Fear of Falling Assessment and Interventions in Community-Dwelling Older Adults: A Mixed Methods Case-Series

Abstract

ABSTRACT Objectives (1) assess fear of falling (FOF) in community-dwelling older adults using subjective and objective measures and, (2) explore older adults’ perceptions of FOF assessments and interventions. Methods A mixed methods case-series was utilized. It consisted of quantitative data collection by objective measures including the BTrackSTM Balance Test (BBT) and a dynamometer to assess physiological fall risk, and in-depth interviews from four older adults in Orlando, Florida. A single Fear of Falling Scale and Falls Efficacy Scale-International (FES-I) were used to assess FOF. To combine quantitative and qualitative data, a case-specific analysis was used and followed by a cross-case analysis to gain a more comprehensive understanding of FOF. Results We found an incongruent fear of falling with physiological fall risk. Four themes emerged: (1) Fluctuating definitions of “fear” contribute to difficulty in assessments and interventions, (2) Fundamental assessments for fear of falling are missing, (3) Feedback from an objective measure is valuable, and (4) Family experiences with fear of falling drive personal interventions. Conclusions The integrated viewpoints from quantitative and qualitative data suggest a need for FOF assessment based on older adults’ perceptive and physiological measures. Clinical Implications Healthcare providers should assess FOF using subjective and objective measures.