Overcoming Obstacles to Policies for Preventing Falls by the Elderly  

The Department of Housing and Urban Development (HUD) has released a wide-ranging report focusing new attention on the rapidly growing problems of senior falls. The report found that while extensive research on specific fall preventions and strategies and their effectiveness exists, there was a significant gap on how to overcome obstacles to improve policies and programs designed to reduce senior falls.

The 36-page report, Overcoming Obstacles to Policies for Preventing Falls by the Elderly Final Report recommends a range of ways for HUD and other government and philanthropic entities to help communities overcome obstacles to the development and implementation of senior falls prevention and coordinated care policies and programs.

The Report covers the severe impacts of fall related injuries on the individual and on healthcare costs to society. About one-third of adults age 65 years or older fall each year, with most falls occurring inside the home.  By 2020, expenditures related to injuries from falls to seniors are projected to cost nearly $59.7 billon.

 The document was developed by the Office of Lead Hazard Control and Healthy Homes (OLHCHH) contractor, Healthy Housing Solutions, and is based on an extensive review of available literature and feedback from a distinguished Expert Panel.

Key sections cover housing and the built environment, with 9 specific recommendations aimed at seniors and affordable housing.  The Report states that “housing is of particular importance to coordinated health and senior falls prevention because of the amount of time seniors spend at home and its potential as a centralized site to provide essential health and wellness to seniors, especially low income seniors.”  The report recommends expanding and improving HUD’s Section 202 program. Other approaches are to increase investment in senior housing, engage community health workers, and that HUD encourage collaborations between housing and healthcare providers to create a “healthy senior homes” medical designation that a physician could use to prescribe specific home modifications and/or use of technology and safety devices within the home.

The Report suggests that as the cost to modify homes to meet seniors’ needs is much higher than building homes that can be readily adapted to accommodate changing physical capabilities. The National Healthy Housing Standards are a good first step.

One high priority remedy offered is creation of a dedicated and coordinated funding stream to support aging-in-place, senior safety at home, and continuous care models.  Policy and funding would be coordinated under one lead agency, include a broad variety of federal/state agencies involving public health, housing, and transportation.  A public health agencies need not lead the effort. Some 20 other ways are identified, including outreach to underserved and low-income communities to increase understanding of what is needed now and in the future.  Authors suggest development of a universal “Community Health Worker” credential so that training is consistent across states. Other suggestions include creation of a Wellness coordinator and/or training of on-site HUD staff to conduct senior assessments, and standardization of building codes to ensure homes are safe for all ages, including seniors.

The Report also contains a toolkit highlighting numerous funding sources and the rationale for outreach to non-traditional partners to improve delivery of services and care to seniors.  The authors avoid duplication of existing seniors’ related toolkit; the goal is to provide important information to help partners bridge the gap between their specific disciplines and areas of interest. The toolkit helps agency and public health professionals learn more about the key players in the housing and community development field. The toolkit covers four key areas:

  • Why senior falls prevention and coordinated care is an important societal issue and what some communities are doing to meet the needs of seniors;
  • What partners and stakeholders should be engaged, and what each can offer to this effort, and why a holistic approach may provide the best potential;
  • What financial resources, from all levels of government to philanthropic, may be available to help create and sustain effective policies and programs.
  • How to sustain policies and programs over the long-term