By all estimates, falls among older adults are a common, costly, and debilitating problem. Consider the following statistics from The Centers for Disease Control and Prevention (CDC) (2015a):
Falls are the costliest type of injury among older persons. It is estimated that the total direct medical costs of fall injuries for older adults (65+) in the United States in 2013 was $34 billion. By 2020, the annual direct and indirect cost of fall injuries is expected to reach $67.7 billion (in 2012 dollars) (CDC, 2015a).
Of those who fall, 20–30% suffer moderate to severe injuries that make mobility and independent living difficult and increase the risk of premature death. Many people who fall develop a fear of falling even if they are not injured. Fear of falling may be as harmful as any injury and can severely limit activities; reduce mobility, strength, and balance; and increase the actual risk of a fall (CDC, 2015a).
Most fractures among older adults are caused by falls (CDC, 2015b):
Mary Tinetti, MD, geriatrician and leading expert in falls research, suggests the most successful approach to reducing falls among older adults is a combination of intervention strategies that include:
Environmental factors play an important role in causing and preventing falls. Designers should pay special attention to providing safe, easy access in residential care spaces (e.g., good quality lighting, handrails on stairs, grab bars in the bathroom, easy-to-reach cabinets, eliminating slip and trip hazards).
Older adults can also reduce falls by engaging in weight-bearing exercise, strength training, and balance training. Including space for tai chi or yoga classes and safe walking paths outdoors can help decrease the incidence of falls.
Safety issues among older adults with Alzheimer’s disease can be complicated by progressive changes in the brain that affect judgment, sense of time and place, physical and sensory abilities, and behavior.
The use of battery-operated resident mobility devices (e.g., motorized wheelchairs or scooters) has increased sharply in residential care settings. With the increase in use comes a number of safety concerns. One set of concerns focuses on the safe operation of the vehicle by the resident (Rohde, 2012):
The other set of concerns around battery-operated mobility devices relates to space, storage, and maintenance of the vehicles:
Alzheimer’s Association. (2014). Staying safe: Steps to take for a person with dementia. Retrieved from: https://www.alz.org/national/documents/brochure_stayingsafe.pdf
Centers for Disease Control and Prevention. (2015a). Falls among older adults: An overview. Retrieved from: http://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html
Centers for Disease Control and Prevention. (2015b). Hip fractures among older adults. Retrieved from: http://www.cdc.gov/homeandrecreationalsafety/falls/adulthipfx.html
Institute for Healthcare Improvement. (2008). Reducing harm from falls. Retrieved from: http://www.ihi.org/resources/Pages/ImprovementStories/ABCsofReducingHarmfromFalls.aspx
Joseph, A. (2006). Health promotion by design in long-term care settings. Concord, CA: The Center for Health Design.
Rohde, J. (2012). Residential healthcare facilities. Concord, CA: The Center for Health Design.
Tinetti, M. (2003). Preventing falls in elderly persons. New England Journal of Medicine, 348(1), 42-49.
Ulrich, R., Zimring, C., Zhu, X., DuBose, J., Seo, H., Choi, Y., . . . Joseph, A. (2008). A review of the research literature on evidence-based healthcare design (Part 1). Health Environments Research & Design Journal, 1(3), 61-126.