Home Environmental Hazards and the Risk of Fall Injury Events Among Community‐Dwelling Older Persons

Abstract

Current fall-prevention strategies of finding and changing all environmental hazards in all community-dwelling older persons' homes may have less potential effect than previously thought. The usefulness of grab bars, however, appears to warrant further evaluation.

A population-based study of environmental hazards in the homes of older persons.

“…Indeed, in contrast to the wealth of information available on personal characteristics and capacity, relatively little is known about the role of the environment in the day-to-day functioning of older persons, '4 and what little is known is limited largely to falls. [15][16][17][18] As a first step in elucidating the relationship between the environment and ADL functioning, we set out, in the current study, to describe the basic epidemiology of potential hazards in the homes of older persons. Our specific aims were to estimate the population-based prevalence of environmental hazards and to determine whether the prevalence of these hazards differs by housing type or by level ofADL disability.…”

Falls prevention: partnering occupational therapy and general practitioners.

“…Fear of falling has frequently been referred to in the literature as a significant barrier to full independence in the aged (Vellas, Wayne, Romero et al 1997;Lachman, Howland, Tennstedt et al 1998;Mclean & Lord 1996). The installation of grab rails has been cited as an effective method of not only preventing a fall but also reducing fear of falling (Sattin et al 1998;Mclean & Lord 1996). The personal attention of the visit and increased patient awareness could create a clouding effect with the perceived worthiness of modifications.…”

“…The effect of home modifications in preventing falls has been questioned (Norton et al 1997;Sattin et al 1998, Hinman 1998Carter et al 1997), but the Fall STOP project found increased confidence and a reduced fear of falling. Fear of falling has frequently been referred to in the literature as a significant barrier to full independence in the aged (Vellas, Wayne, Romero et al 1997;Lachman, Howland, Tennstedt et al 1998;Mclean & Lord 1996).…”

“…Fall STOP differed by utilising professional expertise of occupational therapists to provide home assessments for the elderly and organise environmental modifications within the context of the clients medical circumstances following assessment by a GP. This feature is important, as previous studies (Sattin et al 1998;Carter et al 1997) suggesting that home modifications have limited value in preventing falls have used other professional groups often in isolation from a medical assessment.…”

“…They are the most common cause of accidental injury in the elderly requiring hospitalisation (Australian Bureau of Statistics 1996), 85% of fractures involving a fall occur at home, with 25% of these associated with an object in the home (Norton, Campbell, Lee-Joe et al 1997). There has been significant discussion as to the role of intrinsic and extrinsic risk factors (Sattin, Rodriguez, De Vito and Wingo 1998;Hinman 1998) and the need to embrace a multi-factorial approach (Tinetti, Baker & McAvay et al 1994) in reducing falls in the elderly.…”