Fear of falling is a common problem for many older adults, especially those living in nursing homes, and there is evidence that fear of falling can contribute to activity restriction, social isolation, functional decline, and ultimately, a higher risk of falling. The purpose of this mixed methods study was to gain insight into the factors associated with fear of falling and falls self-efficacy in nursing home residents and to gain an in-depth understanding of possible discrepancies between residents' self-reports of fear of falling and how their caregivers perceive that fear. Data were collected from interviews with 30 resident-staff caregiver dyads. Eligible residents were aged 65 or older and had a self-report of fear of falling. Residents completed questionnaires, an interview, and physical performance tests. Functional status (Nursing Home Physical Performance Test; Katz Index), balance (Three-Stage Balance Test), and social engagement (Index of Social Engagement) were assessed as correlates of fear of falling and falls self-efficacy. Eligible staff caregivers were direct care providers who were familiar with the daily care and practices of a resident enrolled in the study. Staff caregivers completed questionnaires and an interview. Results confirmed that fear of falling is an important concern for nursing home residents, and most residents had concerns about carrying out activities safely. However, for some residents a loss of independence was a greater concern than a fear of falling or an actual fall. This study also supported prior findings that fear of falling and falls self-efficacy are associated with poorer functional status and impairments in balance. Moreover, this study revealed a gap between staff caregivers' knowledge about residents' fear of falling and fears. Thus, it is recommended that all direct caregivers be given education to better understand fear of falling and falls in general and among the clients they serve, and staff caregivers monitor their own behaviors toward residents. It is also important for staff caregivers to routinely question residents about their fall concerns, even among those with low-fall risk. It is equally important for staff to be watchful of declines in social and self-care activities which should be reported for evaluation.
|Advisor:||Lach, Helen W.|
|Commitee:||Lorenz, Rebecca A., Willoughby, Lisa M.|
|School:||Saint Louis University|
|School Location:||United States -- Missouri|
|Source:||DAI-B 75/01(E), Dissertation Abstracts International|
|Keywords:||Falls, Fear of falling, Long term care, Nursing home|
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