Assessing and Adapting the Home Environment to Reduce Falls and Meet the Changing Capacity of Older Adults

Falls in older adults are a serious problem for individuals, their families, and the health care system. This article describes research regarding fall risk assessment, risk reduction interventions, and public policy aimed at reducing the risk of falls for older adults in home settings. Assessments for frail older adults should include observations of not only the physical environment, but also the interactions among the environment, behavior, and physical functioning so that interventions are tailored to the specific situation of the individual. Home modification and technology can prove useful when designing interventions aimed at reducing fall risks. Problems such as cost, reluctance to adopt or implement suggestions, and a lack of knowledge may present barriers to effective home modification. Program and policy options for the future include improved training for service personnel who visit the homes of older adults, increased awareness of and coordination between programs or interventions aimed at reducing the risk of falls in older adults, new sources of funding, and building more housing that follows the principles of universal design.