Role of the environment in falls prevention

Environmental change offers an attractive approach to falls prevention, particularly as part of multidimensional intervention strategies. This article reviews and summarizes prior research that has examined environmental factors in falls experienced by older people in community and long-term care settings. Limitations of this research as a basis for falls prevention activities also are discussed. Studies that focused on environmental hazards as well as those that examined the interaction of environmental conditions and environmental use activities from a situational perspective are included. The first group of studies suggests an approach to falls prevention centered on hazard removal; the second group suggests an approach centered on the provision of more supportive environments that reduce excessive environmental demands. Environmental change and falls prevention in long-term care and community settings, including common barriers to change among older individuals living in the community, are discussed.