Why do hospitalized older adults take risks that may lead to falls?

Background: The behaviour of hospitalized older adults can contribute to falls, a common adverse event during and after hospitalization. Objective: To understand why older adults take risks that may lead to falls in the hospital setting and in the transition period following discharge home. Design: Qualitative research. Setting and participants: Hospital patients from inpatient medical and rehabilitation wards (n = 16), their informal caregivers (n = 8), and health professionals (n = 33) recruited from Southern Health hospital facilities, Victoria, Australia. Main variables studied: Perceived motivations for, and factors contributing to risk taking that may lead to falls. Main outcome measures: Semi-structured, in depth interviews and focus groups were used to generate qualitative data. Interviews were conducted both 2 weeks post-hospitalization and 3 months post-hospitalization. Results: Risk taking was classified as; (i) enforced (ii) voluntary and informed and (iii) voluntary and mal informed. Five key factors that influence risk taking behaviour were (i) risk compensation ability of the older adult, (ii) willingness to ask for help, (iii) older adult desire to test their physical boundaries, (iv) communication failure between and within older adults, informal care givers and health professionals and (v) delayed provision of help. Discussion and Conclusion: Tension exists between taking risks as a part of rehabilitation and the effect it has on likelihood of falling. Health professionals and caregivers played a central role in mitigating unnecessary risk taking, though some older adults appear more likely to take risks than others by virtue of their attitudes.