Date of Award


Document Type

Open Access Dissertation


Health Promotion, Education and Behavior

First Advisor

Daniela B. Friedman


Introduction: One in every three adults over the age of 65 experiences a fall every year, with women experiencing more falls than men. Falls can affect how older women perceive themselves and their independence. The purpose of this study was to examine older women's health decision making after experiencing a fall. Methods: I conducted semi-structured interviews with 17 older women living independently in continuing care retirement communities (CCRCs) who had experienced a fall within the previous six months and 11 individuals the women identified as being involved in their post-fall decision making. I also conducted an exploratory survey on post-fall decision making with 130 older women (65 from CCRCs; 65 from non-institutional homes) who had experienced a fall within the previous 12 months. I analyzed the qualitative data using open and axial coding. I analyzed the quantitative data using bivariate associations and ordinary least square regression. Results: Women used different approaches and decisions to respond to a fall and engaged in substantive work to get "back to normal". This work entailed balancing issues of privacy and independence with their need for personal assistance or aids. Women accessed, accepted, or rejected information from family members and professionals after their fall based on their openness to others’ advice, their assessment of the credibility of the potential information sources, and the relationship patterns they established with these sources. Older women also made medical, corrective, and social decisions after their falls. Making medical decisions resulted in greater decisional conflict compared to other types of decisions. Women's familiarity with assisted living and level of health literacy also predicted how much decisional conflict they would experience in their decision-making process. Discussion: This study examined decisions older women made after a fall, how they made these decisions, and what factors influenced these decisions. Increased awareness, understanding, and communication of these post-fall approaches and decisions is needed to help older women, family members, and professionals work together to enhance older women's post-fall decision making, lower their decisional conflict, and assist them in regaining their health and quality of life.


© 2015, Caroline D. Bergeron