Investigating the relationship between reduced self-awareness of falls risk, rehabilitation engagement and falls in older adults

The present study aimed to investigate whether self-awareness of falls risk is associated with rehabilitation engagement, motivation for rehabilitation, and number of falls after hospital discharge. The sample comprised 91 older adults (M_age = 77.97, SD = 8.04) undergoing inpatient rehabilitation. The Self-Awareness of Falls Risk Measure (SAFRM) was used to measure different aspects of self-awareness. The treating physiotherapist and occupational therapist rated the patient’s engagement in rehabilitation and the patient reported his/her motivation for treatment. Falls information was collected from the patient and significant other once a month for three months following hospital discharge. Significant correlations were found between physiotherapist-rated engagement and intellectual (r_s = −0.22, p <0.05) and anticipatory awareness (r_s = −0.24, p <0.05). Occupational therapist-rated engagement and patient-reported motivation for rehabilitation was correlated with emergent awareness (r_s = −0.38 and −0.31, p <0.05, respectively) and overall self-awareness (r_s = −0.31 and −0.26, p <0.05, respectively). Regression analyses indicated that overall self-awareness provided a unique contribution to occupational therapist-rated engagement when controlling for age, gender, cognition and functional ability. Falls were reported by 29.9% of participants, however, self-awareness did not differ significantly between fallers and non-fallers. The findings suggest that self-awareness of falls risk is associated with rehabilitation engagement and motivation. Therefore, improving patient self-awareness of falls risk may increase engagement in therapy leading to better patient outcomes.