Problems and Obstacles of Fall Prevention in the Elderly from Healthcare Personnel Perspectives

Main Article Content

Chamaiporn Kanchanakijsakul

Abstract

          This study aimed to explore the problems and obstacles of fall prevention in the elderly from healthcare personnel perspectives, using secondary data from the research project “Family Support for Fall Prevention in Older Adults with Mobility Problems.” The original research was a qualitative study employing a phenomenological approach.
            The data used in this study were part of the interview data from the group of healthcare professionals in the aforementioned research project. Key informants were professionals in geriatric care and related fields, who had at least one year of work experience and voluntarily consented to participate in the study. Purposive sampling was used to select participants who met the specified criteria. Data were collected through in-depth interviews combined with observation between January 2018 and March 2019, and continued until data saturation was reached, resulting in a total of 10 participants. The research tools included an interview guide and an observation form. Content analysis was employed to analyze the data in order to answer the above objective.
            The results showed that the problems and obstacles in fall prevention among the elderly, as perceived by healthcare personnel, could be categorized into four main dimensions: (1) Elderly Dimension: (a) physical and health limitations of the elderly, (b) cognitive limitations, (c) misconceptions and incorrect beliefs, and (d) fear of falling; (2) Family Dimension: (a) lack of family involvement, and (b) misconceptions and incorrect beliefs within the family; (3) Community Dimension: (a) limited budgets and resources of local administrative organizations, and (b) lack of collaboration among community stakeholders; and (4) Healthcare Personnel Dimension: (a) inadequate support for the healthcare workforce, and (b) insufficient budgetary support.

Article Details

Section
Research Article

References

National Statistical Office, Ministry of Digital Economy and Society. The 2024 survey of the older persons in Thailand. Survey report. [Internet]. [cited 2025 Apr 30]. Available from: https://www.nso.go.th/nsoweb/storage/survey_detail/2025/20241209145003_27188.pdf. (in Thai).

Department of Older Persons, Ministry of Social Development and Human Security. Falls in the elderly: accidents in the elderly that you must be careful of for your loved ones. [Internet]. [cited 2025 May 5]. Available from: https://www.dop.go.th/th/know/15/548. (in Thai).

Tansakul T. Reducing fall-related accidents among the elderly. [Internet]. Bangkok: Bangkok Hospital; 2024 Sep 14. [cited 2025 Jul 31]. Available from: https://www.bangkokhospital.com/th/bangkok/content/reduce-accidents-in-the-elderly-2. (in Thai).

Maipimai W. Falls in the elderly: a problem that should not be overlooked. [Internet]. [cited 2016 Jul29]. Available from: http://www.ns.mahidol.ac.th/english/th/ns_academic/56/08/old_th.html. (in Thai).

Surakarn E, Sikkarinakul E, Tansakul T, Wattanapanom P. Don’t let the elderly fall – they might not get up. [Internet]. [cited 2025 Jul 9]. Available from: https://www.bangkokhospital.com/th/bangkok/content/beware-of-elderly-people-falling. (in Thai).

Foundation of Thai Gerontology Research and Development Institute (TGRI). Fall prevention medication: a guidebook for preventing falls in the elderly. [Internet]. [cited 2025 Jul 9]. Available from: https://thaitgri.org/?p=36204. (in Thai).

Department of Disease Control, Ministry of Public Health. How much does the government spend on elderly falls? [Internet]. [cited 2025 Jul 7]. Available from: https://ddc.moph.go.th/dip/news.php?news=43338&deptcode=dip. (in Thai).

World Health Organization. Falls. [Internet]. [cited 2025 May 5]. Available from: https://www.who.int/

news-room/fact-sheets/detail/falls.

Rodseeda P. Fall prevention among the elderly living in a community: the nursing role in home health care. Thai Red Cross Nursing Journal 2018;11(2):15-25. (in Thai).

Faculty of Medicine Ramathibodi Hospital, Mahidol University. Falls in the elderly: far more dangerous than in any other age group – a problem that should not be overlooked. [Internet]. [cited 2025 Jul 7]. Available from: http://www.ns.mahidol.ac.th/english/th/ns_academic/56/08/old_th.html. (in Thai).

Institute of Geriatric Medicine, Department of Medical Services, Ministry of Public Health. Guidelines for medical practice to prevent/assess falls in the elderly. [Internet]. [cited 2025 May 5]. Available from: https://agingthai.dms.go.th/agingthai/wp-content/uploads/2021/01/book_8.pdf. (in Thai).

Physical Therapy Center, Faculty of Physical Therapy, Mahidol University. Exercise reduces the risk of falls in the elderly. [Internet]. [cited 2025 Jul 7]. Available from: https://pt.mahidol.ac.th/ptcenter/knowledge-article/exercise-reduces-the-risk-of-falls-in-the-elderly/. (in Thai).

Pongaumpai P, Hoontrakul S, Roojanavech S. The effects of family empowerment program on fall prevention capabilities of the elderly. RTN Med J 2018;45(2):311-27. (in Thai).

Monkanphai P, Mongkong S, Detprapon M. The relationships between physical activity, perceived social support, and fatigue in older adults with lung cancer. JTNMC 2025;40(1):118-30. (in Thai).

Intana J, Pannarong K, Tawetanawanich Y, Yatniyom P, Srisabjanan L. Ensuring medication safety for older people: a protocol for nursing action. Journal of Prachomklao College of Nursing, Phetchaburi Province 2021;4(1):17-32. (in Thai).

Thunyadee N, Bosittipichet T, Leesri T. Polypharmacy, fall-risk increasing drugs, and falls among the elderly attending primary care services in Phra Nakhon Si Ayutthaya province: a cross-sectional study. Regional Health Promotion Center 9 Journal 2022;16(1):236-50. (in Thai).

Hinkhaw C, Pimtara P, Loysak B. Promoting individual and family self-management for glycemic control in diabetic patients with cognitive impairment. Journal of Phrapokklao Nursing College, Chanthaburi 2020;31(2):293-305. (in Thai).

Fernandes JB, Fernandes SB, Almeida AS, Vareta DA, Miller CA. Older adults’ perceived barriers to participation in a falls prevention strategy. J Pers Med 2021;11(6):450.

Kong KS, Lee FK, Mackenzie AE, Lee DT. Psychosocial consequences of falling: the perspective of older Hong Kong Chinese who had experienced recent falls. J Adv Nurs 2003;43(4):350-9.

Kosundilok T, Wannapruek P, Charoenvai P, Katungkang P. Fear of falling in older adults: nursing care with health belief model’s approach. Regional Health Promotion Center 9 Journal 2023;17(3):1050-61. (in Thai).

Reid N, Ali AA. Beliefs and attitudes. In: Reid N, Ali AA. Making sense of learning. Cham: Springer; 2020. p. 253-79.

Seeda K, Tipmed C, Ploysawang P, Jamsri P, Pangmuang P. Assessment of knowledge, beliefs, attitudes and behaviors regarding cancer among village health volunteers in Salok Bat sub-district, Khanu Woralaksaburi district, Kamphaeng Phet. Department of Health Service Support Journal 2023;19(2):49-58. (in Thai).

Krajangjaeng T, Keawkaen P. Effect of integrated motor control training program on balance ability and fall efficacy in elderly. RTN Med J 2021;48(2):420-33. (in Thai).

Noimontree W. Fear of falling: geriatric syndrome and nursing role using evidence-based practice. The Journal of Faculty of Nursing Burapha University 2018;26(3):92-101. (in Thai).

Suwan P, Kanthanaphat N, Soawaphan J, Intarasongkor S, Uonkeaw A, Hankla S. The development of practice guideline for preventing fall using 10 P’s multifactorial concepts among older adults in community. RTN Med J 2020;47(2):414-31. (in Thai).

Seesawang J, Thongtaeng P, Naimkerd P, Tantaphoprasit J. Family participation: a strategy for encouraging treatment adherence among older persons with uncontrolled hypertension. Rama Nurs J 2022;28(2):159-69. (in Thai).

Kanchanakijsakul C. Family participation in supporting drug use for Thai elderly with chronic diseases. Journal of Health Science 2016;25(2):192-203. (in Thai).

Kiami SR, Sky R, Goodgold S. Facilitators and barriers to enrolling in falls prevention programming among community-dwelling older adults. Arch Gerontol Geriatr 2019;82:106-13.

Sherrington C, Tiedemann A. Physiotherapy in the prevention of falls in older people. J Physiother 2015;61(2):54-60.

Chanruang C. Current problems of local government organizations. Bangkok Business. 2022. [cited 2025 Jul 9]. Available from: https://www.bangkokbiznews.com/columnist/1008930?utm_source=chatgpt.com. (in Thai).

Kostseekiaw T, Jaisue D, Chanthanui K, Sritumna P. The development of falls prevention model for elderly by participation of community networks Maha Sarakham province. Journal of Khon Kaen Provincial Health Office 2024;6(4):1-17. (in Thai).

Tanuchit S, Chinnacom D, Malathong N, Doungthipsirikul S, Tantivess S. The situations of emergency medical services associated with elderly falls in Thailand: policy recommendation. Journal of Professional Routine to Research 2019;6:57-68. (in Thai).

Sudsomboon S, Thammaporn W, Puttasukkee T, Chaimay P. Role of local government organization for elderly care. Journal of Southern Technology 2016;9(1):121-7. (in Thai).

Health Systems Research Institute. Health workforce planning research: a compass for developing the health service system in the next decade. [Internet]. [cited 2025 May 5]. Available from: https://www.hsri.or.th/news/1/1777. (in Thai).

Vongvichai C. Health workforce as a workforce: Problems and solutions for the Thai health system. [Internet]. [cited 2025 May 5]. Available from: https://www.hfocus.org/content/2016/04/12004. (in Thai).

Wornsoy S. Factors related to operations of sub-district family doctor’s health team networks in Nam Pat district, Uttaradit province. [Master’s Thesis, School of Health Science]. Sukhothai Thammathirat Open University. 2017. (in Thai).