The impact of home modifications on the risk of falls in older adults

Abstract

Overview of the subject: Falls are a major public health concern all over the world. Falls kill an estimated 684,000 people each year, making them the second leading cause of unintentional injury death. Fall prevention is a key factor because falls are life-threatening cause of death, morbidity, and suffering among the elderly and their families (World Health Organization 2021). The General Assembly of the United Nations (UN) has nominated the years 2021-2030 as the Decade of Healthy Aging. Through age-friendly environments, age discrimination, integrated care, and quality long-term care, it aims to reduce health disparities and improve the lives of older people, their families, and communities. According to the evidence, measuring the health care and medical costs associated with falls will provide critical evidence about the nature of the problem and potential financial investment, which will benefit from the impact of effective prevention strategies. The primary purpose of this thesis was to assess the impact and effectiveness of home and environmental changes in preventing and reducing falls in the elderly (WHO, 2021). Research Question: Among older persons experiencing falls or fear of falling, are home and environmental modification effective to prevent and reduce falls? PICO Elements: Population: Older persons at risk of falls Intervention: Home environmental modification Comparison: No modification Outcome: Prevention and reduction in falls Method: The five articles were found by searching electronic databases such as HyDi, Elsevier, and Google Scholar. The PICO framework was used to generate these keywords and synonyms, which were created by combining alternative terms and search tools, as well as Boolean operators. A comprehensive systematic literature search was conducted using databases. Limiters were used to narrow down the search results. Criteria for inclusion: Full-text English language studies, literature published in the last 10 years, human research, older people aged 60 and over, experiencing falls or fear of falling, prevention and reduction in falls. Criteria for Exclusion: Languages other than English, literature published more than 20 years ago, animal research, people under the age of 60, and the number of fallers and non-fallers taking specific classes of psychotropic drugs or surgical treatment, studies that do not focus on home and environmental modification trials and programs. Search Outcome: The introduction of a PRISMA flow chart to identify the randomised controlled studies (RCTs) cohort randomised studies, meta-analysis of randomised studies, a cluster-randomised control studies. Method of Appraisal: The selected studies used the Critical Appraisal Skills Program (CASP) tools to critically evaluate the 5 key articles identified through a literature search. Results: Home and environmental modification have been significantly effective when compared with no any modification in prevention and reduction of falls among older persons. Conclusion: Home and environmental modifications can raise awareness about fall prevention and home modification behaviors as well as reduce the overall indoor incidence rate of falls among community-dwelling older people. Implications and Recommendations: According to research, nurses should be involved in the planning of fall prevention programs in order to provide the best care to the elderly. Nurses' involvement in the planning and implementation of multifactorial interventions, in collaboration with relevant stakeholders, can improve patient outcomes.