Examine how older adults narrate falls by collecting and analyzing narratives about falls written by older adults.
Falling is recognized as a serious risk for older adults, often marking the transitional moment where activity is curtailed, and at times, living independently gives way to assisted or nursing home living. Yet, research on falling in older adults has historically been framed in terms of objective risk factors and rarely designed with the intention of capturing the unique lived experience of the participant. Research that has focused on older adults’ personal experiences of falling has drawn conclusions from transcribed interviews rather than written narratives. Funded by the Mellon Foundation, The Falls Narrative Study is a feasibility study designed to fill this gap in falls-related research by asking older adults to write a story about a fall or near-fall experience.
Reply by Sue Coppola on Brian Hurwitz: Dear Jane, Found your Report on the Mellon ... | 22 Jun 2016
Hello Brian, These are great points you make about language and context, which seem salient to our analysis. In the Consent we used the phrase "fall or near fall experience" to broadly consider experiences such as slips, trips, and loss of balance. Falls were not defined as, for example, making contact with the floor. Participants mostly wrote and talked about falls to the floor, but also included significant near-fall experiences or loss of balance. They included falls with and without injury. The diversity of 'falls' was evident even in our small sample. It will be great to explore with you, Kym, Molly and Jane this point about expectations and encounters with students. In our preliminary analysis we discussed the co-constituted nature of the narrative by virtue of the surrounding interpersonal transactions. We are also interested in the fidelity between the Subject-Student groups, with our design for flexibility (i.e. dynamic conversations) within the protocol. Others on the team who are more engaged with the data will have more to say, and offer different perspectives- I hope. From a clinical standpoint, it seems useful to categorize types of falls and also be mindful of the context of assessment for falls. Guilty of sometimes "leading the witness", I hope to learn more about the influence of the interviewer on physical and psychological dimensions of the story. Thanks for bringing up these points and for the upcoming discussion. Sue
Dear Jane, Found your Report on the Mellon funded project fascinating. Clever design! I am struck by the different sorts of narrative structures you identified – and wondered if the imaginative sort might be a virtual subset of the iterative type. Interested by the confounding motivational elements of wishing to please – ‘what do the researchers want’?, ‘what do the students want’?, ‘how can I help them’? I wondered about the potential complexity and vagueness of the term 'falls' and the extent to which people already see it as a semi-diagnostic, medical term with therefore a ‘technical’ meaning; this might influence what they take to ‘qualify’ as a fall and how they decide to select one to recount. In terms of the figurative potency of the term I recall a paper I co-authored years ago about the meaning of the terms cough, wheeze and asthma which might be a useful stimulus to approaching the meaning and usage of ‘falls’. Looking forward to meeting you and your gang in London soon. Will post the paper on cough - it's called 'Lineages of language and the diagnosis of asthma'. Best wishes Brian
The Falls Narrative Study is a feasibility study in which older adults wrote a story about a fall or near-fall experience after meeting with a pair of students from a Health Humanities research course at UNC-CH.
Students in Prof. Jane Thrailkill and Prof. Jordynn Jack's joint undergraduate and graduate course, Health Humanities Intensive Research Practice, used the following guidebook to inform their meetings with older adult participants in the Falls Narrative Study.