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Seniors' narratives of asking (and not asking) for help after a fall: implications for identity

Published online by Cambridge University Press:  10 November 2014

PATRICIA A. MILLER ,
CHRISTINA SINDING ,
LAUREN E. GRIFFITH ,
HARRY S. SHANNON  and
PARMINDER RAINA
PATRICIA A. MILLER*
Affiliation:
School of Rehabilitation Science, McMaster University, Hamilton, Canada.
CHRISTINA SINDING
Affiliation:
School of Social Work, McMaster University, Hamilton, Canada. Department of Health, Aging and Society, McMaster University, Hamilton, Canada.
LAUREN E. GRIFFITH
Affiliation:
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada.
HARRY S. SHANNON
Affiliation:
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada. Institute for Work & Health, Toronto, Canada.
PARMINDER RAINA
Affiliation:
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada.
*
Address for correspondence: Pat Miller, PT, PhD c/o School of Rehabilitation Science, Institute for Applied Health Sciences, Room 403, McMaster University, 1400 Main Street West, Hamilton, Ontario, CanadaL8S 1C7. E-mail: [email protected]
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Abstract

Falls among community-dwelling seniors constitute a major public health concern because of the potential morbidity and mortality associated with the fall. This study examined the informal care networks accessed by Canadian seniors who had visited the Emergency Department as a result of a fall, and considered the implications of the processes of asking for and receiving help on the senior's identity. Four themes were identified. The first was valuing independence. The remaining three themes concerned threats to the participants' identities linked to the need to ask for or receive help from family and friends. They were: becoming indebted, feeling devalued and becoming a burden to others. Seniors were noted to excuse family members from the expectation of helping because of work and family commitments, and illness. Participants described a mutually beneficial relationship with friends wherein both parties valued their independence and provided assistance to the other when needed. Their comments suggested that assistance was viewed as a good to be traded among peers. Our findings indicate that seniors value their independence and may not seek help even when it appears to be available, if asking threatens valued identities. Health and social care practitioners and policy makers responsible for planning and delivery of services should take this into account in order to ensure the best possible care for injured community-dwelling seniors.

Keywords

narrative analysisinformal careseniorsidentityfalls
Type
Articles
Information
Ageing & Society , Volume 36 , Issue 2 , February 2016 , pp. 240 - 258
Copyright
Copyright © Cambridge University Press 2014 

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References

Blomgren, J., Breeze, E., Koskinen, S. and Martikainen, P. 2012. Help from spouse and from children among older people with functional limitations: comparison of England and Finland. Ageing & Society, 32, 6, 905–33.CrossRefGoogle Scholar
Burr, V. 2003. Social Constructionism. Routledge, New York.Google Scholar
Chappell, N. L. and Funk, L. 2012. Filial responsibility: does it matter for care-giving behaviour? Ageing & Society, 32, 7, 1128–46.CrossRefGoogle Scholar
Clemson, L., Finch, C. F., Hill, K. D. and Lewin, G. 2010. Falls prevention in Australia: policies and activities. Clinics in Geriatric Medicine, 26, 4, 733–49.CrossRefGoogle ScholarPubMed
Denton, M., Ploeg, J., Tindale, J., Hutchinson, B., Brazil, K., Aktar-Danesh, N., Lillie, J. and Plenderleith, J. M. 2010. Would older adults turn to community support services for help to maintain their independence? Journal of Applied Gerontology, 29, 5, 554–78.CrossRefGoogle Scholar
Dollard, J., Barton, C., Newbury, J. and Turnbull, D. 2012. Falls in old age: a threat to identity. Journal of Clinical Nursing, 21, 17–18, 2617–25.CrossRefGoogle ScholarPubMed
Gooberman-Hill, R. and Ebrahim, S. 2006. Informal care at time of change in health and mobility: a qualitative study. Age and Aging, 35, 3, 261–6.CrossRefGoogle Scholar
Government of Canada 2014. Veterans Independence Program. Available online at http://www.veterans.gc.ca/eng/services/health/veterans-independence-program [Accessed 3 March 2014].Google Scholar
Griffith, L., Raina, P., Worster, A., Émond, M., Sirois, M. J., Clayton, N. and Shannon, H. 2011. Physical functioning following Emergency Department visits for an unintentional injury in Canadian seniors. Abstracts of the 42nd Annual Scientific and Education Meeting of the Canadian Association on Gerontology, in Ottawa, Canada, October 21–23, 2011. Available online at http://www.cagacg.ca/files/ASEM-RSEA2011_Abstracts_FINAL.pdf [Accessed 25 March 2013].Google Scholar
Holstein, J. A. and Gubrium, J. F. 2012. Varieties of Narrative Analysis. Sage, London.CrossRefGoogle Scholar
Horton, K. and Arber, S. 2004. Gender and the negotiation between older people and their carers in the prevention of falls. Ageing & Society, 24, 1, 75–94.CrossRefGoogle Scholar
Hupcey, J. E. 1998. Clarifying the social support theory–research linkage. Journal of Advanced Nursing, 27, 6, 1231–41.CrossRefGoogle ScholarPubMed
Kong, K. S., Lee, F., Mackenzie, A. E. and Lee, D. T. 2002. Psychosocial consequences of falling: the perspective of older Hong Kong Chinese who had experienced recent falls. Journal of Advanced Nursing, 37, 3, 234–42.CrossRefGoogle ScholarPubMed
Lloyd, L., Canlan, M., Cameron, M., Seymour, J. and Smith, R. 2014. Identity in the fourth age: perseverance, adaptation and maintaining dignity. Ageing & Society, 34, 1, 1–19.CrossRefGoogle Scholar
McGee, H. M., Molloy, G., O'Hanlon, A., Layte, R. and Hickey, A. 2008. Older people – recipients but also providers of informal care: an analysis among community samples in the Republic of Ireland and Northern Ireland. Health and Social Care in the Community, 16, 5, 548–53.CrossRefGoogle ScholarPubMed
Minichiello, V., Browne, J. and Kendig, H. 2000. Perceptions and consequences of ageism: views of older people. Ageing & Society, 20, 3, 253–78.CrossRefGoogle Scholar
Mor-Barak, M. E. 1991. Social Networks and Health of the Frail Elderly. Garland Publishing, New York.Google Scholar
Riessman, C. K. 2008. Narrative Methods for the Human Sciences. Sage, Thousand Oaks, California.Google Scholar
Roe, B., Howell, F., Riniotis, K., Beech, R., Crome, P. and Ong, B. N. 2009. Older people and falls: health status, quality of life, lifestyle, care networks, prevention and views on service use following a recent fall. Journal of Clinical Nursing, 18, 16, 2261–71.CrossRefGoogle ScholarPubMed
Scott, V., Wagar, B., Sum, A., Metcalf, S. and Wagar, L. 2010. A public health approach to fall prevention among older people in Canada. Clinics in Geriatric Medicine, 26, 4, 705–18.CrossRefGoogle ScholarPubMed
Seibert, D. C., Mutran, E. J. and Reitzes, D. C. 1999. Friendship and social support: the importance of role identity to aging adults. Social Work, 44, 6, 522–33.CrossRefGoogle Scholar
Sherbourne, C. D. and Stewart, A. L. 1991. The MOS Social Support Survey. Social Science and Medicine, 32, 6, 705–14.CrossRefGoogle ScholarPubMed
Statistics Canada 2013. Portrait of Caregivers, 2012. Available online at http://www.statcan.gc.ca/pub/89-652-x/89-652-x2013001-eng.pdf [Accessed 3 March 2014].Google Scholar
Stevens, J. A., Baldwin, G. T., Ballesteros, R. K. and Sleet, D. A. 2010. An older adult falls research agenda from a public health perspective. Clinics in Geriatric Medicine, 26, 4, 767–79.CrossRefGoogle ScholarPubMed
Tideiksaar, R. 2010. Falls in Older People: Prevention and Management. Fourth edition, Health Professions Press, Baltimore, Maryland.Google Scholar
Vézina, M. and Turcotte, M. 2010. Caring for a Parent Who Lives Far Away: The Consequences. Available online at http://www.statcan.gc.ca/pub/11-008-x/2010001/article/11072-eng.htm [Accessed 25 March 2013].Google Scholar
Walker, W., Porock, D. and Timmons, S. 2011. The importance of identity in falls prevention. Nursing Older People, 23, 2, 21–6.CrossRefGoogle ScholarPubMed
Ward-Griffin, C., Hobson, S., Melles, P., Kloseck, M., Vandervoort, A. and Crilly, R. 2004. Falls and fear of falling among community-dwelling seniors: the dynamic tension between exercising precaution and striving for independence. Canadian Journal of Aging, 23, 4, 307–18.CrossRefGoogle ScholarPubMed
Weir, E. and Culmer, L. 2004. Fall prevention in the elderly population. Canadian Medical Association Journal, 171, 7, 724.CrossRefGoogle ScholarPubMed
Woolcott, J. C., Khan, K. M., Mitrovic, S., Anis, A. H. and Marra, C. A. 2012. The cost of fall related presentation to the ED: a prospective, in-person, patient tracking analysis of health resource utilization. Osteoporosis International, 23, 5, 1513–9.CrossRefGoogle Scholar