Transcript The Role of Home and Community Environment in Fall Prevention

Fall Prevention Task Force of Santa Barbara County
presents
The Role of Home and Community
Environment in Fall Prevention
Excerpts taken from 2005 Joint Conference of the American Society of Aging and The National Council on the Aging,
Philadelphia, PA March 12, 2005. Presentation by Jon Pynoos, PhD, Andrus Gerontology Center
Survey Fall Data
# of people
surveyed
Those Surveyed who have
Fallen in last Six Months
160
140
120
100
80
60
40
20
0
107
49
Yes
No
Survey Fall Data
# of persons
surveyed
# of Sustained Injuries if Fall Occurred
126
160
140
120
100
80
60
40
20
0
33
Yes
No
Survey Fall Data
# people
surveyed
Those Surveyed who Made Changes to
Reduce Risk of Fall
160
140
120
100
80
60
40
20
0
95
52
Yes
No
Survey Fall Data
28
Uneven
surfaces
26
46
Problems
with
balance
160
140
120
100
80
60
40
20
0
Muscle
weakness
# of People
Surveyed
Top Three Reasons for Falls
Survey Fall Data
52
39
41
7
More
than 8
5 to 8
3 to 4
11
1 to 2
160
140
120
100
80
60
40
20
0
None
# of people
surveyed
#of Medications Taken each Day
Survey Fall Data
# of people
surveyed
Doctor/Pharmacist Talked to Patient about
Multiple Medications
160
140
120
100
80
60
40
20
0
54
Yes
41
No
Where People Fall
Source: National Health Interview Survey, 1007=1998 (Kochera, 2002)
Why is the Home and Community
Environment Important

The majority of older adults prefer to
stay in their own homes and communities

However, homes and communities often
have numerous hazards, dangerous areas,
and lack supportive features
Why is the Home and Community
Environment Important

Incidents and severity of falls rise steadily
after age 60

Some falls are preventable by decreasing
risk factors
Why we have Increased Risk of Falls






Reaction time slows
Muscles and joints get stiffer
and decreased flexibility
Illness
Medications
Substance abuse
Vision changes






Decreased Balance
Weakness
Decreased sensation in
lower extremity
Inappropriate footwear
Environmental Hazards
Orthostatic hypotension
Actions to Reduce the Risk of Falls






Regular exercise program that includes
stretching, balance training and
strengthening
Illness – maintain good diet and health
Manage medications and the side effects
Manage Orthostatic Hypotension
Assess Vision Changes
Be aware of Sensation loss
Hazards in the Home


Approximately 80% of the homes investigated
had at least one hazard, and 39% had five or more
hazards (Carter et al., 2000)
Hazards in the home include:






Clutter
Electrical cords/phone cords
Slippery throw rugs
Loose carpet
Unsafe bathroom
Poor lighting
Modifying Your Home Helps Prevent
Falls


Home assessment, OT home visits and provision
of Home Modifications reduced the risk of falling
by 36% among those with history of falls
(Cumming et al., 1999)
The Community and Home Injury Prevention
Program in San Francisco: Home assessment and
minor home modification strategies reduced the
fall incidence rate by almost 60% among relatively
healthy seniors (Rose et. al., 2003)
Home Modification Strategies





Removing hazards
Adding special features or assistive devices
Moving items or furnishings
Changing where activities occur
Renovating or changing existing structure
Problem Areas in the Home

The biggest problem areas of the home:



Outside steps to the entrance
Inside stairs to a second floor
Unsafe bathrooms
Options for Improving Problem Areas

Outside steps to entrance





Hand rails
Ramps
Short deep steps
Bright automatic lighting
Repair uneven steps
Options for Improving Problem Areas

Inside stairs







Hand rails
Ramps
Lift seat,
Bright Lighting
Remove loose or badly worn rugs or tack down
carpeting
Non skid surface
Keep stairs free of clutter
Options for Improving Problem
Areas

Bathroom





Grab bars – not towel bars or
doors
Non skid strips or rubber mat
inside the tub
Sitting on bath chair on tub
transfer bench
A bath mat outside the shower with
non skid backing
Hand held sprayer
Home Modifications and its Challenges
Source: AARP (2000). Fixing to Stay: A National Survey of Housing and Home
Modification Issues.
Problems in the Community

Outdoor community hazards:

Uneven pavement, surfaces and/or cracks


Tree roots





To report problems with City sidewalks or burned out street
lights within the City limits call 925-0951, Ext 804
Within the city limits, Call 925-0951, Ext 260)
Obstacles in walkway
Uneven steps
Unsafe stair design
Poor lighting
Problems in the Community (cont.)

Lack of safety features in your surroundings




Handrails
Grab bars
Ramps
Curb cuts
Conclusion

Falls can be prevented by


Knowing your Risk
Focus on those risks with
personal changes
 home modifications
 and a regular exercise program.
