Survey of Audiologists’ Views on Risk of Falling Assessment in the Clinic

Background: Falls are a significant health problem for older adults. With the projected increase in persons aged 65 yr and older by the year 2050, this continues to be a growing concern. Risk of falling (RoF) assessment is a multifactorial approach. Audiologists routinely evaluate older patients in the clinic and therefore might be in an ideal position to identify falling risk factors.

Purpose: The purpose of this study was to gain a better understanding of audiologists’ views on RoF assessment related to training and education, screening and assessment, prevention and intervention, the effectiveness of RoF assessment, and challenges associated with RoF assessment in the audiology clinic.

Research Design: The survey was e-mailed to 2000 randomly selected audiologists across the United States. The survey was designed with the primary objective of understanding personal views regarding RoF assessment. Demographic information was included to better understand the type of clinic setting, the primary age of patients, year of graduation, and highest degree earned. Additionally, open-ended questions were offered to provide a forum for further testimonials on current RoF experiences and needs. Questions pertaining to resources used to assess RoF and counsel patients on RoF were asked to determine the audiologists’ understanding of a multifactorial approach to assessing patients for RoF. Lastly, a series of Likert scale questions were developed to indicate the strength of agreement or disagreement pertaining to general statements about RoF assessment and the challenges associated with an RoF assessment program. Descriptive statistics (means, standard deviations, frequencies, and percentages) were used for quantitative survey responses. Validation of qualitative data was completed by using triangulation sources.

Results: A total of 275 of 2000 audiologists returned the survey; of those who responded, 238 audiologists were analyzed. Two themes emerged from the survey responses: resources used to assess RoF and audiologists' personal views on RoF. Although a majority (83.0% [n = 197/238]) of audiologists surveyed indicated working with geriatric patients (≥61 yr of age), more than half (62.1% [n = 147/238]) of audiologists surveyed indicated no experience with RoF assessment. Overall, 75% (n = 175/233) of the surveyed audiologists consider RoF assessment a role in the audiologist's scope of practice; however, only 16.3% (n = 38/233) believe audiologists are knowledgeable, 11.8% (n = 27/228) believe audiologists are sufficiently trained to provide RoF assessment, and 14% (n = 33/238) are currently implementing RoF as part of vestibular and balance assessment.

Conclusions: Although audiologists support RoF assessment, further education is warranted for audiologists to efficiently assess RoF. Many audiologists do not have the resources or time to administer RoF assessment in their clinics; however, if audiologists can ask just a few questions regarding fall history and better understand the risk factors, they can be in a position to refer their patients to other professionals for further investigation.

Key Words

Falls - risk of falling - balance - audiology - physical therapy - survey - assessment