The experience of recurrent fallers in the first year after stroke

Abstract

Purpose: Understanding the experiences of fallers after stroke could inform falls-prevention interventions, which have not yet shown effectiveness in this population. The aim of this study was to explore the experience of recurrent fallers post-stroke in relation to recovery and living with falls.

Methods: Participants who had more than one fall in the first year after stroke were identified from a prospective cohort study. The methods of grounded theory informed data collection and analysis. Semi-structured interviews were conducted, audio-recorded and transcribed. Coding was conducted and categories were developed inductively.

Results: Nine stroke survivors aged 53–85 were interviewed 18–22 months post-discharge. Participants had experienced between 2 and 9 falls and one participant suffered a fracture. Three inter-linked categories were identified: (i) Judging the importance of falls by exploring cause and consequence, (ii) getting back up, and (iii) being careful.

Conclusions: Stroke survivors’ assessment of their own falls-risk and their individual priorities contribute to their decisions around activity participation. “Being careful” could be described as a form of self-managing falls-risk. The inclusion of self-management principles, peer-educators, and education to rise from the floor in falls-management programmes warrants investigation. Not all falls were considered equally important by participants. This could be considered when defining falls-related outcomes.

Implications for Rehabilitation

• Healthcare professionals may be able to offer an increased sense of control to stroke survivors through education about how to avoid particular causes and consequences of falls.

• Falls-related advice should be specific, relevant to the individual, and respectful of their sense of identity.

• Being able to rise from the floor appears to be important for coping with falls and falls-risk.

• Professionals should be cognisant of the potential differences of opinion between stroke survivors and their families around management of falls-risk.

Keywords:

• Stroke
• qualitative research
• fear of falling
• accidental falls
• grounded theory

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

This work was supported by the Irish Research Council (Government of Ireland Postgraduate Scholarship Scheme 2013).