How community-dwelling older adults use positive coping strategies to manage fear of falling: a qualitative study using walking interviews

Background Older adults often experience fear of falling (FoF). Falls and FoF impose significant costs on both individuals and the healthcare system. As a result, a wide range of interventions has been developed to prevent them, and much recent research has focused on evaluating the effectiveness of these interventions. However, evidence suggests that community-dwelling older adults also develop individual coping strategies, which remain understudied. This study aims to address this gap by identifying the coping strategies older adults develop and employ in their daily lives. Methods We conducted 13 walking interviews with older people residing in Canada. Our sample consisted of individuals living in an urban area, either with family members or alone. Participants were aged 55 and older and had experienced at least one fall in the past several years. We analyzed the data using reflexive thematic qualitative data analysis approach and identified six themes related to older adults’ coping strategies. At the final stage, we conducted a co-occurrence analysis to explore the coping strategies that are interconnected. Results The analysis of the interview data identified positive individual coping strategies developed by older adults in their everyday lives. These strategies were classified into six main categories, including activity adaptation, social support, environmental modification, psychological resilience, health and wellness strategies, and use of supportive devices. We also found that older adults tend to combine multiple coping strategies. The most frequent co-occurrence is between activity adaptation and social support coping strategies, reflecting both individuals’ personal agency and their reliance on social networks to prevent fear of falling and falls. Conclusions These findings suggest that seniors use a variety of coping strategies and often apply several of them simultaneously. The results can inform the development of devices and awareness campaigns aimed at reducing fear of falling and preventing falls.