Many of my patients are at risk of falling and have even fallen. They attribute the cause of their fall to external factors such as uneven footpaths. They do not believe that they will fall (again), and state that they will ‘take more care’. It is hard to convince them to do anything about it.

It is generally not useful to encourage older people to accept their risk of falling to motivate them to change their falls prevention behaviour. It is very common for older people to believe that taking more care will prevent further falls but there is no evidence to suggest that this is effective. It could be distressing or embarrassing for older people to admit that they could fall for reasons about themselves. Instead frame any suggestions you have such as attending strength and balance training towards the positive (help to keep up with your grandchildren; help to maintain or improve your level of independence) rather than towards the negative (help to prevent falls).