Abstract
Most homes contain potential hazards, and many older people attribute their falls to trips or slips inside the home or immediate
home surroundings. However, the existence of home hazards alone is insufficient to cause falls, and the interaction between
an older person’s physical abilities and their exposure to environmental stressors appears to be more important. Taking risks
or impulsivity may further elevate falls risk. Some studies have found that environmental hazards contribute to falls to a
greater extent in older vigorous people than in older frail people. This appears to be due to increased exposure to falls hazards
with an increase in the proportion of such falls occurring outside the home. There may also be a non-linear pattern
between mobility and falls associated with hazards. Household environmental hazards may pose the greatest risk for older
people with fair balance, whereas those with poor balance are less exposed to hazards and those with good mobility are more
able to withstand them. Reducing hazards in the home appears not to be an effective falls-prevention strategy in the general
older population and those at low risk of falls. Home hazard reduction is effective if targeted at older people with a history of
falls and mobility limitations. The effectiveness may depend on the provision of concomitant training for improving transfer
abilities and other strategies for effecting behaviour change.
Keywords: accidental falls, environmental hazards, mobility limitations, assistive devices