Book contents
- Falls in Older People
- Falls in Older People
- Copyright page
- Contents
- Preface
- Contributors
- Part I Epidemiology and Risk Factors for Falls
- Part II Strategies for Prevention
- 16 Exercise to Prevent Falls
- 17 Volitional and Reactive Step Training
- 18 Cognitive-Motor Interventions and Their Effects on Fall Risk in Older People
- 19 Cognitive Behavioural Interventions for Addressing Fear of Falling and Fall Risk
- 20 The Medical Management of Older People at Risk of Falls
- 21 Fall Prevention Interventions for People with Visual Impairment
- 22 Footwear, Orthoses, Walking Aids, Wearable Technology, and Restraint Devices for Fall Prevention
- 23 Environmental Interventions to Prevent Falls at Home and in the Community
- 24 Fall Injury Prevention: Hip Protectors and Compliant Flooring
- 25 Multi-Factorial Fall Prevention Strategies: Where to Next?
- 26 Fall Prevention in Hospitals
- 27 Fall Prevention in Residential Aged Care Facilities
- Part III Implications for Practice
- Index
- References
23 - Environmental Interventions to Prevent Falls at Home and in the Community
from Part II - Strategies for Prevention
Published online by Cambridge University Press: 04 November 2021
Book contents
- Falls in Older People
- Falls in Older People
- Copyright page
- Contents
- Preface
- Contributors
- Part I Epidemiology and Risk Factors for Falls
- Part II Strategies for Prevention
- 16 Exercise to Prevent Falls
- 17 Volitional and Reactive Step Training
- 18 Cognitive-Motor Interventions and Their Effects on Fall Risk in Older People
- 19 Cognitive Behavioural Interventions for Addressing Fear of Falling and Fall Risk
- 20 The Medical Management of Older People at Risk of Falls
- 21 Fall Prevention Interventions for People with Visual Impairment
- 22 Footwear, Orthoses, Walking Aids, Wearable Technology, and Restraint Devices for Fall Prevention
- 23 Environmental Interventions to Prevent Falls at Home and in the Community
- 24 Fall Injury Prevention: Hip Protectors and Compliant Flooring
- 25 Multi-Factorial Fall Prevention Strategies: Where to Next?
- 26 Fall Prevention in Hospitals
- 27 Fall Prevention in Residential Aged Care Facilities
- Part III Implications for Practice
- Index
- References
Summary
As indicated in Chapter 12, the homes of many older people have environmental hazards [1–3] and the majority of these are amenable to modification. This chapter outlines environmental assessment, adaptations, and strategies to prevent falls and reviews the literature for interventions delivered individually or as part of multi-faceted programmes. It discusses the breadth and quality of assessments available; potential enablers and challenges to hazard removal and design strategies for minimizing older people’s risk of falling at home and in public places. Fall prevention strategies involving the provision of new glasses and assistive devices are presented in Chapters 21 and 22 respectively.
- Type
- Chapter
- Information
- Falls in Older PeopleRisk Factors, Strategies for Prevention and Implications for Practice, pp. 360 - 377Publisher: Cambridge University PressPrint publication year: 2021
References
Carter, SE, Campbell, EM, Sanson-Fisher, RW et al. Environmental hazards in the homes of older people. Age Ageing. 1997;26:195–202.Google Scholar
Stevens, M, Holman, CD, Bennett, N et al. Preventing falls in older people: outcome evaluation of a randomized controlled trial. J Am Geriatr Soc. 2001;49:1448–55.Google Scholar
Gill, TM, Robison, JT, Williams, CS et al. Mismatches between the home environment and physical capabilities among community-living older persons. J Am Geriatr Soc. 1999;47:88–92.CrossRefGoogle ScholarPubMed
Lamb, SE, Jorstad-Stein, EC, Hauer, K et al. Development of a common outcome data set for fall injury prevention trials: the Prevention of Falls Network Europe consensus. J Am Geriatr Soc. 2005;53:1618–22.Google Scholar
Lamb, SE, Hauer, K, Becker, C. Manual for the fall prevention classification system. Version 1. 2007. www.profane.eu.org/documents/Falls_Taxonomy.pdf (accessed April 2021).Google Scholar
Clemson, L, Stark, S, Pighills, A et al. Environmental interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2019;2019:CD013258.Google Scholar
Clemson, L, Cumming, RG, Heard, R. The development of an assessment to evaluate behavioral factors associated with falling. Am J Occup Ther. 2003;57:380–8.CrossRefGoogle ScholarPubMed
Iwarsson, S, Horstmann, V, Carlsson, G et al. Person-environment fit predicts falls in older adults better than the consideration of environmental hazards only. Clin Rehabil. 2009;23:558–67.Google Scholar
Pighills, A, Ballinger, C, Pickering, R et al. A critical review of the effectiveness of environmental assessment and modification in the prevention of falls amongst community dwelling older people. Br J Occup Ther. 2016;79:133–43.Google Scholar
Cumming, RG, Thomas, M, Szonyi, G et al. Home visits by an occupational therapist for assessment and modification of environmental hazards: a randomized trial of falls prevention. J Am Geriatr Soc. 1999;47:1397–402.CrossRefGoogle ScholarPubMed
Clemson, L, Cumming, RG, Kendig, H et al. The effectiveness of a community-based program for reducing the incidence of falls among the elderly: a randomized trial. J Am Geriatr Soc. 2004;52:1487–94.Google Scholar
Kempton, A, van Beurden, E, Sladden, T et al. Older people can stay on their feet: final results of a community-based falls prevention programme. Health Promotion International 2000;15:27–33.Google Scholar
Gitlin, L, Winter, L, Corcoran, M et al. Effects of the home environmental skill-building program on the caregiver-care recipient dyad: 6-month outcomes from the Philadelphia REACH Initiative. Gerontologist. 2003;43:532–46.CrossRefGoogle ScholarPubMed
Law, M, Cooper, B, Strong, S et al. The person environment occupation model: a transactive approach to occupational therapy. Can J Occup Ther. 1997;63:9–23.Google Scholar
Nahemow, L. The ecological theory of aging: Powell Lawton’s legacy. In: Rubinstein, R, Moss, M, Kieban, M, Lawton, M. (Eds.) The Many Dimensions of Aging. New York: Springer; 2000:22–40.Google Scholar
Pighills, AC, Torgerson, DJ, Sheldon, TA et al. Environmental assessment and modification to prevent falls in older people. J Am Geriatr Soc. 2011;59:26–33.Google Scholar
Stevens, JA, Mahoney, JE, Ehrenreich, H. Circumstances and outcomes of falls among high risk community-dwelling older adults. Inj Epidemiol. 2014;1:5.Google Scholar
Bleijlevens, MHC, Diederiks, JPM, Hendriks, MRC et al. Relationship between location and activity in injurious falls: an exploratory study. BMC Geriatr. 2010;10.CrossRefGoogle Scholar
Hill, AM, Hoffmann, T, Haines, TP. Circumstances of falls and falls-related injuries in a cohort of older patients following hospital discharge. Clin Interv Aging. 2013;8:765–73.Google Scholar
O’Loughlin, JL, Robitaille, Y, Boivin, JF et al. Incidence of and risk factors for falls and injurious falls among the community-dwelling elderly. Am J Epidemiol. 1993;137:342–54.Google Scholar
Nyman, SR, Ballinger, C, Phillips, JE et al. Characteristics of outdoor falls among older people: a qualitative study. BMC Geriatr. 2013;13:125.Google Scholar
Timsina, LR, Willetts, JL, Brennan, MJ et al. Circumstances of fall-related injuries by age and gender among community-dwelling adults in the United States. PLoS One. 2017;12.CrossRefGoogle ScholarPubMed
Clemson, L, Cusick, A, Fozzard, C. Managing risk and exerting control: determining follow through with falls prevention. Disabil Rehabil. 1999;13:531–41.Google Scholar
Clemson, L, Mackenzie, L, Ballinger, C et al. Environmental interventions to prevent falls in community-dwelling older people: a meta-analysis of randomized trials. J Aging Health. 2008;20:954–71.Google Scholar
Gillespie, LD, Robertson, MC, Gillespie, WJ et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012:CD007146.Google Scholar
Chu, MML, Fong, KNK, Lit, ACH et al. An occupational therapy fall reduction home visit program for community-dwelling older adults in Hong Kong after an emergency department visit for a fall. J Am Geriatr Soc. 2017;65:364–72.Google Scholar
Pighills, A, Drummond, A, Crossland, S et al. What type of environmental assessment and modification prevents falls in community dwelling older people? Br Med J. 2019;364.Google ScholarPubMed
Nikolaus, T, Bach, M. Preventing falls in community-dwelling frail older people using a Home Intervention Team (HIT): results from the randomized Falls-HIT trial. J Am Geriatr Soc. 2003;51:300–5.CrossRefGoogle ScholarPubMed
Campbell, AJ, Robertson, MC, La Grow, SJ et al. Randomised controlled trial of prevention of falls in people aged >75 with severe visual impairment: the VIP trial. Br Med J. 2005;331:817–25.Google Scholar
Day, L, Fildes, B, Gordon, I et al. Randomised factorial trial of falls prevention among older people living in their own homes. Br Med J. 2002;325:128.Google Scholar
Stevens, M, Holman, CD, Bennett, N. Preventing falls in older people: impact of an intervention to reduce environmental hazards in the home. J Am Geriatr Soc. 2001;49:1442–7.CrossRefGoogle ScholarPubMed
Hopewell, S, Adedire, O, Copsey, BJ et al. Multifactorial and multiple component interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2018:7;CD012221.Google Scholar
Close, J, Ellis, M, Hooper, R et al. Prevention of falls in the elderly trial (PROFET): a randomised controlled trial. Lancet. 1999;353:93–7.CrossRefGoogle ScholarPubMed
Tinetti, ME, Baker, DI, McAvay, G et al. A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N Engl J Med. 1994;331:821–7.Google Scholar
Logan, PA, Coupland, CAC, Gladman, JRF et al. Community falls prevention for people who call an emergency ambulance after a fall: a randomised controlled trial. Br Med J. 2010;340:c2102.CrossRefGoogle Scholar
Fabacher, D, Josephson, K, Pietruszka, F et al. An in-home preventative assessment program for independent older adults: a randomized controlled trial. J Am Geriatr Soc. 1994;42:630–8.Google Scholar
Rubenstein, LZ, Robbins, AS, Josephson, KR et al. The value of assessing falls in an elderly population: a randomized clinical trial. Ann Intern Med. 1990;113:308–16.Google Scholar
Vetter, NJ, Lewis, PA, Ford, D. Can health visitors prevent fractures in elderly people? Br Med J. 1992;304:888–90.CrossRefGoogle ScholarPubMed
Tricco, AC, Thomas, SM, Veroniki, AA et al. Comparisons of interventions for preventing falls in older adults: a systematic review and meta-analysis. J Am Med Assoc. 2017;318:1687–99.Google Scholar
Davis, JC, Ashe, MC, Liu-Ambrose, T et al. Does a home based strength and balance programme in people aged ≥ 80 years provide the best value for money to prevent falls? A systematic review of economic evaluations of falls prevention interventions. Br Med J. 2009;44:80–9.Google Scholar
Salkeld, G, Cumming, RG, O’Neill, R et al. The cost effectiveness of a home hazard reduction program to reduce falls among older persons. Aust NZ J Public Health. 2000;24:265–71.Google Scholar
Keall, MD, Pierse, N, Howden-Chapman, P et al. Home modifications to reduce injuries from falls in the home injury prevention intervention (HIPI) study: a cluster-randomised controlled trial. Lancet. 2015;385:231–8.CrossRefGoogle ScholarPubMed
Keall, MD, Pierse, N, Howden-Chapman, P et al. Cost-benefit analysis of fall injuries prevented by a programme of home modifications: a cluster randomised controlled trial. Inj Prev. 2017;23:22–6.CrossRefGoogle ScholarPubMed
Stewart Williams, J, Kowal, P, Hestekin, H et al. Prevalence, risk factors and disability associated with fall-related injury in older adults in low- and middle-income countries: results from the WHO Study on global AGEing and adult health (SAGE). BMC Med. 2015;13:147.Google Scholar
Mandelbaum, C, Clemson, L, Glassman, M et al. A scoping review of fall hazards in the homes of older adults and development of a framework for assessment and intervention. Aust Occup Ther J. 2019;67.Google Scholar
Blanchet, R, Edwards, N. A need to improve the assessment of environmental hazards for falls on stairs and in bathrooms: results of a scoping review. BMC Geriatr. 2018;18:272.Google Scholar
Peterson, EW, Finlayson, M, Elliott, SJ et al. Unprecedented opportunities in fall prevention for occupational therapy practitioners. Am J Occup Ther. 2012;66:127–30.Google Scholar
Romli, MH, Mackenzie, L, Lovarini, M et al. The clinimetric properties of instruments measuring home hazards for older people at risk of falling: a systematic review. Eval Health Prof. 2016:1–47.Google Scholar
Clemson, L, Fitzgerald, MH, Heard, R. Content validity of an assessment tool to identify home fall hazards: the Westmead Home Safety Assessment. Br J Occup Ther. 1999;62:171–9.Google Scholar
Clemson, L. Validity, usefulness, and reliability of an assessment tool to identify home fall hazards. Master of Applied Science Thesis: The University of Sydney (Lidcombe); 1997.Google Scholar
Clemson, L, Fitzgerald, MH, Heard, R et al. Inter-rater reliability of a home fall hazards assessment tool. OTJR. 1999;19:83–98.Google Scholar
Horowitz, BP, Nochajski, SM, Schweitzer, JA. Occupational therapy community practice and home assessments: use of the Home Safety Self-Assessment Tool (HSSAT) to support aging in place. Occup Ther Health Care. 2013;27:216–27.Google ScholarPubMed
Tomita, M, Saharan, S, Rajendran, S et al. Development, psychometrics and use of Home Safety Self-Assessment Tool (HSSAT). Am J Occup Ther. 2014;68:711–18.Google Scholar
Mackenzie, L, Byles, J, Higganbotham, N. Designing the Home Falls and Accidents Screening Tool (HOME FAST): selecting the items. Br J Occup Ther. 2000;63:261–9.Google Scholar
Clemson, L, Bundy, A, Cumming, RG et al. Validating the Falls Behavioural (FaB) Scale for older people: a Rasch analysis. Disabil Rehabil. 2008;30:498–506.Google Scholar
Chippendale, T, Boltz, M. Perceived neighborhood fall risks and strategies used to prevent outdoor falls: does age matter? J Am Geriatr Soc. 2014;62:2210–12.Google Scholar
Swenor, BK, Yonge, AV, Goldhammer, V et al. Evaluation of the Home Environment Assessment for the Visually Impaired (HEAVI): an instrument designed to quantify fall-related hazards in the visually impaired. BMC Geriatr. 2016;16:214.Google Scholar
Gitlin, LN, Schinfeld, S, Winter, L et al. Evaluating home environments of persons with dementia: interrater reliability and validity of the Home Environmental Assessment Protocol (HEAP). Disabil Rehabil. 2002;24:59–71.CrossRefGoogle ScholarPubMed
Clinical Excellence Commission. Patient safety information [Downloadable handouts on fall prevention]. Available from: https://www.cec.health.nsw.gov.au/keep-patients-safe/falls-prevention (accessed April 2021).Google Scholar
Clemson, L, Swann, M. Stepping On handouts 2016 https://ses.library.usyd.edu.au/handle/2123/14283 (accessed April 2021).Google Scholar
Cumming, RG, Thomas, M, Szonyi, G et al. Adherence to occupational therapist recommendations for home modifications for falls prevention. Am J Occup Ther. 2001;55:641–8.Google Scholar
Nyman, SR, Victor, CR. Older people’s participation in and engagement with falls prevention interventions in community settings: an augment to the Cochrane systematic review. Age Ageing. 2012;41:16–23.Google Scholar
Campbell, AJ, Robertson, MC, Gardner, MM et al. Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women. Br Med J. 1997;315:1065–69.CrossRefGoogle ScholarPubMed
Thompson, PG. Preventing falls in the elderly at home: a community-based program. Med J Aust. 1996;164:530–2.Google Scholar
Connell, B, Wolf, S. Environmental and behavioural circumstances associated with falls at home among healthy elderly individuals. Arch Phys Med Rehab. 1997;78:179–86.Google Scholar
Luz, C, Bush, T, Shen, X. Do canes or walkers make any difference? Nonuse and fall injuries. Gerontologist. 2017;57:211–18.Google Scholar
Li, WJ, Keegan, THM, Sternfeld, B et al. Outdoor falls among middle-aged and older adults: a neglected public health problem. Am J Public Health. 2006;96:1192–200.Google Scholar
Wennberg, H, Phillips, J, Stahl, A. How older people as pedestrians perceive the outdoor environment: methodological issues derived from studies in two European countries. Ageing Soc. 2018;38:2435–67.Google Scholar
Garner, E. Preventing Falls in Public Places. Challenge & Opportunity for Local Government. Report No: NCPHU 96–0026. Lismore, NSW: North Coast Public Health Unit; 1996.Google Scholar
Lai, PC, Wong, WC, Low, CT et al. A small-area study of environmental risk assessment of outdoor falls. J Med Syst. 2011;35:1543–52.Google Scholar
Pardessus, V, Puisieux, F, Di Pompeo, C et al. Benefits of home visits for falls and autonomy in the elderly: a randomized trial study. Am J Phys Med Rehabil. 2002;81:247–52.Google Scholar
- 3
- Cited by