“I’ve been living in the shadows”: Experiences and perceptions of the fear of falling among older adults with T2DM in an inpatient endocrinology setting in China – A qualitative descriptive study

Older adults with type 2 diabetes mellitus(T2DM) face a high risk of falls. Fear of Falling (FoF), a debilitating psychological concern, can further restrict activity and worsen health outcomes. However, a deep understanding of the experience of FoF in this specific population remains limited. To explore the perceptions, experiences, and needs regarding FoF among older adults with T2DM. A qualitative descriptive study. Sixteen older adults with T2DM were purposively recruited from an inpatient endocrinology department in mainland China. Semi-structured interviews were conducted, audio-recorded, and transcribed. Data was analyzed using reflexive thematic analysis. Three key themes emerged: (1) Beneath the Shadows: The Multidimensional Nature of Fear—Fear of Consequences Rather Than the Fall Itself; (2) Unveiling the Shadows: Diabetes-Specific Factors Driving the Fear; (3) Seeking Light in the Shadows: Unmet Needs for Personalized Support. FoF in older adults with T2DM is a multifaceted concern rooted in the intersection of chronic disease and aging. Participants in this study expressed a significant gap between their complex needs and the standardized support they received. A shift towards person-centered care, integrating personalized education, psychological support, and environmental adaptations, may be crucial to effectively address this fear.