How Fall-Safe is the Housing for the Elderly in Rural Areas? : A Cross Sectional Study using Fall Prevention Screening Checklist

Abstract

Background: Certain risk factors present in the immediate housing environment may contribute to falls. Research shows one half to two thirds of falls occur in or around the house of elders. There is a need to keep the houses of elder's age friendly to prevent falls and enable them to do their daily routine comfortably. Objectives: To assess the proportion of elderly (≥60 years) houses that comply with housing standards to prevent falls using fall prevention screening checklist. Method: Observational checklist was prepared from recommended standards of homesafety for fall prevention and modified to screen the individual rooms in rural houses of elders. A total of 655 houses were screened for the study. Results: Common housing risk for fall identified were poor lighting of living room (95%) and bedroom (94%) and absence of light switch near the bed (63%) in the bedroom. 73% of bathroom was located outside the house with 41% having uneven /slippery surface. Only 68.2% had personal toilet of which 66% was present outside the home, 98% had no handrail and absence of western toilet in 62%. Area surrounding the house had stones, leaves and other obstacles in 44% of homes. Conclusion: Overall, using the fall-prevention screening checklist, almost all houses were found to be risky for fall with only very few houses being found to be fall-risk free. Further research has to be done to establish the validity of this tool or to recommend new standards for conditions peculiar to rural India that potentially appear to contribute to fall.

Interobserver analysis of safety practices and behaviors adopted by elderly people to prevent falls

“…The residents who had no gait alterations showed better practices (32.5 ± 31.2) when compared with those who had alterations of this nature (29.00 ± 2.3). This factor may increase fall risks, because it adds to a major risk (gait alterations) unsafe practices related to self-care and accessibility in the physical space, both relevant risks in the genesis of the fall mechanism (1,(3)(4)(5) .…”

“…This problem is difficult to control because of the multifactorial nature of its genesis, which imposes the need for prevention. Despite this difficulty, researchers have emphasized that most risk factors are modifiable by introducing single or multiple interventions oriented toward one or more risk factors (1)(2)(3)(4)(5)(6) .…”

“…One example is the environmental changes in elderly people's houses. It is known that nearly every house has fall risk factors for elderly people because of deficient lighting and the presence of rugs and obstacles that reduce indoor accessibility and mobility, among other problems (3) . Environmental risks can be minimized or eliminated by implementing behavioral changes in the elderly population in combination with modifications in the environment, resulting in a positive impact on the reduction of risks and on the prevalence of falls in elderly people's houses (4)(5) .…”

Reducing the Physical Burden of Older Persons’ Household Caregivers: The Effect of Household Handrail Provision

“…Research literature has used the term ‘handrail’ to define a narrow rail for grasping with the hand as support both inside and outside the home. They can be installed on the stairs, in the bathroom or toilet, and so on [ 36 , 37 , 38 , 39 ]. This study defined household handrail provision as having a stair handrail, a handrail in the bedroom, or a handrail in the bathroom/toilet of the older person’s household.…”

Practices of caregivers when evaluating the risk of falls in the admission of older adults to nursing homes

“…Environmental risks could be minimized or eliminated with behavioral changes in the population, with a positive impact on reducing risks and the prevalence of falls. [20][21][22][23][24][25] However, to that end, the older individual must be informed about the risks and how to move safely through the facility, 24 when obstacles are removed from transit areas. 25 The results of the research indicate that these interventions are a priority for people with a history of falls and/or high risk of falls.…”