. (2013) opened a small falls clinic for adults with intellectual disability.
Staff gave each client a head-to-toe check: vision, strength, drugs, home setup, and more.
They then wrote a personal plan and asked clients and carers if the process felt doable and useful.
What they found
People liked the clinic and said it helped them spot risks.
The team handed out 50 small fixes, such as grab bars or medication changes, across 26 clients.
Booking rooms, chasing forms, and getting carers there on the same day were the big headaches.
How this fits with other research
Hsieh et al. (2012) and McConkey et al. (2010) had already shown that one in three or four adults with ID fall each year.
Enkelaar et al. (2013) added a twist: clients who walk well and stay active fall more, not less.
The clinic used these ‘high-functioning’ flags to decide who needed the deepest checks.
Later work kept the idea but swapped the setting: Sáez-Suanes et al. (2023) moved the program into group homes with short exercise games, while Torres-Unda et al. (2017) ran Feldenkrais classes at work sites.
Both later studies kept the balance piece and still saw gains, proving the clinic concept travels.
Why it matters
You now have a ready-made checklist of red flags—seizures, polypharmacy, prior falls, high activity level—that you can tape to your clipboard.
Use it to pick who gets a full physio review and who needs home tweaks first.
Start small: one combined visit beats three separate appointments, but send reminder texts and offer transport help so carers actually show up.
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02At a glance
03Original abstract
In the general elderly population, multifactorial screening of fall risks has been shown to be effective. Although persons with intellectual disabilities (ID) fall more often, there appears to be no targeted screening for them. The aim of this study was to develop, implement, and evaluate a falls clinic for persons with ID. Based on guidelines, literature, and expert meetings, a falls clinic for persons with ID was developed. In total, 26 persons with ID and a fall history participated in the study. Process evaluation was conducted with evaluation forms and focus groups. Fifty interventions (0-8 per person) were prescribed. The (para)medical experts, clients, and caregivers described the falls clinic as useful. Advice for improvement included minor changes to clinic content. Logistics were the largest challenge for the falls clinic, for example organizing meetings, completing questionnaires prior to meetings, and ensuring that a personal caregiver accompanied the person with ID. Furthermore, the need for a screening tool to determine whether a person would benefit from the falls clinic was reported. In conclusion, the falls clinic for persons with ID was considered feasible and useful. Some minor content changes are necessary and there is a need for a screening tool. However, logistics concerning the falls clinic need improvement. More attention and time for multifactorial and multidisciplinary treatment of persons with ID is necessary. Implementation on a larger scale would also make it possible to investigate the effectiveness of the falls clinic with regard to the prevention of falls in this population.
Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2013.05.041