Home Safety Program
Conceptual Outline
Home Safety Improvement Program
“Prevention of At-Home Injuries”
The Need:
• Each year, 1 out of every 3 Americans over the age of 65, falls down.
• One-half to two-thirds of all falls occur in or around the home.
• 20% - 30% of elders over age of 65 that fall will have moderate to severe
injury.
• 60% of fall-related deaths occur among people 65 and older.
• More than 50% of all fatal falls involve elders 75 years of age and older.
• 87% of all fractures sustained by elders (over the age of 65) are the
result of falls
• Hip fractures:
- The most serious injury related to falls and lead to the greatest number
of health problems and deaths.
- app. 90% of all hip fractures are due to falls.
- 25% of those who sustain a hip fracture die within one year and another 50%
never return to their prior level of mobility or independence.
• About 50% of those elders who fall and sustain injury in their home will
be discharged from the hospital to a nursing home, rather than returning home.
• In 2000, 1.6million seniors were treated in emergency departments for
fall-related injuries and 353,000 were hospitalized. Those hospitalizations have
increased by 44% over 11 years.
• According to the AMA AMNews publication (amednews.com) and Health Affairs:
- Medicare is spending billions to treat preventable injuries incurred by the
elderly
- Many injury-related costs could be saved through better use of preventive
measures.
- Home assessments and modifications, assistive devices, walking and strength
training can mitigate the risk of falls and fractures.
- Researchers recommended focusing on fractures in particular because of the
high cost and prevalence.
- Fractures accounted for 2/3 of the injury related Medicare spending, with
total claims of $5.5B.
- Many of the breaks result from falls, prompting policy-makers and health
experts to turn to fall-prevention efforts.
• Per the “Elder Fall Prevention Act of 2002”:
- Falls are the leading cause of injury deaths among people over 65.
- 65% of fall-related deaths occur among persons 75 and older.
- 25% of elderly persons who sustain a hip fracture die within 1 year.
- The Federal Government should devote additional resources to research regarding
the prevention and treatment of falls in residential as well as institutional
settings.
- Reducing preventable adverse events, such as elder falls is an important
aspect to the agenda to improve patient safety
The Cost
• The average health cost of a fall injury by a senior is app.$19,500.
• In 2000, 1.6 million seniors were treated in emergency departments for
fall related injuries and 353,000 were hospitalized.
• In 1991, Medicare costs for hip fractures were app.$2.9B.
• Hip fractures cost an average of $33,000 per patient for medical care.
• Emergency room visits average $2,000-$4,000.
• Cost of an ambulance dispatch is about $1,500.
• About 18% of Americans do not have health insurance.
• Uninsured patients pay approximately ? of their health care costs, leaving
$43B in unpaid bills to hospitals and doctors.
• The total cost of all fall injuries for people aged 65 or older in 1994
was $20.2B.
What is at risk?
• A fall, a 911 call, ambulance and emergency room expenses, hospitalization
and physical rehabilitation are expensive alternatives to a providing some simple
home improvements.
• Emergency room visits and rehabilitation are expensive and often cannot
be paid by low-income homeowners. Such injuries immediately jeopardize the ability
to remain “independent”: shopping, food preparation, and care for
oneself. Quickly after an injury, the injured elderly lose their independence,
become vulnerable to dependency and require expensive social services.
• The lowest-cost housing solution for low-income homeowners is to remain
in their home. Prevention of injury should be a key initiative, for the homeowner
and for society. Most home safety improvements are affordable, while the cost
of injury is very expensive.
• Expensive uncollectable health care service.
• Rising premiums.
The Program Goal
Reduce at-home falls and injuries for low-income homeowners.
The Plan
Promote Home Safety Improvements and reduce the risk of falls in the home,
especially where older people live. Making a few changes can prevent 50%
of home accidents, including falls.
• Repair hand rails
• Change door knobs to lever handles
• Install smoke detectors
• Replace an old shower head with a hand-held unit
• Add grab bars in the bathroom
• Add non-slip strips in bathtubs
• Tape or replace slippery throw rugs
• Replace light switches with rocker switches
• Make narrow doorways 2” wider with offset hinges
• Improve lighting
• Ensure stable entries to doors
Methodology of Home Safety Improvements
• Deliver 10 basic home improvements designed to reduce falls (and injuries)
by 50%
• Target neighborhoods of low-income neighborhoods living in single-family
dwellings.
• Create 5-10 crews of 3-4 persons each to deliver this standardized package
(1 Saturday/month)
• Coordinate with homeowner associations for publicity and sign-up.
• Target consecutive homes for gains in efficiency
• 2-3 hours per home to deliver home modifications (3 homes/crew/Saturday)
Who Benefits?:
Homeowners
• Improvements in safety, personal comfort, security and independence
• Homeowners remain in their own home (vs. hospitals, rehab and nursing
facilities)
• Investment protection (the home is the principle financial assets for
most Americans)
• Reduction of the loss of financial resources, struggling families and
communities
Community
• Reduction of abandoned homes and crime prevention
• Less disruption to struggling families and communities
Health Care Providers (hospitals, doctors, ambulance service…)
• Reduction of at-home fall injuries (by insured and uninsured patients)
• Reduction of un-collectable health care expenses by uninsured patients
Insurance Companies
• Fewer claims by insured patients
Potential Financial Partners in this Home Safety Improvement Program
• Health Care Providers (Emergency rooms, EMS, doctors, rehab facilities,
long term care)
• Insurance Companies
• Medicare & Medicaid
• Rehab Facilities
• Broward County Elder Services Division
• Area Alliance on Aging
Rebuilding
Together Broward County, Inc.
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Ft. Lauderdale, FL 33301
phone: 954-462-6200 ext.#203
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