Elderly women's experiences of living with fall risk in a fragile body: a reflective lifeworld approach

Abstract

The purpose of this qualitative study was to explore the lived experience of fall risk from a lifeworld perspective in elderly women with previous fragility fractures. Thirteen elderly women with a high risk of fall and fracture, aged 76-86, living in their own homes in rural areas, were recruited from a voluntary fracture prevention programme. All women had a history of fragility fractures and were interviewed in their homes from spring to autumn 2004. A phenomenological reflective lifeworld approach was chosen to analyse in-depth interview data. The study was conducted within an interdisciplinary research group inspired by dialogical research. Elderly women's life space has been narrowed due to advanced age, physical injury or by efforts to prevent new injuries leading to changes in self-perception. However, the women seek strategies to challenge limitations and insecurity, and strive to retain mobility and daily life routines. The four major constituents of the phenomenon 'elderly women's experiences of fall risk' emerged in this study: a changing body, living with precaution, ambiguous dependency and influence and need for understanding. Employing the women's thoughts and resources in trust-based dialogues with caregivers may strengthen their concord and the prospects to continue an active life. Elderly women seek strategies to challenge limitations and feelings of insecurity, and strive to maintain mobility and daily life routines. A trust-based care respecting the preferences of the women seemed to stimulate behavioural change in maintaining an active life.

The Ankle Injury Management (AIM) trial: a pragmatic, multicentre, equivalence randomised controlled trial and economic evaluation comparing close contact casting with open surgical reduction and internal fixation in the treatment of unstable ankle fractures in patients aged over 60 years

“…Older women who have experienced a fall note how walking aids expose their vulnerability and weakness to others yet are essential to maintaining daily life. 108 In this study, living with hopping reduced the geographical space participants could live in, in and outside the home. Reduced life space outside the home is also identified as the result of living more carefully after a fall.…”

“…Reduced life space outside the home is also identified as the result of living more carefully after a fall. 108 Any support for mobility from professionals was gratefully received, although not consistent in its provision. Many participants' skill improved as they felt better and became more mobile, but many did not improve and just waited until they could weight-bear.…”

“…There was some concern in both groups about causing damage to their 'fragile body', which is also evident in women living with osteoporosis 109 and women at risk of falling who actively protect themselves from further damage. 108 Although altruistic reasons for participation in the trial were expressed, other common rationales for trial participation included trust in the surgeon and personal benefits. 84,85 However, there was concern that personal benefits may link to misunderstandings of trial design 84 and, in this study, there was evidence that some participants did not fully understand randomisation or had little memory of the trial.…”

Older adults, falls and technologies for independent living: a life space approach

“…Their findings suggest that not only do some older people experience shame as a result of falling, but that they also restrict their activity rather than suffer the psychological damage that they perceive to be associated with a fall. In Canada, Ward-Griffin et al (2004) used a phenomenological approach to explore perceptions of falling amongst community-dwelling older people and found a tension between ' taking care' and ' striving for independence '. Berlin Hallrup et al (2009) This paper draws on the qualitative elements of a small exploratory, life-space diary study that was part of a large, multidisciplinary and multi-sited Irish research programme into ageing, Technologies for Independent Living (TRIL).…”

What is the evidence of the experience of having a fall across the life course? A qualitative synthesis

“…This literature highlights how strategies such as tackling underlying health problems, initiating strength and balance training, offering home modifications and checking footwear [9,12] cannot be treated as having simple cause and effect impact. Qualitative studies, drawing on psychological, phenomenological and sociological theories, offer individual and societal insights into the meaning of falling and fear of falling [18][19][20][21][22]. Such insights may contribute to the understanding of falling as an unwanted identity [23] or as a negative stereotype of ageing [18,20].…”