Getting help quickly: older people and community worker perspectives of contingency planning for falls management

Abstract

Purpose: Older people living in the community need to plan for getting help quickly if they have a fall. In this paper planning for falls is referred to as contingency planning and is not a falls prevention strategy but rather a falls management strategy. This research explored the perspectives of older people and community workers (CWs) about contingency planning for a fall.

Method: Using a qualitative descriptive approach, participants were recruited through a community agency that supports older people. In-depth interviews were conducted with seven older people (67–89 years of age) and a focus group was held with seven workers of mixed disciplines from the same agency. Older people who hadn’t fallen were included but were assumed to be at risk of falls because they were in receipt of services. Thematic analysis and concept mapping combined the data from the two participant groups.

Results: Four themes including preconceptions about planning ahead for falling, a fall changes perception, giving, and receiving advice about contingency plans and what to do about falling.

Conclusion: Both CWs and older people agree contingency planning requires understanding of individual identity and circumstances. CWs have limited knowledge about contingency planning and may be directive, informative, or conservative.

Implications for Rehabilitation

• Falls can result in serious consequences for older people.

• There is an evidence-practice gap as availability of and access to contingency planning does not necessarily mean older people will use it in a falls emergency.

• Older people prefer community workers to be directive or informative about contingency planning options but they do want choice and control.

• Increased community workers knowledge of, and collaborative decision-making about, contingency planning may promote patient-centered services and assist in closing the evidence-practice gap.

Keywords:

• Aging
• choice and control
• contingency planning
• falls
• health
• preferences

Acknowledgements

The authors would like to acknowledge the support of the Department of Social Inclusion and Domiciliary Care in South Australia. They would like to thank Angela Basso and Mandie Burdon for their encouragement and assistance. They would also like to thank the older people and the community workers who participated in the research.

Disclosure statement

The authors report no conflict of interest