Gender and the negotiation between older people and their carers in the prevention of falls

Abstract

Little is known about how negotiation between older people and their carers varies according to gender. This paper reports a study of older men and women who have had multiple falls and the actions of their key family members to prevent multiple falls. In-depth interviews were conducted with 35 older people who had had recurrent falls, and separately with the identified key family member. The actions taken by the relatives to prevent future falls were classified as protective, coercive, negotiating, engaging and ‘reflective of mutual respect’. It was found that sons caring for older mothers took only ‘protective’ and ‘coercive’ actions, resulting in mothers having passive and submissive roles. In contrast, the daughters who were caring for their fathers undertook most often ‘engaging’ and some ‘negotiating’ actions, which empowered the fathers in their decision making. Daughters had a ‘peer-like’ relationship with the mothers that they supported and cared for, and undertook primarily ‘negotiating’ as well as ‘engaging’ actions. The two men who cared for older men took no specific actions but maintained mutual respect for each other. The findings demonstrate several ways in which the gender of the dyad members influences the nature of the negotiation between close relatives, and throws light on the factors that influence the autonomy and dependence of older people.