Coping with adequate and inadequate self-assessment of older people’s risk of falling: a mixed-methods study in Germany.

Background: Older people are exposed to an increased risk of falling due to a multitude of physiological and functional changes and fear of falling. The risk of falling is assessed and managed differently. It should be found out whether the coping strategies of older people differ with regard to their activities in daily life depending on the adequacy of their self-assessed fall risk. Methods: Adequacy of the perceived fall risk was evaluated with the de Morton Mobility Index and the Activities-specific Balance Confidence Scale among 100 older people. Additionally, semi-structured interviews were conducted in 16 participants with an identified fall risk. Coding techniques, based on structuring qualitative content analysis and the half-split method were applied. Results: Six out of 16 interviewees assessed their fall risk adequately. Interviews with the seniors resulted in topics such as coping strategies and awareness and several sub-topics in each category. Participants who adequately assessed their own fall risk reported an “active/positive” coping behavior and awareness of themselves. In contrast, those who assessed their own risk of falling inadequately covered all identified categories with no identifiable pattern. Conclusion: An adequate self-assessment of fall risks is accompanied by positive coping strategies to maintain an active lifestyle. In contrast, a lack of an adequate self-awareness seems to lead to arbitrary coping strategies. Assisting older people in their self-awareness regarding their own fall risk should be emphasized in order to adopt positive coping strategies. Future studies are necessary to better understand the underlying mechanisms that lead to an adequate or inadequate self-assessment in older people fall risk.