Falls reduction programming can be effective in reducing falls thus enhancing the well-being and independence of many older adults. Even so, agencies and health care providers have difficulty encouraging older adults to take part in falls reduction programs. A recent article in the Journal of Aging Research explores the barriers to and motivations behind participating in falls reduction programs, citing a study conducted in Seattle among a sample of diverse, low-income, older adults (Calhoun et al. 2011).
The researchers conducted open-ended interviews with two groups of older adults treated for falls. One group of individuals accepted an invitation to a falls reduction program, and the other group declined the invitation. Interviews consisted of conversations about health-related beliefs and the role of aging in daily life, and were followed up by more direct questions regarding the experience of falls and attitudes about preventing falls.
Both groups spoke similarly in general terms about aging and wellness. Also, a majority of participants in both groups expressed a sense of loss about diminishing physical function. Both groups also had similar emotional responses to their own falls, expressed vigilance about avoiding further falls, and emphasized the importance of their own independence.
One difference among both groups became clear—participants had a different understanding of terms such as “independence” and “physical activity” than did public health professionals. For instance, older adults who received caregiving either at home or in a facility identified themselves as “independent,” reflecting a broader use of the term generally used in professional literature. Similarly, “physical activity” was used by participants to discuss what professionals tend to refer to as activities of daily living, rather than the sort of exercise and mobility usually referred to by professionals.
Both groups most apparently differed in their perception of a need for falls reduction programs. Participants in falls reduction programs stated that another fall would be the greatest risk to their own independence, and that any action taken to avoid another fall was worthwhile. In contrast, non-participants felt that there was no need for the program, citing a variety of reasons including the belief that they would be able to avoid another fall by being more careful, or even a fatalistic belief that nothing could be done to prevent a fall. Another main reason non-participants cited was a lack of available transportation to and from a falls reduction clinic/program site.
These findings suggest that more effective education of older adults regarding how falls can be a major threat to independence is necessary to best promote falls reduction programming. Agencies and health care providers may consider emphasizing that such programs offer practical recommendations and education to help individuals maintain their current level of functioning. Further, simplifying access and transportation to programs appears especially important.
