Despite aggressive efforts to raise awareness in elders of the dangers of falling, a study conducted on Australians 60 and older reported that most did not consider themselves at any great risk, nor did they regard prevention information as relevant to them. Due to amounting social concerns - such as the feeling of embarrassment associated with using a cane or walker - and the overly positive perception of self-health, most elders acknowledge preventative methods but don't feel that they're in need of them.

The study was performed on three classes of elders: phoned interviews were made to 1) residents of Northern Rivers, New South Wales (where a fall-prevention intervention had been made five years prior) and 2) residents of Wide Bay, Queensland (the comparison community), and 3) a final group consisted of in-person interviews with eight focus groups that recently underwent a similar but shortened intervention process to group 1. The fall-prevention intervention was a five-year program called Stay on Your Feet (SOYF) that emphasized the fact that falls are an important health issue for elders, but are preventable. The phoned interviews asked elders to assess their physical activity, rate their own personal risk of falling and to agree or disagree with the statement: "Older people fall, and there is nothing that can be done about it." In addition to those questions, the focus group concentrated on how to best get the message through to elders to change their behavior through a revamped fall-prevention program.

Analysis of results showed that participants from group 1 had actually been affected by the prevention intervention from five years back. Members of group 1 were more likely than those from group 2 to classify falls as preventable and consider their prevention a priority, and were less likely to agree with the said statement about older people falling and the futility of trying to stop it. Aside from the minor impact of SOYF, however, there was almost no difference between participants' perception in both groups in respect to their personal risk of falling, with an equal 60% of respondents rating their risk of falling as low. For the focus group, most participants favored a message that stressed how keeping active will result in keeping one independent for longer. Members of the focus group were keen to emphasize how important it was for them to be able to live on their own and maintain daily tasks, although a fall would certainly alter any elders' independence. No participants of the focus group agreed with the notion that staying more active would result in a lesser chance of a fall.

In attempting to explain possible reasons for such results, it can be assumed that members of group 1 were duly affected by the intervention and retained knowledge of falls being both dangerous and preventable, but failed to include themselves as candidates at risk. While they were aware of the risks associated with falls, most felt those risks did not apply to them because of their health status. The focus groups' tendency to promote independence as a valuable asset that many elders fear losing may serve as a model that needs to be addressed in creating the best possible preventative program. The targeted program should be one that modifies traditional methods and places more emphasis on health and independence, which seems to be what the majority of elders favor and desire above all else.

-As reported in a February '08 issue of American Journal of Public Health

- Greg Gargiulo
Strulowitz and Gargiulo Physical Therapy
1 Nardone Place
Jersey City, NJ
sgptr Contact: japhyryder1320yahoo

About the author

Greg Gargiulo is the health editor for Strulowitz and Gargiulo Physical Therapy and Rehabilitation, a practice focused on providing high-quality Physical and Occupational Therapy through their offices in Hudson County for over 30 years. Aside from his medical contributions, Greg also writes music reviews for various Web sites and is a copyeditor at The Star-Ledger newspaper in Newark, NJ.

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