Table 2.

Care partners’ lived experience of fall incidents and fall risks among older people with dementian.

Major theme	Sub-theme	Illustrative quotes
Challenges	Increased care demands	“He (older people with dementia) won’t, if he has a bowel movement then he’ll just, he’ll get up and stumble and fall into everything. I just make sure he lets me know, so I have to take him to the bathroom.” (other relative, woman, primary care partner, age 59)
		“My wife told her that she’d fallen earlier that morning also. But she never told me. And her memory is so bad that I don’t know, she could’ve maybe fallen a dozen times. Who knows?” (Husband, primary care partner, age 60)
	Self-sacrificing	There were days when I couldn’t come in (to work) because [older people with dementia ] had fallen and I had taken her to a clinic over there. Her clinic is about two blocks from me, but I have to go over or she’ll fall…I didn’t get the temp job at the end of 90 days because I was absent too many times which I knew I was. So, I’ve been unemployed and mainly just taking care of her. I have depression… and I have been drinking… I was supposed to have a doctor’s appointment at the VA, but I keep putting that off (Husband, primary care partner, age 63).
	Dissatisfaction with healthcare providers	“[The doctor was] talking to me about it like it was something that was going to happen to my mom like she’s a piece of meat, you know what I mean?” (daughter, primary care partner, age 59)
	Increased conflicts with older people with dementia	“You know, she got up and started doing it (cook food) herself and almost fell, so I pushed her back in the chair and she kept trying to get up and I kept holding her down because I knew she was going to fall if she stood up. She called 911. Instead of paramedics, the police came and took me away.” (Husband, primary care partner, age 63)
	Intense emotions	Fear and worry: “I don’t sleep much. I was really freaked. I didn’t know if her use of her right side would come back. If that’s permanent, I don’t know what I’m going to do (Husband, primary care partner, age 60).”
		Traumatic experiences: “I keep kicking myself for it for a long time after her hospitalization last year…it was the most frightening thing I have seen in a long time.” (daughter, primary care partner, age 62)
		Physical exhaustion: “I was pretty overwhelmed and frustrated because you know, you can’t think of everything. You got discharged and you are just like, okay, she’s accepted she’s going to go to a facility instead of home. Even then we pulled up, and she went, “what are we doing here? Why didn’t we go home? What are you, leaving me here? What are you doing?” I mean there’s so much you are dealing with minute by minute.” (daughter, primary care partner, age 59)
		Anger: “Everything was taken care of. But her memory part started coming when she hit her head. When she fell, I was very upset because she took the medication change. She should’ve never taken that pill. ‘Cause that- and so- and that’s when she said she don’t want to have the doctor.” (Husband, primary care partner, age 84)
Adaptations	Cultivating acceptance of older people with dementia ’s falls	“I learned what I can from it and then we move on and then we try not to repeat the same things again or it’s unfortunate that it happened but it’s fortunate that it happened if that makes sense. I can hold both of those ideas in tension, you know. That dichotomy is okay for me.” (Son, secondary care partner, age 52)
	Approaching falls as an opportunity	“Well I’ve finally had a chat with everybody about the safety issue and my deep-rooted feelings on the need for 24/7 care, and it’s time.” (daughter, primary care partner, age 59)
	Getting help from informal and formal care networks	Facilitating collaborations within informal care networks: “And embracing the tension between those things and knowing how to…use your network of folks who want to be helpful. And still set boundaries (other relative, primary care partner, age 48).”
		Facilitating collaborations within formal care networks: “I asked one physical therapist, show me what you want me to do and I’ll do it, I’m here all day.” (Husband, primary care partner, age 60)
	Collaborating with older people with dementia	“No one wants to get the phone call that your mom’s on the floor, you know, could we have avoided that? But at the same time, she was so fiercely independent and her identity was that. We wanted to give that to her as long as she could take care of herself.” (Son, secondary care partner, age 52)
	Modifying the physical environment	“(Alzheimer’s Association) provide equipment, like shower holders, the fire department comes, they call the fire department, they come and put new shower head in, and put all stuff for equipment to prevent him from falling in the shower and all that stuff.” (Son, primary care partner, age 58)