© 2019 - IOS Press and the authors. All rights reserved. BACKGROUND: Fear of falling (FOF) is often reported post-hospitalization and has been associated with functional decline. Identifying the determinants of FOF during hospitalization and patients' perception of FOF can help guide their managements. To inform a planned future intervention study, this study aimed to evaluate (1) the effects of acute hospitalization on FOF among older adults, (2) older adults' perception of risk factors, interventions and coping strategies for FOF. METHODS: Thirty-two older inpatients were recruited in an acute teaching hospital. This was a mixed methods study. FOF was measured quantitatively using the Single-item question "Are you afraid of falling?" and Fall-Efficacy Scale-International (FES-I), self-reported for premorbid status (retrospectively), on admission and again at discharge. Patients with FOF completed a questionnaire exploring their perception of FOF, possible coping strategies and interventions they believed may help. RESULTS: No significant changes in FES-I scores were detected over time, suggesting acute hospitalization did not change FOF in this cohort. A change in FOF (FES-I) score was associated with the history of falls in previous year. Perceived risk factors included balance problems (n=10), breathlessness (n=5), reduced lower limb muscle strength (n=5) and history of falls (n=4). To cope with FOF, most would avoid activity, seek help and slow their pace. Exercises and education were perceived as effective interventions to reduce FOF. CONCLUSIONS: Fear of falling did not appear to develop or change during hospitalization. Patients had faith in education and exercise prescription as effective treatments for FOF post-hospitalization.