PREVENTING CLIENT FALLS

Understanding Risk Factors and Home Modifications

The resources on this page will help you to understand risk factors for falls, and ways to prevent them. Falls are caused by intrinsic factors, or internal characteristics of the person themselves, or extrinsic factors, or external factors such as the environment that the person lives in (American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention, 2001). These factors are presented on the handout and will help you to be aware of if your client is at an increased risk to fall.

Common strategies to reduce fall risks include reducing the number of medications taken, engaging in physical exercises, ensuring good vision, managing medical conditions, taking supplements, managing proper foot care and attire, educating the client on fall prevention, and changing the physical environment (Panel on Prevention of Falls in Older Persons, American Geriatrics Society and British Geriatrics Society, 2011). As you may notice, many of these strategies fall outside of the care you provide. Though you cannot make these changes for them, you can recommend to your client that they visit their doctor to talk to them about these areas.

The area you can more directly help in is modifying the physical environment and providing more support to your client during transfers and mobility. Home modifications refer to changes made within the home environment to “make everyday tasks easier, increase comfort, reduce the number of accidents, and support independent living” (Pynoos, Sabata, & Choi, 2005; cited in Pynoos, Steinman, & Nguyen, 2010, p. 3). The handout below will provide some modifications that you can make or suggest to your client. If you are unsure of what modifications to make or how, you can recommend to your client to request a home assessment from an occupational therapist or a certified aging in place specialist. Home assessment checklists can also be found on the Center for Disease Control’s website, found here. For more information on assistance with transfers, please visit the in-home training page of this website.

We want to emphasize that home modification is a collaborative effort with your client. Changes should not be made to a client’s home without their direction and approval. The suggestions found on the handout are suggestions for you to discuss with your client. Evidence has shown that older adults often do not want to discuss or perform modifications to their home to prevent falls due to their attitude regarding falling, attitude regarding risk of falling, attitude toward what is an appropriate modification (such as moving cords away from the floor) and what is an inappropriate modification (such as removing rugs), attitude towards wanting their house to continue to feel like a home with meaningful objects, and denial of their being a need to modify the home (Kruse et al., 2010). If your client denies wanting to make home modification, we suggest educating them further about fall risks, safety, and the benefits of home modification, or recommending they consult an occupational therapist or certified aging in place specialist. However, do not make the modifications without their approval or request the occupational therapist or certified aging in place specialist yourself. You are working in your client’s home, and it is important that their sense of home be respected.