Fear and Risk of Falling, Activities of Daily Living, and Quality of Life Assessment When Older Adults Receive Emergency Department Care

Abstract

Background: Falls tend to create fear and concern in older adults who also seek care in emergency departments (EDs) at high rates. Aim: The purposes of this study were to (a) describe risk and fear of falling in older adults seeking care in the ED and (b) explore relationships between risk and fear of falling with activities of daily living and quality of life. Methods: The study was conducted in the ED of Ondokuz Mayis University Hospital in Samsun, Turkey. Data were collected for 7 months in 2013-2014. Adults aged 65 years and above who scored at least 20 on the Standardized Mini-Mental Test and who presented for care in the ED were eligible to take part. Patients self-reported demographic information and completed the Tinetti Falls Efficacy Scale, the Morse Fall Scale, the Nottingham Health Profile (NHP), and the Modified Barthel Index (MBI). Results: A total of 151 older adults took part. Prevalence of falls was high (48.3%), as well as fear of falling (63.6%). Risk of falling (Morse Fall Scale scores) was negatively correlated with the ability to carry out activities of daily living (MBI scores; r = -.50, p < .001) and positively related to scores on the NHP (r = .45, p < .001); likewise, fear of falling (Falls Efficacy Scale scores) was negatively correlated with the ability to carry out activities of daily living (MBI scores; r = -.79, p < .001) and positively correlated with NHP scores (r = .64, p < .001). Discussion: Older adults seeking care in the ED who have a higher risk of falling are more dependent in daily living activities and experience lower quality of life. Care seeking in the ED offers an opportunity to assess fall risk and fear of falling and provide guidance on prevention and management of falls in older adults.