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Objective: To identify from the older adults' perspective, the factors associated with discussion about falls with their general practitioners and other health professionals and the factors associated with initiation of these discussions. We explored the content of and barriers to discussion about falls., Methods: A prospective cohort study where a baseline cross-sectional survey was followed by a survey 1 year later. Survey domains were drawn from constructs of behavioural change models. Data from 245 older community dwellers in Victoria, Australia, in the follow-up survey were used for this study. Survey format consisted of yes and no responses, Likert scale and open/closed-ended responses., Results: Few older adults talked with and initiated a talk with their health-care providers about falls in the follow-up period. Multiple regression showed anxiety or depression [OR = 2.78, 95% CI (1.21-6.41)], chronic medical conditions such as diabetes [OR = 2.71, 95% CI (1.19-6.17)] and having a self-reported fall in the last 12 months [OR = 4.26, 95% CI (2.16-8.41)] were associated with discussion of falls with general practitioners. Higher perception of risk of sustaining a serious injury from falling [OR = 1.49 (1.03-2.13)] was associated with discussion about falls with other health professionals. Participants discussed various topics of falls with their health-care providers. Different barriers to discussion about falls were identified., Conclusion: Health-care providers should routinely discuss falls prevention with older adults. Dissemination of evidence-based advice and followed up with referral during consultations, particularly in general practitioners could advance falls prevention practice. The results could help to develop a conceptual framework to predict the likelihood of falls discussion., (© 2013 John Wiley & Sons Ltd.)

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., (© 2012 John Wiley & Sons Ltd.)