Understanding carers’ fall concern and their management of fall risk among older people at home

Abstract

Background Many older people (care recipients) experience long-term psychological distress due to the fear of falling again. Falls can affect carers due to concerns about their care recipients falling. Understanding carers’ fall concern is crucial to determine if carers are coping with the provision of care or have adequate knowledge and support in preventing their care recipients from falling at home. Methods A descriptive qualitative study was conducted to explore carers’ concern about their care recipients being at risk of falling and their management of fall risk at home. Twenty-two carers were recruited from two research registers and a large tertiary hospital in a regional centre of Australia. Carers were interviewed face-to-face, or by telephone using a semi-structured interview guide about their fall concern. The data was analysed using an inductive content analysis method. Results Eight major themes emerged from the interviews. Four themes described key factors influencing carers’ fall concern which include: 1) carers’ perception of fall and fall risk, 2) care recipients’ behaviour and attitude towards fall risk, 3) care recipients’ health and function, and 4) care recipients’ living environment. Another four themes described the management of care recipients’ fall risk which include: 5) fall prevention strategies used, 6) risk of preventing falls, 7) support from family and friends, and 8) support from healthcare professionals. Conclusions The findings from this qualitative study provide an insight into the carers’ awareness of fall risk, knowledge, and the availability of support in preventing their care recipients from falling at home. Healthcare professionals are encouraged to include carers and address their fall concern to improve fall prevention programmes for care recipients at risk of falling at home.

Care Transition Decisions After a Fall‐related Emergency Department Visit: A Qualitative Study of Patients’ and Caregivers’ Experiences

“…Given the complexity of the post-fall time period and the SNF placement decision-making process, qualitative research is well suited to assess generated themes. Prior qualitative studies have assessed community caregivers' concerns of care recipients' risk of falling and management at home, 23 as well as families' experiences with relationships and the quality of care following SNF placement of an older relative. 24 Ang et al 23 identified four themes in their interviews with carers: carers' perception of fall and fall risk, care recipient's behavior and attitude towards fall risk, care recipient's health and function, and care recipient's living environment.…”

“…Prior qualitative studies have assessed community caregivers' concerns of care recipients' risk of falling and management at home, 23 as well as families' experiences with relationships and the quality of care following SNF placement of an older relative. 24 Ang et al 23 identified four themes in their interviews with carers: carers' perception of fall and fall risk, care recipient's behavior and attitude towards fall risk, care recipient's health and function, and care recipient's living environment. The findings of our study highlight the many factors in the post-fall period that patients and caregivers consider in determining if SNF placement is indicated.…”

Knowledge, skills and attitudes of older people and staff about getting up from the floor following a fall: a qualitative investigation

“…From the evidence on falls prevention, the model of potential intervention considerations we developed (Fig. 1 ) is also supported by existing quantitative and qualitative evidence [ 8 , 11 , 21 ]. Physical and functional impairments [ 22 ] and living alone are associated with ability to get up after a fall [ 23 ]; only one staff participant highlighted that time and exercise training may be required to get people to the point of having the physical ability to get up, yet the benefits of maintaining activity for older people is recognised and has similar barriers to those we identified.…”

“…It is not only the person who has fallen who suffers; carers suffer distress due to the person fallen not being able to get up, or not being able to help them. They may be unsure how best to assist, which may result in their own injury or the need for additional assistance [10,11].…”

Investigating the psychometric properties of the Carers’ Fall Concern instrument to measure carers’ concern for older people at risk of falling at home: A cross‐sectional study

“…A recent qualitative study further explored the impact of older people's fall risk on carers and their management of fall risk at home (Ang, O’Brien, & Wilson, 2019). The findings revealed that fall concern was not limited to the intrinsic factors related to the older person such as ageing, cognitive and functional decline, or non‐compliance to fall prevention advice which can increase the risk of falling.…”