Electronic Thesis and Dissertation Repository


Doctor of Philosophy


Health and Rehabilitation Sciences


Dr. Denise Connelly


The increasing number of injurious falls amongst older people living in the community is continuously portrayed as a major public health problem facing the Canadian health care system. As additional resources are allocated for community-based fall prevention programs, health service providers are increasingly expected to understand and enact fall prevention in effective and meaningful ways. The aim of this two-phase interpretive phenomenological study was to enhance understandings of the taken-for-granted meanings that characterize everyday practices of community-based fall prevention in order to foster more sensitive, tactful, and meaningful approaches to fall prevention with older people.

In the first phase of this study, I engaged nine older people living independently in the community in individual phenomenological interviews to explore the meaning of the experience of anticipating falling. In the second phase of this study I engaged six health professionals working on a community outreach team in phenomenological interviews exploring the meaning of the experience of enacting fall prevention with older people in the community.

The findings of this two-phase study overall give rise to four key insights that may inform the refinement of fall risk assessment and fall prevention practice for physiotherapists and other service providers. First, a phenomenological ethics of caring was central to enacting fall prevention for service providers in the community. Second, lived-identity was central to the experience of anticipating falling for older people. Third, meaningful risk-taking was essential to older peoples’ quality of life and enactment of their lived-identity. Finally, the meaning of anticipating falling was learned experientially through older peoples’ experience of falling or witnessing others experience falls. Understanding these key insights, service providers might seek to adopt a transformative learning approach to fall prevention that focuses on affirming an appreciative understanding of lived-identity, meaningful risk, and meaningful caution in older peoples’ lives. Erich Fromm’s distinction between having and being orientations to lived-identity may be used to provide insight into the enactment of such a transformative approach to fall prevention.

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