Abstract:

OBJECTIVES: To examine the frequency of environmental hazards in the homes and care environments of patients with dementia and their associations with falls. METHOD: Falls were prospectively assessed in 65 dementia patients using carer diaries, and the safety of the environment assessed by an occupational therapist using a home hazard checklist. RESULTS: Hazards were found in 20 (95%) of patients' own homes and 31 (74%) of residential or nursing home environments (care environments). Patients' homes had a mean of 5.4 hazards compared to a mean of 1.8 hazards in care environments, with two or more hazards in 90% of patients' homes and 52% of care environments. Common hazards included low chairs, an absence of grab rails (toilet area), toilets too low and a missing second banister on the stairs. There was no significant association between the number of hazards and the number of falls, although 13 (10%) falls could be attributed to a specific hazard. CONCLUSION: Rigorous assessment of the patient's environment revealed multiple rectifiable risks that were contributory to a significant minority of falls.