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      Characteristics of outdoor falls among older people: a qualitative study

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          Abstract

          Background

          Falls are a major threat to older people’s health and wellbeing. Approximately half of falls occur in outdoor environments but little is known about the circumstances in which they occur. We conducted a qualitative study to explore older people’s experiences of outdoor falls to develop understanding of how they may be prevented.

          Methods

          We conducted nine focus groups across the UK (England, Wales, and Scotland). Our sample was from urban and rural settings and different environmental landscapes. Participants were aged 65+ and had at least one outdoor fall in the past year. We analysed the data using framework and content analyses.

          Results

          Forty-four adults aged 65 – 92 took part and reported their experience of 88 outdoor falls. Outdoor falls occurred in a variety of contexts, though reports suggested the following scenarios may have been more frequent: when crossing a road, in a familiar area, when bystanders were around, and with an unreported or unknown attribution. Most frequently, falls resulted in either minor or moderate injury, feeling embarrassed at the time of the fall, and anxiety about falling again. Ten falls resulted in fracture, but no strong pattern emerged in regard to the contexts of these falls. Anxiety about falling again appeared more prevalent among those that fell in urban settings and who made more visits into their neighbourhood in a typical week.

          Conclusions

          This exploratory study has highlighted several aspects of the outdoor environment that may represent risk factors for outdoor falls and associated fear of falling. Health professionals are recommended to consider outdoor environments as well as the home setting when working to prevent falls and increase mobility among older people.

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          Most cited references46

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          Interventions for preventing falls in older people living in the community

          Cochrane Database of Systematic Reviews
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            Summary of the Updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons.

            (2011)
            The following article is a summary of the American Geriatrics Society/British Geriatrics Society Clinical Practice Guideline for Prevention of Falls in Older Persons (2010). This article provides additional discussion of the guideline process and the differences between the current guideline and the 2001 version and includes the guidelines' recommendations, algorithm, and acknowledgments. The complete guideline is published on the American Geriatrics Society's Web site (http://www.americangeriatrics.org/health_care_professionals/clinical_practice/clinical_guidelines_recommendations/2010/). © 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.
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              Understanding environmental influences on walking; Review and research agenda.

              Understanding how environmental attributes can influence particular physical activity behaviors is a public health research priority. Walking is the most common physical activity behavior of adults; environmental innovations may be able to influence rates of participation. Review of studies on relationships of objectively assessed and perceived environmental attributes with walking. Associations with environmental attributes were examined separately for exercise and recreational walking, walking to get to and from places, and total walking. Eighteen studies were identified. Aesthetic attributes, convenience of facilities for walking (sidewalks, trails); accessibility of destinations (stores, park, beach); and perceptions about traffic and busy roads were found to be associated with walking for particular purposes. Attributes associated with walking for exercise were different from those associated with walking to get to and from places. While few studies have examined specific environment-walking relationships, early evidence is promising. Key elements of the research agenda are developing reliable and valid measures of environmental attributes and walking behaviors, determining whether environment-behavior relationships are causal, and developing theoretical models that account for environmental influences and their interactions with other determinants.
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                Author and article information

                Journal
                BMC Geriatr
                BMC Geriatr
                BMC Geriatrics
                BioMed Central
                1471-2318
                2013
                18 November 2013
                : 13
                : 125
                Affiliations
                [1 ]Bournemouth University Dementia Institute and Psychology Research Centre, School of Design, Engineering & Computing, Bournemouth University, Poole House, Talbot Campus, Poole, Dorset BH12 5BB, UK
                [2 ]Research Design Service South Central, Faculty of Medicine, University of Southampton, Tremona Road, Southampton SO16 6YD, UK
                [3 ]Centre for Innovative Ageing, Swansea University, Singleton Park, Swansea SA2 8PP, UK
                [4 ]SURFACE Inclusive Design Research Centre, School of the Built Environment, The University of Salford, The Crescent, Salford M5 4WT, UK
                Article
                1471-2318-13-125
                10.1186/1471-2318-13-125
                3835551
                24245830
                47e27931-6054-4ce7-acd2-5b74da661f27
                Copyright © 2013 Nyman et al.; licensee BioMed Central Ltd.

                This is an open access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 August 2013
                : 12 November 2013
                Categories
                Research Article

                Geriatric medicine
                accidental falls,outdoors,older people,environment and public health,fear of falls,qualitative research

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