Posted: April 30th, 2022

Assessing the Home Environment to Reduce Patient Fall Risk

Assessing the Home Environment to Reduce Patient Fall Risk

Falls are a common and serious problem for older adults, especially those living in the community. Falls can cause injuries, disability, loss of independence and even death. According to the World Health Organization, falls are the second leading cause of accidental or unintentional injury deaths worldwide. Therefore, it is important to identify and address the factors that increase the risk of falling among older people.

One of the main factors that contribute to falls is the home environment. The home environment includes the physical layout, furniture, lighting, flooring, rugs, clutter and other features of the living space. A home environment that is not well designed or maintained can pose many hazards for older people, such as tripping, slipping, losing balance or bumping into objects. These hazards can be especially dangerous for older people who have impaired vision, hearing, mobility or cognition.

To reduce the risk of falls at home, older people and their caregivers should assess their home environment and make necessary changes to improve safety and accessibility. Some of the common home hazards and interventions are:

– Floors, stairways and hallways: Ensure there are handrails on both sides of any stairs, and make sure they are secure. Hold the handrails when you go up or down stairs, even when you are carrying something. Don’t let anything you’re carrying block your view of the steps. Ensure there is good lighting with light switches at the top and bottom of stairs and on each end of a long hall. Consider using motion-activated lights that plug into electrical outlets and automatically turn on when you walk by them to help illuminate stairwells and pathways. Keep areas where you walk tidy. Don’t leave books, papers, clothes, or shoes on the floor or stairs. Check that all carpets are fixed firmly to the floor, so they won’t slip. Put no-slip strips, which you can buy at any hardware store, on tile and wooden floors. Don’t use throw rugs or small area rugs. Don’t walk on slippery, newly washed floors.

– Bathrooms: Mount grab bars near toilets and on both the inside and outside of your tub and shower. Place nonskid mats, strips, or carpet on all surfaces that may get wet. Remember to leave a light on in the bathroom at night or use a night light that turns on automatically in the dark.

– Bedrooms: Put night lights and light switches close to your bed. Keep a flashlight by your bed in case the power goes out and you need to get up. Place a landline or well-charged phone near your bed.

– Kitchen: Keep frequently used pots, pans, and kitchen utensils in a place where they are easy to reach. Clean up spills immediately. Prepare food while seated to prevent fatigue or loss of balance.

– Outdoor spaces: If you have steps leading to your front door, make sure they are not broken or uneven. Add non‐slip material to outdoor stairways. Keep the lawn, deck, or porch areas clear of debris, such as fallen branches. Consider installing a grab bar near the front door to provide balance while you are locking or unlocking the door. Turn on your porch light at night and if you leave during the day but plan on returning home after dark. In the winter, treat outdoor walkways with an ice melt product or sand to make them less slippery.

– Other living areas: Keep electrical cords near walls and away from walking paths. Arrange your furniture (especially low coffee tables) and other objects so they are not in your way when you walk. Make sure your sofas and chairs are the right height for you to get in and out of easily. Keep items you use often at waist level or within easy reach. Don’t stand on a chair or table to reach something that’s too high — use a “reach stick” instead or ask for help.

Assessing and modifying the home environment is an effective way to prevent falls among older people living in the community. However, it is not enough to rely on environmental interventions alone. Older people should also consult their health care providers about their medications, health conditions, prior falls and physical activity levels that may affect their risk of falling. By taking a comprehensive approach to fall prevention, older people can enhance their quality of life and avoid unnecessary injuries.

Bibliography

[1] World Health Organization (WHO), “Falls,” 16 September 2020 [Online]. Available: https://www.who.int/news-room/fact-sheets/detail/falls.

[2] National Institute on Aging (NIA), “Preventing Falls at Home: Room by Room,” 17 November 2017 [Online]. Available: https://www.nia.nih.gov/health/falls-and-falls-prevention/preventing-falls-home-room-room.

[3] Mayo Clinic, “Fall prevention: Simple tips to prevent falls,” 28 September 2019 [Online]. Available: https://www.mayoclinic.org/healthy-lifestyle/healthy-aging/in-depth/fall-prevention/art-20047358.

[4] Cleveland Clinic, “Fall Risk Assessment for Patient Safety,” 14 January 2020 [Online]. Available: https://my.clevelandclinic.org/health/articles/23330-fall-risk-assessment.

[5] American Academy of Family Physicians (AAFP), “Environmental Interventions for Preventing Falls in Older People Living in the Community,” 15 November 2023 [Online]. Available: https://www.aafp.org/pubs/afp/issues/2023/1100/cochrane-preventing-falls-older-people.html.

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