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. Copyright © 2000 John Wiley & Sons, Ltd.
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