RESUMEN
AIM AND OBJECTIVE: This study has investigated older people's experiences of a recent fall, its impact on their health, lifestyle, quality of life, care networks, prevention and their views on service use. BACKGROUND: Falls are common in older people and prevalence increases with age. Falls prevention is a major policy and service initiative. DESIGN: An exploratory, qualitative design involving two time points. METHOD: A convenience sample of 27 older people from two primary care trusts who had a recent fall. Taped semi structured qualitative interviews were conducted and repeated at follow up to detect change over time and repeat falls. Data were collected on their experience of falls, health, activities of living, lifestyle, quality of life, use of services, prevention of falls, informal care and social networks. Content analysis of transcribed interviews identified key themes. RESULTS: The majority of people fell indoors (n = 23), were repeat fallers (n = 22) with more than half alone when they fell (n = 15). For five people it was their first ever fall. Participants in primary care trust 1 had a higher mean age than those in primary care trust 2 and had more injurious falls (n = 12, mean age 87 years vs. n = 15, mean age 81 years). The majority of non-injurious falls went unreported to formal services. Falls can result in a decline in health status, ability to undertake activities of living, lifestyle and quality of life. CONCLUSIONS: Local informal care and support networks are as important as formal care for older people at risk of falls or who have fallen. Access to falls prevention programmes and services is limited for people living in more rural communities. RELEVANCE TO PRACTICE: Falls prevention initiatives and services should work with local communities, agencies and informal carers to ensure equitable access and provision of information, resources and care to meet the needs of older people at risk or who have fallen.
Asunto(s)
Accidentes por Caídas , Actitud Frente a la Salud , Estado de Salud , Estilo de Vida , Calidad de Vida/psicología , Accidentes por Caídas/prevención & control , Accidentes por Caídas/estadística & datos numéricos , Actividades Cotidianas/psicología , Anciano de 80 o más Años , Comorbilidad , Costo de Enfermedad , Femenino , Estudios de Seguimiento , Encuestas de Atención de la Salud , Encuestas Epidemiológicas , Humanos , Masculino , Investigación Metodológica en Enfermería , Investigación Cualitativa , Factores de Riesgo , Apoyo Social , Encuestas y Cuestionarios , Reino Unido/epidemiologíaRESUMEN
AIM: This paper is a report of a study to explore the experiences of older people who suffered a recent fall and identify possible factors that could contribute to service development. BACKGROUND: Falls in older people are prevalent and are associated with morbidity, hospitalization and mortality, personal costs to individuals and financial costs to health services. METHOD: A convenience sample of 27 older people (mean age 84 years; range 65-98) participated in semi-structured taped interviews. Follow-up interviews during 2003-2004 were undertaken to detect changes over time. Data were collected about experience of the fall, use of services, health and well-being, activities of daily living, informal care, support networks and prevention. Thematic content analysis was undertaken. FINDINGS: Twenty-seven initial interviews and 18 follow-up interviews were conducted. The majority of people fell indoors (n = 23) and were alone (n = 15). The majority of falls were repeat falls (n = 22) and five were a first-ever fall. People who reflected on their fall and sought to understand why and how it occurred developed strategies to prevent future falls, face their fear, maintain control and choice and continue with activities of daily living. Those who did not reflect on their fall and did not know why it occurred restricted their activities and environments and remained in fear of falling. CONCLUSION: Assisting people to reflect on their falls and to understand why they happened could help with preventing future falls, allay fear, boost confidence and aid rehabilitation relating to their activities of daily living.