A new study has revealed that home adaptation interventions help to reduce emergency fall admissions amongst older people.
The Population Data Science at Swansea University led research which has been published in Age and Ageing (Oxford University Press); it is a collaboration with the University of Leeds, Care & Repair Cymru and the University of Liverpool, supported by Health and Care Research Wales, The Dunhill Medical Trust, Health Data Research UK (HDRUK) and Administrative Data Research UK (ADR UK).
Falls are common among older people, with 30% of people aged 65 and over and 50% of people aged 80 and over falling at least once per year. Falls cause increased morbidity, mortality and use of health care services and are a growing concern, with falls costing the NHS an estimated £2.3 billion per year.
Home adaptation services are an example of one approach that aims to support independent home living and reduce falls at home. Still, there is insufficient high-quality evidence to support widespread commissioning. Care & Repair Cymru (C&RC) is a national charity in Wales (UK) that supports an All-Wales network of Care & Repair Agencies. C&RC provides home adaptation, home safety interventions and advice to enable older people to live safely and independently in their own homes.
This study linked administrative, geographical, C&RC data and electronic health record data within the Secure Anonymised Information Linkage (SAIL) Databank to investigate fall outcomes following home adaptation interventions. The key objectives were to determine if home adaptation interventions carried out by C&RC led to a reduction in falls resulting in emergency admissions to hospital and investigate if there were differences in the risk of a fall based on area.
The research involved 657,536 individuals aged 60 and over living in Wales (UK) between 1st January 2010 and 31st December 2017, 123,729 of which received a home adaptation service.
Main findings
- Compared to the control group (who didn’t receive any interventions), C&RC clients had higher odds of falling -this indicates that C&RC are successfully targeting a more vulnerable sub-population of older adults.
- C&RC adaptions/interventions in older people’s homes reduced the odds of falling.
- Falls were more likely in females.
- Older age increased the chance of a fall.
- People living in deprived areas were more likely to fall.
- Increased frailty severity was linked to a higher chance of falling.
Evidence to support widespread commissioning
C&RC identified people more likely to have an emergency fall admission occurring at home, and their service reduced the odds of falling post-intervention. The study recommended that service provisioning should meet the needs of an individual, and need varies by personal and regional circumstance.
Dr Joe Hollinghurst, Swansea University, said: “This project has been a great example of how the SAIL Databank can be utilised to benefit the public. Working collaboratively with Care & Repair Cymru, we could anonymously link data on home adaptations to demographic, health, and administrative records for over 100,000 older people in Wales. This enabled us to provide robust quantitative evidence for the benefits Care & Repair Cymru provide, which will help to influence policy and funding decisions.”
Neil Williams, Care & Repair Cymru and Chair of National Prudent Healthcare Falls Prevention Taskforce, added:
‘‘We welcome the research findings from this project as they provide significant underpinning evidence for our work across Wales in keeping older people safe, warm, and living independent lives. Public Health Wales indicate that more than 132,000 older people will fall more than once in their own home this year, with potential associated costs to NHS acute services and Social Care. Evidence is crucial for Government and Commissioners as they consider how to invest. The thousands of older people we help, and the many we support to return home from hospital or prevent becoming hospitalised, will welcome this evidential support for the services that have helped transform their lives.’’
Read the complete publication here: https://academic.oup.com/ageing/advance-article/doi/10.1093/ageing/afab201/6399893