The Essence of Fear of Falling: A Phenomenology of Fear of Falling Amongst Care Recipients and Caregivers

Abstract

Fear of falling (FoF) has been extensively studied in aging populations, due to the high prevalence of both falling and FoF in older adults. Research has identified a number of biological, psychological, and social/environmental factors related to the development of FoF. Research has yet to explore how FoF impacts the daily lives of caregiver and care recipient dyads along biological, psychological, and social/environmental domains. Existing literature also fails to provide clinicians, and in particular physical therapists, with considerations for the evaluation and clinical interviewing process for individuals seeking care related to FoF. This dissertation study is a phenomenology in which the essence of FoF was explored to understand the lived experiences of caregivers and care recipients who experience FoF within the dyadic relationship. Semi-structured interviews were conducted with four caregiver - care recipient dyads where at least one member of the dyad self -reported having FoF. An a priori code list, informed by the biopsychosocial model, was combined with an open analysis that assisted the principal investigator in gaining a deeper understanding of how FoF impacts the daily lives of older adults and their caregivers. Care recipient experiences with regard to FoF included: threats to autonomy, acceptance, maintenance of independence, and influence of the caregiver. Caregiver experiences with respect to caregiver concern for the care recipient falling included: burden of caregiving with respect to caregiver fall concern, compartmentalization during a fall emergency, , and reasons for caregiver fall concern. Lastly the experiences of the dyads were highlighted by the following themes: planning for the future and limiting burden. Communication regarding fall concerns, perception of care recipient fall risk and physical limitations were identified as potential sources of turbulence within the caregiving dyad. The results of this investigation suggest that the shared essence ofFoF amongst study participants was the need to preserve their way of life. This investigation identified suggestions for the initial examination of individuals seeking physical therapy care regarding FoF and supports interdisciplinary treatment.