Identifying carers’ concern for older people at risk of falling at home

Background: Informal carers such as family members and friends are crucial in providing assistance to older people (care recipients) and preventing them from falling at home. Many carers experience increased psychological distress and caregiving burden when looking after their care recipients who have fallen previously. However, there were no previous studies found about carers’ concern for their care recipients at risk of falling, and there was no validated instrument for measuring this concern. Aims: This thesis aims to: 1) explore the factors influencing carers’ fall concern, 2) develop an instrument for measuring this concern, and 3) evaluate the psychometric properties of the Carers’ Fall Concern Instrument (CFC-I). Methods: The study was conducted over three phrases which include: 1) interviewing 22 carers about their fall concern, 2) exploring the content validity and reliability of the initial CFC-I on 32 carers, and 3) testing the construct validity and reliability of CFC-I on 143 carers. All participating carers were providing support for an older person aged 60 years and over and living at home. Results: During Phase One, four themes were identified as influencing carers’ fall concern. These included: 1) carers’ perception of fall and fall risk, 2) care recipients’ behaviour and attitude towards fall risk, 3) care recipient’s health and function, and 4) care recipients’ living environment. During Phase Two, a 46-item CFC-I was developed and tested with a resultant average content validity of 0.82. In Phase Three, the final 16-item CFC-I reported a Cronbach alpha of 0.93 and can discriminate carers looking after care recipients with or without falls. Conclusion: The CFC-I is the first multi-item instrument designed for measuring carers’ fall concern. Healthcare professionals are encouraged to use the CFC-I in future fall prevention programmes to determine the impact of fall risk on carers and to develop targeted interventions for managing their fall concern.