12 Community Dwelling Elderly’s Perception of the Environment is the Missing Link in Understanding the Dynamics of Outdoor Falls and FOF in Falls Prevention

Abstract

Abstract Falls amongst elderly are common and with an ageing population fall numbers are steadily rising. Consequently, governments put increasing emphasis on prevention. At the same time, international concepts like “urban vitality” and “age friendly cities” are being implemented. As a result, there is an increasing need to make public space safe and accessible to elderly. We used a mixed methods approach within an interpretative framework to research how community dwelling elderly perceive their outdoor environment in relation to falls and fear of falling (FOF) in a neighborhood in Amsterdam, the Netherlands. Second, we determined how this perception affects outdoor mobility, behavior, activities and participation in order to conclude on the relevance of environment in falls prevention. We show that the environment has the ability to either enable or to limit seniors and determined which perceived environmental factors pose the greatest problem. However, we also argue that the influence of biopsychosocial factors is key in elderly’s perception of their surroundings. Furthermore, we discovered, through a process of interpretative theme finding, that self-perception, independence, adaptation and avoidance are important themes. Overall, our study contributes to provide governments with insight into how elderly experience the outdoor environment, which helps them to revise and adjust public space and social policy accordingly. Furthermore, it provides the basis for further research on how environmental factors can be integrated in a multi-faceted approach to falls prevention in order to enable elderly to negotiate the city jungle.