Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing · 2026
Informal Caregiver-Observed Fall Risk Indicators and Caregiver Responses to Prevent Falls Among Community-Dwelling Older People: A Systematic Review.
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Labrague Leodoro J, Visbal-Dionaldo Liza
Аннотация
INTRODUCTION: Informal caregivers are uniquely positioned to recognize subtle changes that precede falls because of their continuous presence in older people's everyday environments. However, caregiver-observed indicators of escalating fall risk have not been systematically synthesized. This systematic review synthesizes the evidence on informal caregiver-observed fall risk indicators and caregiver responses to prevent falls among community-dwelling older people.
METHODS: A targeted synthesis of peer-reviewed literature was undertaken using six electronic databases (PubMed, CINAHL, Scopus, Web of Science, PsycINFO, and Embase) that were searched. Qualitative content analysis was used to synthesize the findings. A total of 16 studies were included in the review.
RESULTS: Caregivers recognized a broad range of observable indicators associated with increased fall risk, including: (1) mobility and gait changes; (2) cognitive and neurobehavioral changes; (3) functional decline and increasing dependence in activities of daily living; (4) physiological warning signs; (5) environmental hazards; and (6) behavioral risk indicators. The synthesis further revealed an observation-to-response pathway, whereby caregivers translated perceived fall-risk indicators into: (1) increased surveillance and protective monitoring; (2) providing mobility and functional assistance; (3) implementing environmental modifications; (4) promoting safety behaviors; and (5) seeking health care support through care coordination and professional consultation.
CONCLUSIONS: Informal caregivers detect early signs of fall risk and initiate preventive responses that may reduce fall risk among community-dwelling older people.
CLINICAL RELEVANCE: Nurses should systematically incorporate caregiver observations into routine fall-risk assessment and care planning to improve the early identification of escalating fall risk and support timely, individualized fall-prevention interventions. Health policies should recognize informal caregivers as essential partners in fall prevention by promoting standardized caregiver education, documentation of caregiver observations, and their integration into routine fall-risk assessment and community-based care.
METHODS: A targeted synthesis of peer-reviewed literature was undertaken using six electronic databases (PubMed, CINAHL, Scopus, Web of Science, PsycINFO, and Embase) that were searched. Qualitative content analysis was used to synthesize the findings. A total of 16 studies were included in the review.
RESULTS: Caregivers recognized a broad range of observable indicators associated with increased fall risk, including: (1) mobility and gait changes; (2) cognitive and neurobehavioral changes; (3) functional decline and increasing dependence in activities of daily living; (4) physiological warning signs; (5) environmental hazards; and (6) behavioral risk indicators. The synthesis further revealed an observation-to-response pathway, whereby caregivers translated perceived fall-risk indicators into: (1) increased surveillance and protective monitoring; (2) providing mobility and functional assistance; (3) implementing environmental modifications; (4) promoting safety behaviors; and (5) seeking health care support through care coordination and professional consultation.
CONCLUSIONS: Informal caregivers detect early signs of fall risk and initiate preventive responses that may reduce fall risk among community-dwelling older people.
CLINICAL RELEVANCE: Nurses should systematically incorporate caregiver observations into routine fall-risk assessment and care planning to improve the early identification of escalating fall risk and support timely, individualized fall-prevention interventions. Health policies should recognize informal caregivers as essential partners in fall prevention by promoting standardized caregiver education, documentation of caregiver observations, and their integration into routine fall-risk assessment and community-based care.