Falls and falls prevention in residential care: perspectives of older people in Western Australia and Wales, UK.

Background Older people living in residential care face a 50% chance of falling annually (Nyman and Victor 2011). Reducing falls through a range of multi-factorial falls prevention interventions is a goal of most provider organisations. To be effective interventions need to be adopted and enacted in people’s daily lives. However, there is limited evidence identifying what older people think and understand about falls and falls prevention or what may limit or enable adoption of interventions in residential care settings. Aim This study aimed to ascertain knowledge and awareness of falls risks and prevention strategies and opportunities, motivation and confidence to adopt falls prevention activities amongst older adults living in residential care. MethodsA cross-sectional survey with a convenience sample of people (n=70) with mental capacity aged over 65 living in residential care in Australia (n=6) and Wales (n=6) between May 2015 and October 2016. A customised questionnaire developed using health behaviour change domains (Michi et al., 2011) incorporating open and closed questions and Likert scales was administered by researchers. Data were summarised using descriptive statistics and compared using the Mann-Whitney U test. Open-ended responses were transcribed and content analysis utilised.Results Participants had limited knowledge about intrinsic falls risk factors and strategies to address these. They frequently expressed self-blame regarding falling. Almost all [n=67, (95.7%)] felt highly motivated to maintain their current functional mobility and independence in everyday tasks. Preferences for falls prevention messages favoured a positive approach promoting wellness and independence via pictorial posters or brochures [n=37 (52.9%)] and small group discussions with demonstrations [n=18 (25.7%)].Conclusions Clear, current information about evidence for falls and strategies most beneficial for falls prevention must be provided. To be meaningful falls prevention education should be co-produced and re-framed around what motivates older people using alternative formats for delivery. This should facilitate intervention uptake and longer term adherence