Home assessment for elderly at risk of falls

Question 1

What is the aim of home assessments? Who is it done by?

Answer 1

Aim
- identify potential environmental hazards (rugs, stairs, pets, lighting, flooring, handrails) in the home that may increase the risk of a fall
assess & modify performance
- identify & agree strategies to reduce falls risk
- education & information giving

Usually done by an occupational therapist.

Question 2

What is assessed during the home visit?

Answer 2

Asses:
- intrinsic, extrinsic & behavioural risk factors
- the patient for functional ability (e.g. climbing stairs) (going to the toilet)

Question 3

What action is taken after the home assessment?

Answer 3

1. provide aids & techniques for patient to complete ADLs (activities of daily living) safely
   - provide adaptations to home i.e. placement of furniture to maximise safety, advice on footwear & how to stay safe on the floor
   - Provide equipment e.g. stairlifts, toilet rails, Zimmer frame
2. Identify people that can help e.g. family, friends/neighbours
3. Help make action plans
4. Check if patient eligible for grants if they need further care or expensive adaptations
5. Arrange for MDT to provide package of care. E.g. physio: exercise programmes to improve strength and balance, get GP/pharmacist to review medications if problems are identified
6. Refer to falls clinic if deemed necessary
7. Discuss w/ patient changes they are willing to make & potential barriers to compliance (e.g. fear of falling).
8. Older people who present for medical attention because of fall, or report recurrent falls in the past year should be offered a multifactorial falls risk assessment & intervention (NICE)