EFFECTIVENESS OF HOME VISITS FOR DWELLING ADJUSTMENTS IN PREVENTING FALLS AMONG OLDER ADULTS: AN INTERVENTIONAL STUDY

Abstract

Background: Falls among older adults are a growing public health issue due to the aging population, leading to injury, disability, and mortality. Dwelling adjustment and continuous home care are proposed to reduce falls and improve the quality of life for older adults and their families. Objective: To compare the incidence of falls in older adults with and without home visit support and dwelling adjustments. Methods: A prospective randomized controlled study was conducted with patients over 70 years old in Surin province from January 1st to June 30th, 2022. 40 patients from each district were selected by random sampling and assessed for baseline fall risk scores. Patients were randomized to receive two home visits with follow-up monitoring of falls over six months. Nurses and physiotherapists conducted home visits, assessing mobility barriers, fall risk, and home safety using validated tests. A protocol for dwelling adjustments was implemented, including modifications to mobility aids, furniture placement, and the installation of railings and handlebars. Results: 638 patients participated, with an average age of 79 years. Among them, the 319 patients who received dwelling-adjustment home visits had a significantly lower incidence of falls (P<0.001). The number needed to treat was eight to prevent one fall (95% CI: 6-12). Conclusions: The findings support the use of preventive, home-based interventions in older adult care. By reducing falls, these interventions improve the quality of life for older adults and reduce healthcare system burdens. A comprehensive approach, including clinical practice improvements, public health initiatives, and policy reforms, can significantly enhance fall prevention efforts.