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DOI: 10.1111/j.1741-6612.2009.00347.x

Bookshelf
Blackwell Publishing Asia

Falls in older people: Risk factors and strategies for

prevention (2nd edn)
Stephen Lord, Catherine Sherrington, Hylton Menz, and Jacqueline
Close. Cambridge University Press, Cambridge, UK, 2007. 395p.
A$130.00 (soft cover).

The first edition of Falls in older people was published in 2001

and was intended as a review of research on fall prevention
strategies for elderly people published in the final 20 years of
the twentieth century. This second edition includes new
research in this field published over the last 7 years. The
authors use a chart to demonstrate the increase in research
output on falls from 1986 to 2004; the increase over the last
4 years is double the number of publications from the preceding
16 years. This increase in attention to falls is not surprising as
falling has been recognised as a major health risk for older
people. Older people who lie for an hour or more after falling
are less likely than those who get up or are helped up to make
a good recovery. More than 50% of those who remain on the
floor for over an hour will die within 6 months, even though
not directly injured by the fall.
Each chapter of the text is specific in focus, citing population
studies and other research (both with and without the use of
matched controls) to identify factors that increase the likelihood of falls. Good use is made of diagrams and tables to illustrate the text.
The final chapters of the book include a review of assessments
used to assist in identifying potential fallers. The authors
recommend exercise and balance training programs to assist
older people who have been identified as potential fallers to
improve their stability and reduce the likelihood of a fall, and
remedial actions such as cataract removal. The last chapter
suggests further areas of research in seeking causes for fall
likelihood, and further preventative strategies.
An integral feature of the text is well-designed tables listing
research done, numbers of participants and types of assessments
carried out. Every chapter has a lengthy bibliography and there
is an excellent index.
This is an outstanding resource for professional carers of older
people in medical and allied health positions. It was interesting
to learn that someone suffering from lowered balance, eye
problems or vestibular difficulties will function better on a
surface such as carpet or a wooden floor. I would intuitively
have thought that a soft surface would help to prevent the
serious effect of a fall, such as a broken hip, arm or leg.
Floor coverings must be maintained in good condition. An
obvious recommendation was to use walking aids such as a
stick or trolley to assist in maintaining independence.
However, unfortunately, many older people will object to this
Australasian Journal on Ageing, Vol 28 No 1 March 2009, 4748
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Journal compilation 2009 ACOTA

suggestion. My elderly parent at the age of 87 insisted that he

was not going to be seen using a stick like an old man.
This is a very scholarly and well-prepared text and something
that would be of use to any person involved in the fields of
gerontology or orthopaedic care. It is not a text for the average
family carer.
Jean M Stokes
Psychologist in private practice
Bookshelf
XXX

Aged care in Australia: A guide for aged care workers

D. Dawbin & A. Rogers. TAFE NSW, Community Services, Health,
Tourism and Recreation Curriculum Centre, NSW, Australia, 2006.
ISBN 9781920967291 (soft cover). A$69.95.

This guide, published by TAFE NSW, provides information on

aged care industry standards, current Australian legislation
and best practice principles for aged care workers, carers and
volunteers. Areas covered include occupational health and
safety, key government policies, legal funding in Australia,
proper record-keeping, and home and community care services
available to older adults. In addition to this, the authors have
successfully incorporated useful information about ageing and
description of healthy ageing, physiology of ageing such as skin
changes, diseases commonly present in older adults, and
other vital theoretical components that will benefit care
workers in understanding and providing care to older adults.
Of particular note, the guide challenges the readers views
on ageing and older adults, briefly discusses elder abuse, and
provides strategies for effective communication to ensure
safety and respect and to maximise quality of life for older
adults in care.
The use of case studies and personal stories adds a warm touch
to the textbook, which is written in everyday language. The
printing and book layout are simple and make the content very
easy to follow. The inclusion of form templates such as a pain
assessment chart is very helpful and practical for aged care
workers who may wish to refer or use these for future reference.
Furthermore, website addresses to relevant services and information sources are strategically well placed throughout and
tables of commonly used acronyms are handy add-ons.
Minor additions would have enhanced the comprehensiveness
of this guide in particular, more photographs or illustrations
of illness and disease in older adults, such as glaucoma or
cellulitis, would have been useful for aged care workers in
identifying and addressing client health. Inclusion of a brief
explanation and provision of best practice strategies regarding
client capacity (e.g. capacity to consent to medical treatment
and/or refuse services) would have assisted aged care workers,
carers and volunteers to uphold the rights of their clients and
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B o o k s h e l f

allowed them to better evaluate potential risks and issues when

the capacity of the older adult is questioned. Finally, readers
would have benefitted from a section that covers best practice in
communicating with family members and friends of older clients.
Overall, this guide is highly recommended to all aged care
workers, not only as a valuable information resource about
local services, policy and procedures, but also for its broad
coverage of relevant theories of ageing, provision of practical
management strategies, and promotion of positive ageing.
Judy Tang
La Trobe University
Bookshelf
XXX

Generational change and social policy challenges

Australia and South Korea
Phillips R. (ed.). Sydney University Press, NSW, Australia, 2007. ISBN
978-1-920898-64-9 (soft cover). A$34.95.
http://ses.library.usyd.edu.au/handle/2123/1966

Given Australias growing links with Asian countries (in

immigration, trade and politics), this book is a valuable and
relatively new addition to our understanding of mutual
concerns about policy, culture and practices with respect to
generational changes in our respective countries. While not all
topics are new (e.g. contrasting definitions of the welfare state),
specific comparisons between Australia and South Korea are
novel. Australia can learn from South Korea because South
Koreas demographic change has been quicker and its people
have embraced technology more fully (e.g. a network for
broadband). South Korea may be able to learn from Australia,
current global downturn aside, because Australia leads in
terms of superannuation policy and asset growth.
Ruth Phillips, in the first chapter, provides an excellent overview of common and diverse issues in welfare in both countries,
with a very usable comparative table of key social policies in
Australia and South Korea. The next two chapters (by Peter
McDonald and Ik Ki Kim) provide essential demographic
statistics in both countries, with relatively recent data and
references. Ali Mubarak has written a very up-to-date chapter
on the important new digital technologies in Australia with a
particularly interesting section on the effect of the exposure of
young people to sexually explicit or offensive materials online.
There are very interesting sections on internet industry
codes of practice and community education on digital media,
which are relevant across the generations. Heejin Lee and
colleagues, in their chapter, focus on civic participation and
broadband access in South Korea and present two very interesting case studies of programs (one on haircutting, the
other on the university entrance selection scheme) that
enabled teenagers to voice their concerns about their rights in
the education system.
In Chapter 6 Deborah Brennan exposes the relationship
between demographic change, work and care, and measures
needed to make workforce participation possible for those,
48

particularly women, who have responsibilities to care for parents, spouses or children. The issues of paid work and unpaid
care, support for elderly and for people with disabilities
are very well discussed with reference to recent reports and
statistical data. Jeong-hee Kims chapter picks up on some of
these issues also, but emphasises maternity and paternity leave
with respect to child care. In South Korea, working women
with children have a particularly difficult role in that they have
duties to care both for their children and for their elderly
parents. Such burdens appear to have impacted very negatively
on the South Korean birth rate.
In Chapter 8, Hal Kendig and Ruth Phillips examine ageing as
a social policy issue, highlighting costs for the future and
attitudes towards ageing. The changing notions of retirement,
and post-retirement income issues, are very well discussed.
Health phenomena such as growing numbers of people
with dementia, who are at the higher cost end of health-care
services, pose threats to the quality and quantity of health care.
On the brighter side, the authors point to a neglected economic
opportunity with more older Australians working longer.
Realistically, they point out, we should not be perpetuating
stereotypes of the ageing problem (ageism) which serves to be
an obstacle across Eastern as well as Western cultures. Instead,
an age-friendly society will seek to facilitate social participation for all age groups. In a parallel chapter, Eun-jeong Kang
points to the higher labour force participation rate of the elderly in South Korea, compared to Australia, for example.
Unfortunately, this is not reflected in higher health status or
longevity (especially for men). South Korea is regarded as an
ageing but not yet aged society with challenges of continuity
of care, quality control and financial security, within the context of a weakening of family values, and hence a shift to the
government in responsibility for delivering long-term care.
The implementation of the Elderly Care Act (2006) began a
dramatic experiment in South Korean health care.
The last chapter, by Eugene Sebastian, provides a wide context
of changes in South Korean, Chinese and Japanese leadership,
with resolving enigmas of traditional and modern attitudes
and values. He points to the need for research on how
generational change has influenced the foreign policy of Asian
countries, and how changes there will influence their relations
with Australia.
This is an exciting book to read. References are broad and
recent and tables are usefully descriptive and informative. I
would recommend the book for those interested in generational
change, with emphasis on ageing and youth; female labour
force participation; child care and elderly care; and the impact
of digital technology. The interest will be for academics and
students providing demographics for health care in an ageing
world, and all health-care providers and managers interested
in health-care policy within the ageing context.
Andrew G Remenyi
Remenyi & Associates Pty Ltd
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