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Effective Approaches to Minimize Falls and Beyond

What home and/or community strategies or modifications are most important to reduce the risk of falling and how can policymakers encourage their widespread adoption? View the full forum.

By Ryan Frederick

My dear friend, Al, is in his early 80s. When my family and I first met him, our kids were too young to say his name properly. They called him “Owl.” That name has stuck.

Owl has boundless energy and he has lived a full life. He has also faced more than his share of tragedy. Shortly after we met Owl, his wife, Carol, slipped, fell down a flight of stairs, suffered a major brain injury and passed away.

Sadly, Carol’s story is not unique. Many of our homes today were not designed with older adults in mind. Often stairs, bathrooms, kitchens and other areas are fraught with fall risks. Some changes can be easily implemented. For example, throw rugs should be minimized, spaces decluttered and furniture optimally positioned. However, some important changes are more involved. Widening doorways and reconstituting kitchens and bathrooms to make them wheelchair accessible can be complicated and expensive.

There are programs making a difference today that could benefit from broader adoption and scale. One such program is CAPABLE (Community Aging in Place, Advancing Better Living for Elders) in Baltimore. I serve on the Advisory Board of Johns Hopkins School of Nursing (SON) and have had a chance to get to know and be inspired by Associate Professor Dr. Sarah Szanton, CAPABLE’s creator. CAPABLE comes alongside people with minimal resources who wish to stay in their homes and whose health conditions may otherwise qualify them to move into skilled nursing. A team composed of a nurse, an occupational therapist, and a handyman visits low-income elderly, checking not just their vital signs and mobility but also for home environment details like handrails and smooth flooring. For an older person, not being able to navigate stairs or safely use a bathroom can be as disabling as disease. CAPABLE has shown significant savings in Medicare and Medicaid by keeping people healthier and in their homes longer with its approach.

There are also opportunities to make an impact with new approaches. One such approach is to help people age in community by rethinking what affordable senior housing can look like. New models can incorporate the best in universal design, including slip-resistant tiles, blocking behind the walls for grab bars and better lighting, among other features. However, these new models offer more than minimizing fall risk. Such environments can help elevate overall well-being, including giving people greater purpose, social connection, physical well-being and engagement with their community. I am the Founder & CEO of Smart Living 360, which is developing a new community in Rockville, MD called The Stories. Opening in March, this market rate community is designed with well-being in mind and has the prospect of not only minimizing falls but also positively impacting people’s health more broadly. An affordable version of this model could be a game changer.

As we move forward, we need to encourage both expansion of programs that are working as well as models of tomorrow that promise to have an even bigger impact.

Ryan Frederick is the Founder & CEO of Smart Living 360.

Welcome to the BPC Health and Housing Expert Forum. Each month contributors from different parts of the health and housing sectors will be invited to respond to a discussion topic. Have a question you’d like us to consider? Please leave it in the comments.

Any views expressed on this forum do not necessarily represent the views of the Senior Health and Housing Task Force, its co-chairs, or the Bipartisan Policy Center.

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