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Project Summary:
Falls among older adults 65 years and older rank as the #2 cause of injury related deaths in the United States. Across all settings, older adults fall. Nearly 1/3 of community dwelling elders fall yearly, and in long term care facilities, the incidence of recurrent falls increases to over 50%. Older adults’ lived experiences of a serious fall, and as shown in prior work, often caused significant emotional distress due to the trauma incurred in the aftermath of the fall, igniting concrete plans of action to reduce risk of future falls [1]. In order to understand the perspective of the older adult who falls and can get up, even if injured, it is essential to uncover elders’ self- management habits and action plans.
Capturing the experiences of older adults who have survived a fall(s) and become adept in balancing potential falls in daily living can be accomplished through a focused exploration using narrative accounts and story-telling. This qualitative data can provide the foundation for secondary content analysis of how people manage to stay upright and not fall. Exemplars from this data can also be utilized to inform and educate younger and older audiences through illustrations, story books and other creative works. However, exploring older adults’ discourse about falls through their accounts alone, fails to address other poignant relationships which may exist between falling and one’s ability to get up. Examples include those related to locus of control, level of independence in function, character traits, coping style, sociodemographic variables, emotional, health and cognitive status, and quality of life. Therefore, another objective of this research project is to triangulate multiple data sources from one point in time, so that a richer portrayal can emerge to capture the essence of how older adults balance falls in their lives without becoming emotionally distressed. A third objective is to validate prior research findings of older adults emotional responses post fall [1]with a representative sample of older adults to one day develop a post fall emotional response rating scale to assist practicing clinician’s to better assess older adults.
We plan to enroll approximately 16 older adult residents from one of two long-term care facilities: CareOne at Evesham and/or the Frances E. Parker Home, Piscataway, NJ. Informed consent will be obtained from all study participants. Older adult residents entering the study will be followed for up to 3 months post-fall by one of 4 trained research assistants. Each trained research assistant will interview and prospectively follow between 3-4 older adults who are cognitively intact and interested in sharing their most recent fall experience. In addition to the interviews, residents will be assessed for their physical, mental, emotional and overall well being using standard metrics. One or two research assistants will be sought who are able to illustrate pictorial figures which capture the falling experience, in anticipation of creating a short story or other artistic work. Two research assistants will be sought to work with the researchers to analyze and prepare the findings for presentation.
Students will be involved and trained in obtaining informed consent and qualitative and quantitative data collection that captures the perspectives of residents at one of 2 clinical facilities. Supervision and training will be provided by Dr. Gray-Miceli, Assistant Professor of Nursing (a qualitative and quantitative nurse researcher) and Dr. Sabrina Chase, (a medical anthropologist), Assistant Professor and Director of the Urban PhD Program.
References:
Gray-Miceli D, Ratcliffe S.J. (2015). Post-fall emotional responses, functional limitations and action plans to manage falls among independent residing older adults with recurrent falls. The Gerontologist 55 (Suppl 2): 644 doi:10.1093/geront/gnv341.14.
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