Fear of Falling

Aubrie Hurt
Occupational Therapy Student
United Healthcare
Services, 2016
 Fear of Falling (FOF)
Post-fall syndrome

Common in older adults who have and have NOT experienced a fall

FOF increases with age

More prevalent in women

Most commonly experienced when performing ADLs and when

ascending/descending stairs

National Council on Aging

 Fear of Falling in Older Adults
Older adults are more afraid of
falling than of robbery, financial
issues, or health problems

10% report an excessive fear

3% do not leave home due to this

fear

7% think no one one would notice

because they go days without
seeing anyone
Anxiety and Depression Association of America
 The Paradox
FOF increases the risk of

Falls

Entering a healthcare facility

Entering a nursing home

Loss of independence

Self-limiting activities
 Study
Purpose: To determine the effectiveness of an educational intervention in
reducing fear of falling and preventing recurrent falls in community-dwelling
older adults post fracture.
Population: 102 older adults (mean age 67) who sustained a wrist fracture
during a fall, discharged from ED
Randomized Control Trial
Intervention: Educational packets with evidence based information for fall prevention and
follow up phone call
Control: Educational packets with information about osteoporosis and follow up phone call
Outcome Measure: Validated 4 point fear of falling scale

Rucker, D., Rowe, B. H., Johnson, J. A., Steiner, I. P., Russell, A. S., Hanley, D. A., . . . Majumdar, S. R. (2006)
Results
Educational intervention was no more effective than non- fall related
educational materials with respect to either reducing fear of falling or falls
No significant difference between groups for FOF (p=.08)
Although intervention pts were less likely to report increase in fear of falling at 3 months post
follow up.
No significant difference between groups for falls...but almost (p=.059)
There was a trend towards an increase in recurrent falls among intervention patients compared
with controls.
Chang et al. (2014) also found that educational fall materials lead to an increase in falls.
Conclusion: a simple and pragmatic educational intervention undertaken in the
ED is unlikely to be sufficient to either reduce fear of falling or falls.
Rucker, D., Rowe, B. H., Johnson, J. A., Steiner, I. P., Russell, A. S., Hanley, D. A., . . . Majumdar, S. R. (2006)
 Treatment
Self-directed thinking
View falls as controllable, they are not a normal part of
aging!
Make changes at home to decrease fall risk
Set goals to increase activity
Exercise to increase strength and balance
Tai-Chi
Yoga
Exercise Programs
Fall Related Multi-factorial Programs
Zijlstra, G. A., Haastregt, J. C., Rossum, E. V., Eijk, J. T., Yardley, L., & Kempen,
Fear of Falling in Acute Care
What can we do?
Motivational Interviewing
Relate therapeutic exercise and activities to fall prevention
Address pts self-awareness
Pause and assess pts performance throughout session
Thorough review of Fall Prevention Handout
Suggest Yoga or Tai-Chi
Area Agency on Aging of West Michigan offers Tai-Chi, Yoga, and Matter of Balance
classes
Senior Neighbor Centers
Recovery Yoga at MVP Sports Complex
 References
https://www.adaa.org/living-with-anxiety/older-adults/fear-of-falling

http://www.karger.com/Article/Abstract/212543#

https://www.uhc.com/newsletters/november-2016/dangerous-falls

Lawson, Katherine A., and Eugenia Catalina Gonzalez (2014). The impact of fear of falling on functional independence among older adults receiving home health
services. Open Journal of Occupational Therapy, 2(3). Health Reference Center Academic,
go.galegroup.com/ps/i.do?p=HRCA&sw=w&u=lom_gvalleysu&v=2.1&it=r&id=GALE%7CA378558072&sid=summon&asid=c2234439328cf69bdaf9e35baa8d9d70.
Accessed 4 June 2017.

Rucker, D., Rowe, B. H., Johnson, J. A., Steiner, I. P., Russell, A. S., Hanley, D. A., . . . Majumdar, S. R. (2006). Educational intervention to reduce falls and fear of
falling in patients after fragility fracture: Results of a controlled pilot study. Preventive Medicine, 42(4), 316-319. doi:10.1016/j.ypmed.2006.01.008

Suzuki, M., Ohyama, N., Yamada, K., & Kanamori, M. (2002). The relationship between fear of falling, activities of daily living and quality of life among elderly
individuals. Nursing and Health Sciences,4(4), 155-161. doi:10.1046/j.1442-2018.2002.00123.xSuzuki, M.,

Zijlstra, G. A., Haastregt, J. C., Rossum, E. V., Eijk, J. T., Yardley, L., & Kempen, G. I. (2007). Interventions to Reduce Fear of Falling in Community-Living Older
People: A Systematic Review. Journal of the American Geriatrics Society, 55(4), 603-615. doi:10.1111/j.1532-5415.2007.01148.x