Perspectives of older adults on falls, fall prevention, and the role of family medicine following fall-related hip fractures: a qualitative study

Falls are a primary cause of hip fracture and loss of independence in later life, and a substantial proportion are preventable. Family physicians (FPs) are well positioned to assess fall risk and provide guidance; however, these practices are not consistently integrated into primary care appointments. This study explored the perspectives of older adults who were hospitalised after surgery for fall-related hip fractures on falls and fall prevention, and what role they expect from their FPs. A qualitative descriptive study was conducted with 26 adults aged 65 and over hospitalised after surgery for a fall-related hip fracture at a tertiary hospital in Ankara, Türkiye, between July and August 2024. Participants were recruited consecutively and interviewed face to face using a semi-structured guide until data saturation was reached. Interviews were audio-recorded, transcribed verbatim, and analysed using inductive thematic analysis. Reporting followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Four themes were identified: awareness and attitudes toward falling; the effects of falling on the individual; prevention as individual vigilance and adaptive behaviour; and missed opportunities for fall prevention in family medicine. Participants commonly normalised falls as a natural consequence of ageing or attributed them to fate, yet most also considered falls preventable, indicating that fatalism coexisted with rather than displaced an awareness of preventability. Almost all participants (22 of 26) reported concern about falling, and most of those with a prior fall history reported restricting their daily activities afterwards. Additionally, despite frequent consultations, only two participants (7.7%) recalled ever having their fall risk assessed by their FP, and most had not disclosed earlier falls to their FP. Despite frequent consultations, few participants recalled their fall risk being assessed or discussed, and many did not perceive fall prevention as part of their FP’s role. Embedding fall risk enquiry as a routine, active part of consultations could raise patient awareness and help reduce fall-related morbidity.