Fear of falling : the experience of elderly individuals who have previously fallen

Fear of falling resulting from a previous fall has serious health implications for elderly individuals who live in the community. This fear has been linked to activity restriction, poor physical health, increased dependence, and lifestyle changes. Previous research on fear of falling has described it in relation to other outcomes of a fall and not as a discrete entity. None of the studies included the individual's perspective. Therefore, the purpose of this study was to describe the meaning of the experience of fear of falling from the perspective's of elderly individuals who have previously fallen. The phenomenological method was used to gain an understanding of the subjective experience of the nine elderly community-dwelling individuals who participated in the study. All of the participants had fallen more than once and all had sustained an injury from a fall. In the course of two or three interviews, each participant and the researcher constructed an account of the participant's experience of the fear of falling. Using content analysis the data was conceptualized into themes and concepts reflective of the participants' perspectives. The presentation of this descriptive data was organized into two major themes which represented a process of adjustment: making meaning of the experience of the fear of falling and integrating the meaning of the experience into daily living. The findings revealed that fear of falling threatened the individual's physical and psychological survival. In response a process of adjustment was initiated in which the individual used behavioural and cognitive activities that sought to maintain control and were self-enhancing. The participants' accounts of their fear of falling highlight the importance of determining the client's perspective in order to understand and work with elderly individuals who fall and are afraid of falling again. In light of the research findings implications for nursing practice, nursing education, and nursing research are discussed.