Sustaining agency after a fall: navigating healthcare and adjusting everyday life – a qualitative interview study

Abstract

Abstract Background Falls among older adults are a major public health concern and are associated with recurrent falls, functional decline, fear of falling, and reduced quality of life. Older adults presenting to emergency departments (EDs) following a fall are often discharged directly home despite ongoing rehabilitation and support needs. Although person-centred approaches are recommended in international guidelines, less is known about older adults’ and relatives’ experiences following an ED visit for a fall. This study aimed to describe older adults’ and their relatives’ experiences of a fall, including the ED visit and the transition back home. Method A qualitative study design was used, involving semi-structured interviews with older adults aged 75 years and older and their relatives. Participants had attended the ED following a fall but were discharged without hospital admission. Seventeen participants (11 older adults and 6 relatives) were recruited. Data were analysed using qualitative content analysis according to Graneheim and Lundman. Results The analysis generated one overarching theme, Sustaining agency through recovery across care and everyday life , which reflected how older adults and their relatives sought to manage daily life following a fall. Both groups described addressing immediate care needs while simultaneously adapting to longer-term changes in everyday life. Participants described difficulties navigating healthcare services to access follow-up care and rehabilitation, contributing to feelings of insecurity, financial strain, and increased responsibility. A persistent fear of falling affected daily activities and required adaptations and new roles for both older adults and their relatives. Despite these challenges, many participants demonstrated resilience and an ability to manage daily life following injury. Individual coping strategies and support from relatives were described as central to managing everyday life and healthcare contacts. Conclusions Older adults discharged home after a fall may benefit from coordinated, person-centred follow- up that supports rehabilitation, recovery, and fall prevention. Despite variation in support needs, participants described a common need for clearer guidance and improved support structures, while also demonstrating considerable resilience and capacity for self-management. Clinical trial number Not applicable.