| Description |
Older adults who fall can develop fear of falling (FOF), resulting in self-imposed activity restriction and contributing to deconditioning and additional caregiving demands. Family caregivers can also develop fear of the older adult falling (FOAF), which has not been well studied. Using a mixed-method, cross-sectional, descriptive correlational design, study purposes were to determine the psychometrics of a modified scale, Fear of Older Adult Falling Questionnaire (FOAFQ); gain understanding of the meaning of FOF and FOAF; and describe the interdependent associations of FOF, FOAF, activity restriction, and caregiving burden among older adult-caregiver dyads. Evaluating the FOAFQ involved 5 content experts' surveys, 10 caregiver interviews, and 53 older adult-caregiver dyad surveys. The content-validity indices of content experts were lower (range 0.60-1.00) than caregivers (range 0.90-1.00). FOAFQ response patterns using graded-response modeling revealed a one-factor, 3-item FOAFQ version with acceptable psychometrics. Based on in-person interviews and surveys with 25 older adult-caregiver dyads using content analysis and quantitative coding with computational linguistic programs, being careful was one of the most important fall-coping strategies used by both older adults and caregivers. The constructs of FOF and FOAF involved affective (e.g., worry) and cognitive (e.g., cautious) properties. Affective words were more frequently used by caregivers than older adults (z = -2.23, p = .026). Caregivers reported considerably higher FOAF than older adults themselves (z = -2.81, p = .005). Older iv adults and caregivers also differed in their perceptions of falls and caregiving in the future and what level of being careful was sufficient. Despite these differences, dyad members relied on each other to cope with older adults' falls. Data analysis from a survey of 53 older adult-caregiver dyads using the actor-partner interdependence model revealed that family caregivers' FOAF was positively related to their caregiving burden (β = 1.05, p = .000) and their older adults' physical activity restriction (β = 1.55, p = .033). However, older adults' FOF was not related to physical activity restrictions (β = .68, p = .238), nor to their caregivers' burden (β = .17, p = .441). Taking these findings together, it is clear that older adults' falling can affect family caregivers. Fall intervention programs need to consider the relational context of falls, FOF, and FOAF among older adult-family caregiver dyads. |
