Older Adults and Informal Caregiver Perceptions on Prevention of Falls during Care Transitions

The significance of discharge instruction has been demonstrated when older adults are equipped with knowledge regarding self-care following hospital discharge (Bobay et al., 2010; Foust et al., 2012; Maloney & Weiss, 2008). However, only one study of 333 subjects, conducted in Australia, examined older adults’ perceptions about fall prevention strategies after discharge and found that many had little knowledge about appropriate strategies to prevent falls at home (Hill et al., 2011). Carroll, Dykes, and Hurley (2010) interviewed nine patients who had fallen while hospitalized and found that most were not aware of their risk of falling. A recent pilot study demonstrated that elders designated at high risk for falls during hospitalization did not perceive that they were at risk for falls or received interventions to prevent falls during hospitalization and at discharge (Shuman et al, in press). These findings suggest that patients may not be mindful of their risk for falls, and perceive that the healthcare team will keep them safe. These findings also suggest that there is significant room for improvement of healthcare providers’ engagement with patients and families to address fall risk and interventions to prevent falls.

No studies have elicited informal caregivers’ perceptions about their family members’ risk for falls and actions to prevent falls. Understanding informal caregivers’ perceptions are an important component of care transitions of older adults. The public health problem of falls and fall injuries in older adults is not likely to improve until we address this issue from a care transitions perspective that is patient and caregiver specific.

Thus, the purpose of this exploratory study is to examine patients’ and their informal caregivers’ perceptions about falls and prevention of falls as they transition from the hospital to their home.