Fear of falling is common among persons with Parkinson’s disease and is negatively associated with quality of life. However a lack of in-depth understanding of fear of falling as a phenomenon persists. This qualitative study aimed to explore the experiences of fear of falling in persons with Parkinson’s disease. Individual interviews were performed with twelve persons with Parkinson’s disease (median age 70 years, median Parkinson duration 9 years, 50% women). The interviews were semi-structured and followed a study-specific interview guide. The transcribed interviews were analyzed using qualitative content analysis. Fear of falling was experienced as a disturbing factor in everyday life. It generated a feeling of vulnerability and made daily activities and everyday environments seem potentially hazardous. Persons also missed performing previous activities. The fear of falling was a varying experience, fueled by an awareness of falls and near falls, Parkinson-related symptoms and disabilities, and by others in their environment. The persons adopted different strategies to handle their fear of falling. Activities were adapted, avoided, performed with help, or carried out despite their fear of falling. The experiences of fear of falling were complex, multifaceted and varied over time and in relation to different activities and environments. This indicates that interventions targeting fear of falling need to be individually tailored for persons with Parkinson’s disease and should focus on several aspects, such as Parkinson-related symptoms and disabilities, activities and environmental factors. This study provides new information that increases the understanding of fear of falling, which has implications for researchers as well as clinicians working with persons with Parkinson’s disease and fear of falling.

The built environment needs to be designed so that all people can participate in the activities they want and need to do. Yet, accessibility is difficult to put into practice, and accessibility issues tend to be overlooked in the building and planning processes. The aim of this scoping review was to summarize the research front in the area of accessibility to public buildings. Specific aims were to identify knowledge gaps, to identify access activities in relation to environmental features and to link to predominant activities in terms of the International Classification of Functioning, Disability and Health (ICF). A literature search was performed in PubMed, PsycINFO, Inspec, Embase and Cochrane databases. Articles in English based on original empirical studies investigating accessibility of public buildings for adults aged ≥18 years with functional limitations were considered. Of the 40 articles included, ten involved study participants, while 30 only examined buildings using instruments to assess accessibility. In addition, the psychometric properties were only tested for a few of them. All articles concerned mobility and several visual limitations, while few addressed cognitive or hearing limitations. Ten main access activities were identified, from using parking/drop-off area to exiting building. By using the ICF and theoretically relating the accessibility problems to activities, the results revealed that there are large knowledge gaps about accessibility to public buildings for older people and people with functional limitations and that there is a need for more methodological considerations in this area of research.

It is estimated that global dementia rates will more than triple by 2050 and result in a staggering economic burden on families and societies. Dementia carries significant physical, psychological and social challenges for individuals and caregivers. Informal caregiving is common and increasing as more people with dementia are being cared for at home instead of in nursing homes. Caregiver burden is associated with lower perceived health, lower social coherence, and increased risk of morbidity and mortality. The aim of this trial is to evaluate the effects of information and communication technology (ICT) on caregiver burden among informal caregivers of people with dementia by reducing the need for supervision. This randomized controlled trial aims to recruit 320 dyads composed of people with dementia living in community settings and their primary informal caregivers. In the intervention group, people with dementia will have a home monitoring kit installed in their home while dyads in the control group will receive usual care. The ICT kit includes home-leaving sensors, smoke and water leak sensors, bed sensors, and automatic lights that monitor the individual’s behavior. Alerts (text message and/or phone call) will be sent to the caregiver if anything unusual occurs. All study dyads will receive three home visits by project administrators who have received project-specific training in order to harmonize data collection. Home visits will take place at enrollment and 3 and 12 months following installation of the ICT kit. At every home visit, a standardized questionnaire will be administered to all dyads to assess their health, quality of life and resource utilization. The primary outcome of this trial is the amount of informal care support provided by primary informal caregivers to people with dementia. This is the first randomized controlled trial exploring the implementation of ICT for people with dementia in a large sample in Sweden and one of the first at the international level. Results hold the potential to inform regional and national policy-makers in Sweden and beyond about the cost-effectiveness of ICT and its impact on caregiver burden. ClinicalTrials.gov, NCT02733939 . Registered on 10 March 2016.

Background: Reforms are changing pension systems in many European countries, in order to both restrict early retirement and force people to extend their working life. From occupational therapy and occupational science perspectives, studies focusing on aspects of working life that motivate the older worker is urgent. Aim: The aim was to describe incentives behind an extended working life among people over age 65. Method: Focus group methodology was used, with participants ages 66–71, from varying work fields: construction and technical companies and the municipal elderly care sector. Findings: Work was considered important and valuable to the degree of how challenging work was, the possibilities for inclusion in a team of colleagues and the chances for better personal finances. Amongst all, the participants expressed a feeling of a strengthened identity by being challenged and having the opportunity to manage working tasks. Conclusion: The finding showed the actual reasons behind an extended working life among older workers. However, a risk of rising social inequity may appear with increased working life if older people are forced to extend their working life due to a difficult financial situation as a pensioner. A variety of retirement options and initiatives in order to support older workers are justified.

Occupational balance promotes health, knowledge about occupational balance among older workers is important. This qualitative study aimed to describe occupational balance among older workers in Sweden. Six focus groups and two individual interviews were conducted with 26 workers, aged 65 years and older. The findings showed that drawing on abilities and resources, a harmonious mix of occupations, as well as congruence with values and personal meaning contributed to the participants’ occupational balance. From a work perspective, organizational factors such as support from managers and having the freedom to influence work tasks, as well as work time, also contributed to occupational balance. The participants changed their occupational pattern to achieve a more harmonious mix of occupations. This change was based on values and experience derived through the meaning of occupations, and on abilities and resources. Enabling older people to achieve occupational balance and promoting health may contribute to possibilities for an extended working life and active ageing.