Overcoming an Irrational Fear of Falling: A Case Study

Abstract

Irrational fear of falling is defined by the high degree of psychological fear a person has of falling when in reality, that person is at low physiological risk of falling. It is a significant problem in older people and may manifest from previous falls or fall-related depression and/or anxiety. If untreated, it may lead to increased falling, decreased mobility, social isolation, and decreased participation in daily activities. A mixed-methods, home-based, 8-week, physio-feedback/exercise program was developed for an older adult to help mitigate her irrational fear of falling. In this pilot case study, the quantitative independent variables of fear of falling, static balance, dynamic balance, fall risk factors, and fall risk appraisal were assessed pre- and post-intervention. A qualitative semi-structured interview was also conducted to help assess the participant’s reaction to the intervention. Data from quantitative, qualitative, and integrated viewpoints converged to indicate the intervention improved fear of falling, shifted the participant’s perception from irrational to rational fall risk appraisal and increased participation in daily activities.

A concept analysis of fear of falling in older adults: insights from qualitative research studies

“…They were more conscious of the activities they could perform and places they could visit because of their fear of falling [ 39 ] and reported that they strictly planned every day to maintain a good balance [ 34 ]. They recognized that their bodies are aging and expressed that this aging process made them more vulnerable to falls [ 35 , 39 , 40 ]. Reduced balance control, decreased vision and hearing, dizziness-related instability, and osteoporosis due to aging were associated with a fear of falling, and the older, lonely, and weaker they were, the stronger their fear of falling became [ 32 , 34 , 35 , 39 , 40 ].…”

“…They recognized that their bodies are aging and expressed that this aging process made them more vulnerable to falls [ 35 , 39 , 40 ]. Reduced balance control, decreased vision and hearing, dizziness-related instability, and osteoporosis due to aging were associated with a fear of falling, and the older, lonely, and weaker they were, the stronger their fear of falling became [ 32 , 34 , 35 , 39 , 40 ]. These feeling of weakness and vulnerability was caused by the lack of trust in their body.…”

“…The antecedent factors of fear of falling identified through previous studies were direct and indirect experiences of falls, threats perceived through near-fall experiences where they almost fell but managed to restore balance and changes in the environment [ 10 , 29 ]. Fear of falling also occurred after experiencing falls or depression or anxiety related to falls, or serious falls requiring medical intervention [ 30 , 36 , 40 , 42 ], friends’ or relatives’ experiences of bad falls [ 29 , 36 ].…”

“…It is reported that fear of falling forces individuals to avoid actions that are thought to perform without falling, thereby reducing the number of safe activities available to participate in, which eventually leads to avoidance and immobility [ 32 ]. They avoided activities they enjoyed in the past [ 39 , 42 ], partially, temporarily, or completely abandoned activities such as using stairs, or taking walks, and restricted themselves to perform only activities they felt confident in [ 36 , 40 , 44 ].…”

“…It is said that social activities decrease, resulting in social isolation (Fig. 2 ) [ 29 , 40 , 41 ].…”