Home Modifications and Exercise Are Key to Falls Prevention

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 Loren Colman

According to the American Geriatrics Society’s Clinical Practice Guideline for the Prevention of Falls in Older Persons, every older adult who has had at least one fall and a balance or gait problem should receive a multi-factorial risk assessment. This assessment should be followed by a set of interventions tailored to the specific risks the person is experiencing. The interventions found to have the most significant impact on reducing a person’s fall risk are home modifications and exercise (focused mostly on lower body strength and balance).

Home modifications need to be done with an eye towards improving the overall safety of the home environment as well as maximizing the ability of individuals to function within this environment. Many of the modifications that are needed are cheap and easy to do. These include removing throw rugs, increasing lighting in the bedroom and hallways (including motion detector lights for at night), installing grab bars in the bathroom, and removing clutter in walkways. Some individuals may benefit from larger modifications such as a ramp to their front door, a chair lift to get to a second floor, or moving the washing and dryer machines to the main floor. Policymakers can encourage the widespread adoption of home modifications by funding education and awareness programs targeted to high risk older adults.

Tai Chi is the most effective type of exercise program to reduce fall risk in older adults. And, based on Minnesota’s implementation experience, they love it! Older adults in all parts of our state and from all cultural and ethnic communities are enjoying their participation in a Tai Chi program. We are implementing the Tai Ji Q’uan: Moving for Better Balance Program, which is proven to reduce fall risk in older adults.

Policymakers can encourage the widespread adoption of Tai Ji Q’uan and other evidence-based exercise programs through increased Older Americans Act Section III-D funding. This funding supports the implementation of evidence-based health promotion and disease prevention programs through a nationwide infrastructure of state, regional and local entities. The success of these entities in disseminating evidence-based health promotion programs to high-risk older adults is supported through a partnership with state and local public health agencies.

Loren Colman is the Assistant Commissioner of Continuing Care for Older Adults.

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