Home and environmental intervention and the reduction of falls in high risk elderly

Conclusion: Strong indications for effectiveness

Home and environmental intervention undertaken by appropiately trained individuals is effective in reducing falls in frail older people with a history of recurrent falling and/or a fall-related hospitalisation and/or with poor vision (=high risk group).
Interventions to prevent falls need to be population specific; a one-size-fits-all approach will fail to deliver a significant population-level fall and fracture reduction.

Recommendations (for research & practice)

The home and environmental intervention in high risk elderly consists of:
· home visits to assess the home for environmental hazards,
· providing information about possible changes,
· facilitating any necessary modifications,
· training in the use of technical and mobility aids
Home and environmental improvement is generally offered as a discipline of multifactorial intervention.

Review Date: 20/06/2007
Version: 1.2
Status: Publish

Procedure
First the titles and then abstracts were scanned in order to include relevant studies. Two recent reviews were selected and scrutinized and background documents were created. The resulting evidence statements were subjected to expert review and if necessary adapted.

Background documents

Modification of the home environment for the reduction of injuries (version 1)
R.A. Lyons, L.V. Sander, A.L. Weightman ... [et al.] (2006)

Interventions for preventing falls in older people living in the community (version 1)
L.D. Gillespie, M.C. Robertson, W.J. Gillespie ... [et al.] (2009)

Randomised controlled trial of prevention of falls in people aged >=75 with severe visual impairment : the VIP trial (version 1)
A. John Campbell, M. Clare Robertson, Steven J. La Grow ... [et al.] (2005)

Environmental interventions to prevent falls in community-dwelling older people : a meta-analysis of randomized trials (version 1)
L. Clemson, L. Mackenzie, C. Ballinger ...[et al.] (2008)

Home visits by an occupational therapist for assessment and modification of environmental hazards : a randomized trial of falls prevention (version 1)
Robert G. Cumming, Margaret Thomas, George Szonyi ... [et al.] (1999)