Falling in Old Age: Prevention and Management, 2nd ed.

Tideiksaar R. New York, NY 10012, Springer Publishing Co, 1997, hardback, 398 pp, $48.95.

The purpose of this book is to educate health care professionals on how to become involved in the prevention of falls among elderly patients. The author holds a doctorate in gerontology and is a physician assistant with past experience in academia. He also has served as director of several geriatric programs. The book is written for health care professionals in gerontologic clinical practice. Terminology is kept at a level that will make it easily comprehensable by professionals from a variety of fields.

The second edition was written in response to the recently increased number of fall-related investigations and research conducted since the publication of the first edition. Additional sections discuss rehabilitative strategies to reduce the risk of falls and the issues surrounding the use of mechanical restraints. Numerous well-written case studies were added to each chapter. The large number of impressive references sets this book apart from others on the subject of falls.

Physical therapists who have been working in the balance and falls arena will not find a lot of new information, but they will have a comprehensive source of current research in one book. The referenced statistics on fall-risk factors and the epidemiology, etiology, and sequelae of falls will be helpful in convincing administrators to establish fall intervention programs or perhaps in preparing grant proposals. The review of intrinsic and extrinsic balance factors, the gait cycle, and the effects of age on gait and balance reactions will be helpful in preparing in-services.

The chapters on medical, psychosocial, and environmental strategies to reduce fall risk are lengthy and contain a variety of checklists, scales, and questionnaires useful in assessment. The short chapter on rehabilitative strategies to reduce fall risks is very basic; however, it does provide information useful for aides or other institutional personnel. The "common sense" approach to basic exercises, assistive gait devices, and wheelchairs will be useful for patient or family education.

The final chapter, on mechanical restraints, provides a history on the use of restraints in acute care and long-term care facilities. An overview spans earlier studies through current research, including the Omnibus Budget Reconciliation Act regulations, that clinicians would find helpful. Alternative suggestions to restraints are correct, with few new or unique ideas.

This book would be useful for physical therapists who have been in practice for a number of years and who want to quickly update and educate themselves on the subject of falls. It would make a handy reference for physical therapy educators and their students. Depending on curricular needs, the book would be an appropriate text in a physical therapist assistant program. It would be very appropriate for therapists working in nursing homes and long-term care facilities.

Sondra E Dunkle, EdD, PT
Idaho State University
Pocatello, Idaho

Dr Dunkle is Professor in the Physical Therapy Department, with a special interest in balance, falls, gerontology, and higher education.