Assessment of Household Environmental Risk Factors for Falls Among Community Dwelling Older Persons in Thiruvananthapuram District of Kerala

Falls constitute a major public health problem among older persons worldwide. This study attempted to observe and identify the potential environmental hazards within and outside the houses that could have caused fall-related injuries of older persons. The modifications done to the house after the falls were also observed. Households of older persons who were hospitalised at a tertiary care centre in Thiruvananthapuram district of Kerala, India for complaints of fall related injuries (participants of a case-control study) were observed using a guide that was customized and adapted for the setting. The areas around the houses were slippery and had several tripping hazards. Marble, granite and tiled floors were found to be slippery. Door thresholds, door mats with no grip backing and plastic chairs were found to be potential tripping hazards. Steps/stairs were important in causation of falls. The bedrooms were often dark, small and cluttered with furniture. The bathrooms were frequently located outdoors and at a different level from the rest of the house. Lighting was a problem within the house, inside the toilet and bathrooms. Commonest alteration made to prevent falls was introduction of mats inside and outside the house. Changes that were needed for a safe environment for older persons are often challenged by the need to display status markers. Several potential hazards were identified within and around the house. They either precipitated the falls or modified the outcome of falls. Further research is necessary to work out a guideline for constructing safe and friendly houses for older persons.