Older adults’ well-being in the home is always a priority, preventing falls and disability. Besides the apparent physical and psychological effects of a fall, broader societal and economic ramifications exist for the victim, their loved ones, and the healthcare industry. As part of fall prevention for people over 65, recent guidelines recommend conducting home safety assessments and modifying the home to reduce the risk of injury. The goal of this article is to identify components of a home hazard and safety assessment for older adults living at home as part of a geriatric assessment.
FALLS AT HOME
About 20-55% of all unintentional falls and injuries caused by falls in adults over 60 years of age take place within the four walls of their own homes, with the majority of the falls occurring in the bathrooms. Most of these falls occur in normal daily activities, while 44% occur in the presence of one or more environmental hazards, and 2-5% occur while performing hazardous activities, such as climbing ladders. A fall can result in a decrease in productivity, increased health care costs and dependency, and early admission to an assisted living or long-term care facility. Fall-related fatalities are rarely reported, but the most common cause of death is a fall down the stairs when they are. Other common reasons included slipping, tripping, and falling from a bed or chair.
- Fall injury events in older adults who have fallen are not associated with an increased risk of environmental hazards in those who have not fallen.
- There are more home hazards for homebound seniors who have fallen than those who haven’t.
- The risk of a fall for older adults who have never fallen before is four times higher than existing home hazards.
- Older adults who have previously fallen may be more aware of their surroundings and be more cautious in the immediate area.
HOME SAFETY AND HAZARD ASSESSMENT:
Medical care for elderly patients should include a home safety and risk assessment as part of the patient’s treatment plan.
Elderly and cognitively impaired individuals should be assessed in their own homes if they have recently fallen or are at risk of doing so in the future. A person who has not had a fall may benefit from home assessments, which can help prevent a fall.
Home safety assessment include: an evaluation of frequently used areas inside and outside the home; observation of the older person moving around the home environment; and fall risk and health status of the older person. For the assessment’s primary goal, the person’s ability to function safely is maintained by developing and implementing effective strategies to reduce hazards, fall risk factors, and accessibility issues.
The most common home safety checklists identify three main types of problems: hazards, problem areas, and a lack of supportive or safety features.
Depending on the type of lighting, flooring, and obstructions, we can sort out the dangers. These hazards can be documented by counting the number of throw rugs and uneven surfaces (e.g., thresholds), piles of clutter and electrical cords, oxygen cords, low tables or other furniture, assistive device use, and pets in the most frequently used path (e.g., from the favorite chair to the bathroom). Railings, good lighting, and uneven surfaces are also inspected along the most frequently traveled path in the outdoor area.
Following the home safety check, geriatric examinations include a possible risk of tripping and falling.
For example, it’s essential to observe the person getting up from a chair, climbing stairs, and getting in and out of the bathtub, walk the usual walking path while paying attention to whether or not the person is holding on to or touching furniture or walls to maintain balance.
These observations can assess people’s ability to function in their own homes.