The Perspective and Needs of Older Adults With Osteoporosis With a Recent Upper Extremity Fragility Fracture Concerning Fall Risk and Fear of Falling

BACKGROUND AND PURPOSE: Osteoporosis increases the risk of fragility fractures, contributes to significant morbidity, and is a psychological challenge-fear of falling (FoF)-which can limit activity and engagement in rehabilitation. These challenges are often overlooked after a fracture, despite their relevance to rehabilitation planning. Understanding these challenges is crucial for health care practitioners, particularly physical and occupational therapists, who are central to fall prevention and post-fracture care. This study explored the perspectives of older adults with osteoporosis who had upper extremity fractures, focusing on their health concerns, the impact of falls and FoF on daily life, and their views on rehabilitation. METHODS: This qualitative study used interpretive description methodology. Thirteen participants (mean age: 67.3 years) were recruited from a hospital in Ontario, Canada. In-depth, semi-structured interviews were conducted and analyzed using inductive coding and constant comparison, with themes emerging from the participant narratives. Interviews continued until thematic saturation was reached. RESULTS: Four overarching themes emerged: (1) The complex interplay of multiple factors is associated with falls, (2) Navigating life after a fall involves both adaptive strategies and maladaptive changes, (3) Implementing comprehensive strategies is crucial for preventing falls and managing FoF, and (4) achieving optimal osteoporosis care remains an ongoing struggle. Participants described limited awareness of osteoporosis as a fall risk factor and gaps in education and rehabilitation support. CONCLUSIONS: Older adults with osteoporosis face multifaceted challenges related to fall risk and FoF. Findings highlight the need for better patient education, psychological support, and access to comprehensive rehabilitation addressing both physical and psychological health needs.