Caring for a relative with dementia: A theoretical model of coping with fall risk

The purpose of this study was to discover how carers of dementia sufferers deal with fall risk. Using grounded theory techniques, data were collected by a focus group and interviews with carers. A core category of being on the edge of chaos emerged, in which a fall represented moving into chaos. Carers used multiple strategies to avoid falls and maintain their precarious position on the brink of chaos, by creating order in their lives. They selectively used information, exercised control, redefined normality, reconstructed their self-identity and the relationship with their impaired relative. Although ordering strategies lowered carers' perception of fall risk, it may have increased actual risk by enhancing relatives' dependency and helplessness. Professionals need to help carers balance their use of 'ordering' strategies with others that allow more independence and freedom.