The experience of falling of older people with dementia and their carers

Abstract

Falling by older people is of significant global concern as the population ages, because of subsequent injury, disability, admission to long-term care and mortality. Older people experiencing dementia are twice as likely to fall with more severe consequences. Unsurprisingly, carer-burden increases when a care-recipient falls. Older people are rarely asked about their falls experiences and those with dementia less so. The studies presented in this thesis explore the experiences of falling of older people with dementia and memory problems, and their carers. The studies were informed by contextualism and the primary study used interpretative phenomenological analysis to explore the experiences of nine older people with dementia and their 10 carers, using one-to-one and joint interviews, and three focus groups with nine older people experiencing memory problems and 12 carers from a branch of the Alzheimer’s society. Analysis of the data considered the falls experience itself and the perceived consequences of falls within two higher level themes: ‘Falling as a malevolent force’ as two themes - ‘Going back to the experience’, ‘Reactions, responses and coming to terms with events’, and ‘Falling as the manifestation of dementia’ as two themes - ‘Self, identity and falling’, ‘The caring relationship’. The secondary study elaborated upon primary study data using an inductive interpretative approach unaligned to any tradition. Older people recently diagnosed with dementia and carers from another Alzheimer’s Society branch participated in two focus groups. Participants discussed stimulus cards with quotations from primary study participants. Thematic analysis suggested four major themes: Making sense of falls, The personal and social significance of falling, Falling, self and identity and Struggling to care. The findings demonstrate how falling and dementia are enmeshed and embodied experiences for participants. Spouse-carers’ discussion of their own falls emphasise the need for joint assessment and intervention to reduce carerburden and preserve couplehood.