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Home Safety Assessment (home + safety_assessment)
Selected AbstractsHome safety assessment in the prevention of falls among older peopleAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 5 2000Nancye Peel Objective:Home safety assessment was examined as part of a randomised trial of falls prevention interventions among older community dwellers. Method:Falls prevention strategies, including education and awareness-raising, exercise, home modifications and medical assessment, were trialled with 252 members of the National Seniors Association. Falls outcomes were monitored using a daily calendar diary during intervention and follow-up periods. Results:The home assessment group was significantly more likely to modify their home environment than the controls (p<0.0001). Participants, regardless of group allocation, reported a significant reduction in concern about falling (p<0.0001). During the intervention, the home assessment group had lower incidence rates for falls and injuries than the control group, although differences were not significant. The lowered rates were sustained post-intervention. Conclusions:While the effect on falls incidence of a home safety intervention on its own could not be demonstrated, other benefits, including improved confidence attributable to awareness of such falls prevention measures, were recorded. Implication:The null effects of home modifications on falls prevention in this study may indicate that the program is more appropriate for the frail aged. [source] Kenosha County Falls Prevention Study: A Randomized, Controlled Trial of an Intermediate-Intensity, Community-Based Multifactorial Falls InterventionJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 4 2007Jane E. Mahoney MD OBJECTIVES: To decrease the rate of falls in high-risk community-dwelling older adults. DESIGN: Randomized, controlled trial. SETTING: Community-based. PARTICIPANTS: Three hundred forty-nine adults aged 65 and older with two falls in the previous year or one fall in the previous 2 years with injury or balance problems. INTERVENTION: Subjects received two in-home visits from a trained nurse or physical therapist who assessed falls risk factors using an algorithm. The intervention consisted of recommendations to the subject and their primary physician, referrals to physical therapy and other providers, 11 monthly telephone calls, and a balance exercise plan. Control subjects received a home safety assessment. MEASUREMENTS: The primary outcome was rate of falls per year in the community. Secondary outcomes included all-cause hospitalizations and nursing home admissions per year. RESULTS: There was no difference in rate of falls between the intervention and control groups (rate ratio (RR)=0.81, P=.27). Nursing home days were fewer in the intervention group (10.3 vs 20.5 days, P=.04). Intervention subjects with a Mini-Mental State Examination (MMSE) score of 27 or less had a lower rate of falls (RR=0.55; P=.05) and, if they lived with someone, had fewer hospitalizations (RR=0.44, P=.05), nursing home admissions (RR=0.15, P=.003), and nursing home days (7.5 vs 58.2, P=.008). CONCLUSION: This multifactorial intervention did not decrease falls in at-risk community-living adults but did decrease nursing home utilization. There was evidence of efficacy in the subgroup who had an MMSE score of 27 or less and lived with a caregiver, but validation is required. [source] A Randomized, Controlled Trial of Fall Prevention Programs and Quality of Life in Older FallersJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 4 2007Mau-Roung Lin PhD OBJECTIVES: To compare the effects of three fall-prevention programs (education (ED), home safety assessment and modification (HSAM), and exercise training (ET)) on quality of life (QOL), functional balance and gait, activities of daily living (ADLs), fear of falling, and depression in adults aged 65 and older. DESIGN: A 4-month randomized trial. SETTING: Randomized, controlled trial. PARTICIPANTS: One hundred fifty participants who had experienced a recent fall. MEASUREMENTS: QOL was assessed according to the brief version of the World Health Organization Quality of Life instrument (WHOQOL-BREF), functional balance and gait according to functional reach and Tinetti balance and gait, ADLs according to the Older Americans Resources and Services questionnaire, fear of falling according to a visual analog scale, and depression level according to the Geriatric Depression Scale. RESULTS: The score changes for the ET group were 2.1 points greater on the physical domain (95% confidence interval (CI)=,1.2,5.3), 3.8 points greater on the psychological domain (95% CI=0.7,7.0), and for the WHOQOL-BREF, 3.4 points greater on the social domain (95% CI=0.7,6.1) and 3.2 points greater on the environmental domain (95% CI=0.6,5.7) than for the ED group. The score change for each domain of the WHOQOL-BREF for the HSAM group was greater than that for the ED group, although these results were not statistically significant. The ET group also had greater improvements in functional reach, Tinetti balance and gait, and fear of falling than the ED group. CONCLUSION: The QOL outcome supports the superiority of ET over the other two interventions in older people who have recently fallen. This finding also parallels those gathered from the functional measures. [source] | ||||||||||