{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T06:39:01Z","timestamp":1792651141773,"version":"4.5.0"},"reference-count":42,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["sigmapubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Nursing Scholarship"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>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\u2010observed indicators of escalating fall risk have not been systematically synthesized. This systematic review synthesizes the evidence on informal caregiver\u2010observed fall risk indicators and caregiver responses to prevent falls among community\u2010dwelling older people.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A targeted synthesis of peer\u2010reviewed 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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\u2010to\u2010response pathway, whereby caregivers translated perceived fall\u2010risk 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Informal caregivers detect early signs of fall risk and initiate preventive responses that may reduce fall risk among community\u2010dwelling older people.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>Nurses should systematically incorporate caregiver observations into routine fall\u2010risk assessment and care planning to improve the early identification of escalating fall risk and support timely, individualized fall\u2010prevention 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\u2010risk assessment and community\u2010based care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jnu.70142","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T05:46:58Z","timestamp":1792648018000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Informal Caregiver\u2010Observed Fall Risk Indicators and Caregiver Responses to Prevent Falls Among Community\u2010Dwelling Older People: A Systematic Review"],"prefix":"10.1111","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0315-4438","authenticated-orcid":false,"given":"Leodoro J.","family":"Labrague","sequence":"first","affiliation":[{"name":"Fran and Earl Ziegler College of Nursing The University of Oklahoma Harold Hamm Health Campus  Oklahoma City Oklahoma USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liza","family":"Visbal\u2010Dionaldo","sequence":"additional","affiliation":[{"name":"Fran and Earl Ziegler College of Nursing The University of Oklahoma Harold Hamm Health Campus  Oklahoma City Oklahoma USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,21]]},"reference":[{"issue":"24","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","DOI":"10.3390\/healthcare13243271","article-title":"Challenges and Social Implications of Informal Caregiving for People With Alzheimer's: A Qualitative Study","volume":"13","author":"Alcaraz\u2010C\u00f3rdoba A.","year":"2025","journal-title":"Healthcare"},{"issue":"1","key":"e_1_2_13_3_1","doi-asserted-by":"crossref","DOI":"10.1186\/s12877-019-1162-7","article-title":"Understanding Carers' Fall Concern and Their Management of Fall Risk Among Older People at Home","volume":"19","author":"Ang S. 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