Falls can happen to anyone, but as we get older, a fall can have a significant impact on confidence, independence and the ability to continue doing the things we enjoy.
Falls prevention is often thought of as simply removing rugs, improving lighting or installing grab rails. While these things can help, effective falls prevention is much more than making a home safer.
From an Occupational Therapy perspective, the key is understanding the whole picture: the person, their environment and the everyday activities they want and need to do.
What can increase the risk of falls?
Falls are rarely caused by one factor alone. Changes in strength, balance, mobility, vision, cognition, footwear, medications and the home environment can all contribute to falls risk.
Occupational Therapy Australia explains that occupational therapists are experts in assessing and addressing the different factors associated with falls, including physical function, environmental hazards and changes to cognition.
“Falls prevention isn’t about telling someone what they can’t do. It’s about understanding what they want to keep doing and finding ways to make those activities safer,” says Gen Health Occupational Therapist, Sophie O’Keefe.
Looking beyond the obvious hazards
A falls risk assessment should consider more than whether there is a loose mat in the hallway.
An Occupational Therapist can look at how someone actually moves around their home and completes everyday activities. This might include getting in and out of the shower, preparing a meal, getting dressed, moving between rooms or getting up during the night.
This person-centred approach helps identify risks that may not be obvious to someone simply looking around the home.
The Australian Commission on Safety and Quality in Health Care recommends tailored home safety interventions delivered by an Occupational Therapist for older people at increased risk of falls. This includes people who have fallen in the past year, have mobility difficulties, need assistance with everyday activities or have recently returned home from hospital.
Small changes can make a big difference
Falls prevention doesn’t always mean major changes to someone’s home.
An Occupational Therapist might recommend:
- Removing or securing trip hazards
- Improving lighting, particularly along pathways and near the bedroom or bathroom
- Reviewing bathroom safety and recommending appropriate equipment
- Considering rails, grab bars or other supports
- Reviewing the use of mobility aids
- Changing how an everyday task is completed
- Reorganising frequently used items so they are easier and safer to access
- Recommending assistive technology or equipment
- Providing education and strategies to improve safety and confidence.
Importantly, recommendations should be individualised. What works for one person may not be appropriate for another.
“Our role is to find practical solutions that fit into someone’s real life. The goal isn’t to change everything about their home; it’s to identify the changes that will make the biggest difference to their safety and independence,” explains Gen Health Occupational Therapist Chrissy Radcliffe.
Falls prevention is about independence, not restriction
It can be tempting to avoid activities because of fear of falling. However, becoming less active can lead to further reductions in strength, balance and confidence.
Falls prevention should therefore support people to stay active and continue participating in everyday life, rather than unnecessarily restricting what they do.
Occupational therapists can help by looking at how a person performs activities and providing education, training, activity modification, aids and equipment where appropriate.
Falls prevention is also most effective when it is approached as part of a broader strategy. Exercise targeting balance, mobility and strength is an important component of falls prevention, alongside addressing environmental and other individual risk factors.
Why consider an Occupational Therapy home assessment?
Your home is familiar to you, which can make it easy to overlook potential risks.
An Occupational Therapist can assess the home in the context of how you actually live and move within it. They can identify potential hazards, consider your individual abilities and routines, and work with you to develop practical solutions.
Occupational Therapy Australia notes that home hazard reduction delivered by an occupational therapist can reduce falls by 38% in people at high risk of falls.
The latest Australian falls guidelines also recommend working collaboratively with the older person when identifying hazards and developing environmental modifications.
The key to falls prevention?
It’s not simply removing every potential hazard or filling a home with equipment.
The key is understanding the person, the environment and the activities that matter to them, and finding practical ways to make those activities safer.
If you or someone you care for is concerned about falls, an Occupational Therapist can help identify risks and recommend strategies to support safety, confidence and independence at home.
Speak with the Occupational Therapy team at Gen Health Hamilton to find out how an OT assessment could help.
Disclaimer: This information is general in nature and is not a substitute for personalised medical advice.
Reference: Occupational Therapy Australia, Occupational therapy in community aged care.
Reference: The Australian Commission on Safety and Quality in Health Care.
