Falls are on the mind of your aging patients. A 1996 study by Myers, Powell and Maki* reported that 56 percent of community-living elder patients who had experienced a fall indicated an ongoing fear of falling (FOF) – a number surprisingly lower than the 58 percent of the same population living with FOF who had not themselves fallen.
Considering that no American presidential candidate has received more than 58 percent of the popular vote since Ronald Reagan in 1984, the universality of FOF should be evident. As a nation, we can’t agree on much, but as we age, we agree in large numbers that we’re afraid of falls.
Unfortunately, though this reality should unite us, it often proves to do just the opposite. As FOF grips aging adults, they’re prone to believe themselves capable of less physical activity. They frequently start making excuses to avoid situations in which they anticipate a greater risk of experiencing a fall. This decrease in ostensibly risky physical activity can breed increased social isolation. Both have their own impacts on quality of life, none of which are positive.
Standing in the way of more beneficial outcomes is the stigma aging patients associate with being labeled a “faller.” Frailty, weakness and a general inability to take care of oneself are attached to such a stigma. Naturally, nobody desires to be viewed in these terms. It’s one thing to limit one’s own activities due to a secret fear of falls, but quite another to have restrictions imposed by a caregiver or medical provider once the “faller” label has been attached. Nothing validates the feared stigma more than when a patient who has fallen is immediately told that her frailness will require serious lifestyle restrictions and changes.
Try some of the following with your patients to de-stigmatize how they feel about being labeled a “faller.” You’ll help your patients remain invested in a care plan that will preserve their perceived self-efficacy and thereby their quality of life.
Share the Facts
Empowering your patients with solid, detailed information about falls and FOF can help them start to put their own views on the matter in a more educated context. Studies abound. They’ll tell you what you already know to be true – that a plurality of your older patients have FOF.
Philips Lifeline’s eBook, Fear-of-Falling in Older Persons distills much of the recent research into a digestible, seven-page PDF. In it, you’ll learn about various assessment tools to gauge FOF in your patients, and about various interventions designed to help mitigate the negative effects of FOF.
When you coordinate these messages with the mental health providers, nurses or other caregivers who see your patients, you’ll reinforce the validity of the information, as well as give your patients the experience of participating in more and more non-judgmental and non-stigmatized conversations. Over time, you’ll help break down the notion that there is anything especially different about being a “faller.”
Knowing that you’re not alone in fearing falls is a good first step to removing the stigma in your own mind. Getting your patient to this mindset may take more than just information.
Change the Context
Sometimes it’s hard to get your brain around something that has such concrete consequences in your own current life. It’s too close to home, and too packed with immediate emotional baggage. Instead, pick another label that might be seen as unsavory – “bad at sports,” for example – and explore the dynamics of the stigma associated with that label.
Chances are, everyone has experienced being bad at sports at some point in their lives. Consider the classic “being chosen last for a sport team” scenario depicted in countless films, television shows and books. The emotionally evocative power of these scenes depends upon a universally held memory of the feelings of anxiety and embarrassment that every individual who has ever waited to be chosen has felt in the past. Though the first few kids chosen may seem confident and fearless, their reactions to being selected often reveal a palpable relief that they no longer are at risk of being chosen last. Nobody wants everyone else to think they’re terrible at sports. No children, that is.