Personal Identity and Participation in Falls Reduction

Research on falls reduction has identified several effective approaches to reducing falls risk. Current evidence-based programs exist and can be used to reduce the risk of falls among older adult falls reduction program participants. Still uncertain, however, is how to recruit and retain older adult participants to falls reduction programs.

A recent qualitative study suggests that attending to an individual’s sense of identity when trying to recruit them for falls reduction programming is essential. (Walker et. al. 2011).

The authors of the study argue that falls reduction research should consider “the psychosocial effect of a fall on the health and well-being of older people” (Walker et. al., 22), or simply, the attitudes, feelings, and social life of the individual. In particular, the authors argue that identity is an important aspect to consider when examining the experience of a fall and falls prevention in general. The authors define identity as “knowing who you are and what is meaningful to you,” and refer to both self-identity and collective identity, or sense of belonging to a group or category.

Two falls prevention groups were observed consecutively, and interviews were conducted with a total of eleven members from both groups. Four themes that emerged from the data were:

  • service referral,
  • ideas of the typical “faller”,
  • age/gender difference, and
  • polite compliance.

These four themes were relevant to falls reduction programming in terms of recruitment and maintaining participation.

First, most participants attended the falls prevention program because a professional whom they respected had referred them to the program, not because they had identified any particular benefit themselves. Second, group participants also believed that a distinction exists between “people who are likely to fall” and those who aren’t—that is, there are “fallers” and “non-fallers.” Most participants indicated that “fallers” would be over 80 or better, be of particularly poor health, or have poor mobility. Interestingly, most participants who had fallen before saw themselves as “non-fallers.”

Third, individuals who saw themselves as different from the other program participants due to age or gender often felt alienated from the group, or struggled to participate. Fourth, the participation of many appeared to be “polite compliance”—maintaining the appearance of participation out of good manners and a wish to be respectful—rather than significant involvement in the program.

This finding adds to a growing body of qualitative literature that focuses on the attitudes and perceptions of falls reduction program participants (or potential participants). In reviewing this literature, it appears that involving individuals with falls reduction programs depends on a few factors—trusted professionals or friends can encourage participation, for example. And for such encouragement to work, the program must be designed around the identities of potential participants. Perhaps by focusing on aspects of falls reduction, namely those that encourage independence and the attainment of other goals such as mobility, providers can augment the appeal and effectiveness of falls reduction programs.


Walker, W.; Porock, D.; and Timmons, S. (2011). “The Importance of Identity in Falls Prevention.” Nursing Older People 23(2).


Click here for information about SAFE-TI, Mather LifeWays Institute on Aging’s falls reduction program.


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