Environmental and behavioral circumstances associated with falls at home among healthy elderly individuals. Atlanta FICSIT Group.
OBJECTIVE
To conduct an in-depth examination of the environmental and behavioral circumstances associated with falls and near-falls experienced by elderly individuals and to evaluate the usefulness of reenactment as a method for studying falls.


METHODS
Observational and self-report data of incidents were obtained through a reenactment procedure. Environmental characteristics were documented with physical measurements, visual inspection, and photography.


METHODS
Incidents occurred inside participants' homes, and reenactments were conducted at incident sites.


METHODS
Subjects were 15 community-dwelling, relatively healthy individuals, age 70 to 81 years.


METHODS
Incidents were analyzed to determine patterns of interaction of individuals' personal characteristics, environmental use behaviors, and environmental characteristics.


RESULTS
Seven patterns were identified: collisions in the dark, failing to avoid temporary hazards, preoccupation with temporary conditions, frictional variations between shoes and floor coverings, excessive environmental demands, habitual environmental use, and inappropriate environmental use.


CONCLUSIONS
There is a dynamic interaction between environmental conditions and behavior involving use of the environment and its implications for falls in older people. Although some incidents involved familiar environmental and behavioral risk factors, less familiar factors also were critical contributors to the incidents. Successful elimination of these factors is likely to be closely related to an individual's perception that an environmental or environmental use problem is correctable, motivation to undertake changes in the environment, and a desire to integrate changes into daily activities.
Connell
B R
BR
Rehabilitation Research and Development Center, Atlanta VA Medical Center, Decatur, USA.
Wolf
S L
SL
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000061:Accidents, Home / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D004779:Environment Design; D005260:Female; D005845:Georgia; D006801:Humans; D008297:Male