aging in the community: fall prevention outside of the home

The Fall Prevention Center of Excellence is supported by the Archstone Foundation

Aging in the Community: Fall Prevention Outside of the

HomeJon Pynoos, PhD Co-Director

Caroline Cicero, MSW, MPL, Research Asst.Fall Prevention Center of Excellence

Andrus Gerontology CenterUniversity of Southern California 90089-0191

www.stopfalls.org


Impact of Falls on Governments and Agencies

• Emergency Personnel get Called to Help Older People up when They Fall

• Injuries from Falls Cost Billions/Year in Medi-Cal and Medicare Expenditures

• Falls Result in Hundreds of Claims against Cities, Costing Local Governments Millions.

• When a Participant in an OAA-Funded Program Falls, Hours are Spent Managing the Resulting Care.


FALLS: Beyond the Individual and Beyond Aging in Place

• Older People who Age in Place Also Age in the Community at Large.

• The Aging in Community Paradigm, Recognizes Older Persons’ Interaction with the Environment, both in the Home and Outside.


Indoor or Outdoor?

Frail Older Adults Fall More Often Inside Their Homes, Where Home Modifications can Help.

However, Younger, More Active Seniors Fall More Often Outside the Home, and Often While Engaging in Physical and Leisure Activities such as Walking or Gardening (Li et al, 2006).


Away from the home23%

Outside, but near the house

24%

Inside the house

53%

Location of FallsSource: National Health Interview Survey, 1997-1998 (Kochera, 2002)


Outdoor Falls Happen in Many Places:

• Front steps

• Sidewalks and Driveways

• Gardens and Yards

• Intersections and Crosswalks

• Parking Lots

• Public Spaces

• Recreational Trails

• Commercial Properties

• Loading on and off buses and trains

• Escalators


Design Features that Contribute to Falls in the Community

• Poorly Maintained Sidewalks

• Tree wells• Poor Lighting• Steps or Bumps • Debris from Trees and

Plants• Crosswalks that Force

People to Rush • Lack of Handrails • Poorly Marked Steps and

Curbs


Simple Community Policies to Help Reduce Falls

• Mark Damaged Sidewalks with Paint• Install Respite Benches

• Increase Street

Crossing Signals• Illuminate Sidewalks not only Streets• Clear Debris from Trees and Plants• Paint Speed Bumps and Car Stops


Examine Neighborhoods at Night as Well as Day Time


Conduct a Walkability Audit in Your Community


What is a Walkability Audit?

• Purpose: To Identify Concerns for Pedestrians Related to the Safety, Access, and Comfort of the Walking Environment.

• Use: To Identify Potential Alternative Solutions (such as Engineering Treatments, Policy Changes, or Education and Enforcement Measures).

Source: http://www.walkinginfo.org/problems/audits.cfm


Who Performs a Walkability Audit?

• A Local Community Group or Collaborative Partnership

• A Multidisciplinary Team of Trained Professionals, including Engineers, Planners, Transportation Researchers, Pedestrian and Bicycle Specialists.

• It is Important to Include Older Adults, Persons with Disabilities and Intergenerational Community Members


Neighborhood Walkability SurveyThe City of Citrus Heights, (87,017 pop.) in Sacramento County performed a Walkability Survey.

• Partners were a Community Group Called REACH—The Residents’ Empowerment Association of Citrus Heights and local Neighborhood Associations.

• Funding: Center for Civic Partnerships’ Healthy Cities and Communities Grant


2 Parts to Citrus Heights Survey

Initial Survey in which Participants Answer Questions about: Walking in the Neighborhood,Sidewalk Availability and Conditions, and Access to Services within Walking Distance


“Outdoor Survey”, Citrus Heights Participants Walked and Evaluated the Community Based on the Following:

• Traffic Speed and Volume

• Unsafe Street Crossings

• Lighting

• Night Safety

• Pedestrian Trails

• Sidewalk Conditions and Obstructions


Results of Citrus Heights Audit, Presented in February, 2008

• Most Suggestions and Requests Related to the Control of Traffic, Clearing Obstructions on Sidewalks, and Installing More Sidewalks.

• Residents Pointed out Specific Streets, Intersections that Needed Improvements in Signage, Lighting, Speed Control, and Enforcement of Existing Laws.


What You Can Do:

• AAAs can Engage their Local Senior Centers and Related Community Organizations to Collaborate on Walkability Audits.

• Seek out Intergenerational Partnerships with Schools, Community Colleges, or Local Community Groups to Evaluate the Neighborhood’s Friendliness to People of all Ages and Abilities.

• ADVOCATE!. Inform and Educate Local Policymakers.


Resources

1. Citrus Heights Neighborhood Walkability Survey Report, Prepared by Marois Consulting and Research, Feb., 2008

2. AARP’s Livable Communities: An Evaluation Guide has a checklist on page 52.www.aarp.org/research/housing-mobility/indliving/d18311_communities.html


Questions?

Caroline Cicero, MSW, MPL, CPGResearch Assistant

Fall Prevention Center of ExcellenceUniversity of Southern California

3715 McClintock AvenueLos Angeles, CA 90089-0191

[email protected]

aging in the community: fall prevention outside of the home

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