State Veteran Home Resident Reflections on Fall Prevention Strategies.

OBJECTIVES: We explored the perspectives of State Veteran Home (SVH) residents regarding their experiences with fall-reduction strategies. DESIGN: We used a cross-sectional, qualitative approach to identify SVH resident reports of fall-reduction strategies. SETTING AND PARTICIPANTS: We interviewed veteran residents of SVHs. METHODS: We analyzed interview data qualitatively to identify resident-reported fall-reduction strategies. We categorized strategies as "helpful" or "unhelpful" based on resident perspectives, and within each category, we grouped like strategies and calculated the proportion of residents who reported each and the relative frequency of each. RESULTS: We interviewed 68 residents in 8 SVHs. Sixty residents (88%) reported 18 perceived "helpful" fall-reduction strategies. The most frequently reported categories were resident behavior (36%), which related to resident-initiated efforts (eg, asking for help); reminders and education (31%), which related to resident perceptions of staff being vigilant and reminding residents about fall-reduction strategies (eg, to use their walkers); and equipment (17%), which related to using devices or objects to improve stability (eg, using grip socks). Sixteen residents (24%) reported 16 "unhelpful" strategies. Seventy-one percent related to unmet resident needs (eg, slow staff response time); 25% related to poor staff-resident interactions (eg, staff being impatient); and 4% related to the physical environment (eg, having a cramped room). Some resident-perceived "unhelpful" strategies were done for safety reasons. CONCLUSIONS AND IMPLICATIONS: SVH resident reports of perceived helpful strategies support commonly used fall-reduction efforts in nursing homes. Resident reports of perceived unhelpful strategies highlight resident unmet needs and the tension between resident safety and autonomy. To better promote safe mobility and mitigate "unhelpful" strategies from a resident point of view, improving staff-resident interactions, implementing interventions focused on maintaining or improving resident functional capacity, and creating safer environments are recommended. Staff may be able to reduce nursing home resident fall risk while fostering resident autonomy by improving staff-resident interactions, by addressing resident unmet needs, and by creating safer environments.