Qualitative study on the impact of falling in frail older persons and family caregivers: foundations for an intervention to prevent falls.
OBJECTIVE
The primary aim of this study was to explore the impact of falling for frail community-dwelling older persons with and without cognitive impairments who have experienced a recent fall and their primary family caregivers. The secondary aim was to define components for a future fall prevention programme.


METHODS
Grounded theory interview study, with 10 patients (three cognitively unimpaired, four with mild cognitive impairment and three with dementia) and 10 caregivers.


RESULTS
All patients described a fear of falling and social withdrawal. Caregivers reported a fear of their care recipient (CR) falling. Most patients were unable to name a cause for the falls. Patients rejected the ideas that falling is preventable and that the fear of falling can be reduced. Some caregivers rated the consequences of their CRs' cognitive problems as more burdensome than their falls and believed that a prevention programme would not be useful because of the CRs' cognitive impairment, physical problems, age and personalities.


CONCLUSIONS
Falling has major physical and emotional consequences for patients and caregivers. A fall prevention programme should focus on reducing the consequences of falling and on promoting self-efficacy and activity. The causes of falls should be discussed. The programme should include dyads of patients and caregivers because caregivers are highly involved and also suffer from anxiety. Before beginning such a programme, providers should transform negative expectations about the programme into positive ones. Finally, caregivers must learn how to deal with the consequences of their CRs' falling as well as their cognitive impairment.
Faes
Miriam C
MC
Department of Geriatric Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. m.faes@ger.umcn.nl
Reelick
Miriam F
MF
Joosten-Weyn Banningh
Liesbeth W
LW
Gier
Maartje de
Md
Esselink
Rianne A
RA
Olde Rikkert
Marcel G
MG
D000058:Accidental Falls / Q000517:prevention & control; D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology / Q000523:psychology; D000544:Alzheimer Disease / Q000503:physiopathology / Q000523:psychology; D017028:Caregivers / Q000193:education* / Q000523:psychology; D004522:Educational Status; D004644:Emotions; D005260:Female; D016330:Frail Elderly / Q000523:psychology; D006801:Humans; D007398:Interpersonal Relations; D007406:Interview, Psychological; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011314:Preventive Health Services; D036301:Qualitative Research; D012111:Residence Characteristics; D012737:Sex Factors