The Etiology and Experience of Falls: Community-Dwelling Older Adults' Perspectives

Background: Community-dwelling older adults’ falls represent a significant public health problem, and prevention is an important step to reducing healthcare costs and improving quality. According to Kochera (2002), 78% of all injuries that occurred from elderly falls happened in the community. Despite the fact that community-dwelling older adults have a higher risk for falls, there is less focus on fall prevention for this group. With the shift in the models of healthcare delivery from institutional to community settings; it is imperative that clinicians begin to understand fall prevention from community-dwelling older adults’ perspectives. This study explored the perspectives of fall experience from community-dwelling older adults to gain in-depth understanding of their views and experiences. Purpose: The purpose of the study was to gain better understanding of community-dwelling older adults’ views and experience of falls to support the design of appropriate fall prevention and reduction programs. Methods: This qualitative descriptive project utilized semi-structured questions with probes to explore the views of community-dwelling older adults who have experienced a fall within the previous 12 months of the study. Braun and Clarke’s (2006) six phase process of thematic analysis (TA) was used to guide the data analysis and generation. Results: 31 codes that were collated into seven themes described participants’ perceived etiology of falls and the implication for perceived quality of life following their fall experiences. Conclusion: This project provides firsthand evidence to strengthen fall prevention and reduction strategies for community-dwelling older adults.  Clinicians in community healthcare settings should take into account community-dwelling older adults’ perceived etiologies and implications of falls in designing fall prevention programs.  Healthcare professionals in general should recognize older adults’ awareness of the risk that the inevitable decline of aging present to their identity and dignity as individuals and a group. Their adherence to a fall prevention and reduction plan is influenced by the need to preserve their autonomy and identity as competent and independent members of society.

Significance and Implications: The study affirmed some existing evidence on the etiologies of community-dwelling older adults’ falls and perceived quality of life about their experience of falls. It also offers new information about community-dwelling older adults’ perception of the causes of their falls along with their perceived quality of life. Strength and Limitations: This study advanced the dialogue for fall prevention in community-dwelling older adults and offers new evidence to strengthen fall prevention and reduction strategies for community-dwelling older adults. However, findings should be interpreted in light of the relatively small sample size. This study should be replicated using a larger sample to validate or refute the findings of this study and gain deeper understanding of community-dwelling older adults’ perspectives of the etiology of falls. Older adutlts’ percieved etiologies and experince of falls will be imperative to finding solutions to the burden that older adult falls presents to society.