Yale researchers, in what is believed to be the first population-based study of its kind, have discovered that many older people have physical hazards in their homes that easily could be eliminated.
Potential hazards such as poor lighting, exposed electrical cords, throw rugs and insufficient bathroom grab rails or stairway banisters are common in the homes of most older people.
The research is particularly significant because it is based on data collected through visits to homes, as opposed to information obtained from secondary sources, according to Dr. Thomas M. Gill, assistant professor of medicine at the School of Medicine's Program on Aging, the chief investigator for the study. Results of the research were published in the American Journal of Public Health.
"Baby boomers are now facing the challenge of how to care for their aging parents," notes Gill, a Robert Wood Johnson Generalist Physician Faculty Scholar and a Beeson Physician Faculty Scholar in Aging Research. "The environment has to be a part of that equation."
The study looked at 1,000 people aged 72 and older who were living in New Haven in 1989. All were cohort members of Project Safety, a study funded by the National Institute on Aging. Researchers looked at variables that might influence the day-to-day functioning of senior citizens. Information was collected by a trained research nurse, who assessed each room in the home for potential environmental hazards.
Dr. Mary Tinetti, professor of medicine and of epidemiology and public health, and director of the Program on Aging, assembled the Project Safety cohort. Seventy-two percent of the participants were female, and 84 percent were white. Sixty-nine percent lived alone. The study included people living in houses, apartments, condominiums and age-restricted housing, such as senior-citizen complexes.
Homes were checked for 20 potential hazards. The most common-- found in 77.9 percent of the homes -- are on the floor. These include loose throw rugs, electric cords and curled carpet edges.
Bathrooms, too, were found to be a danger zone: Two or more hazards were found in 59 percent of the bathrooms, with 61 percent of the homes lacking grab bars in the tub or shower. Other household hazards were dim lighting; shadows or glare in rooms and along stairs; unclearly marked kitchen light switches; and absence of stairway night lights.
According to Gill, the everyday function of frail older persons may be enhanced, and the potential for disabling accidents may be decreased, by assessing the home for potential hazards and then minimizing those hazards. Gill believes his group's study could have far-reaching implications. "We used a very sophisticated sampling technique that allows us to produce a sample that is population-based," he explains. "The representative sample of older persons in New Haven can be generalized to other comparable urban settings."
Research such as this could be used to help determine how resources earmarked for the elderly will be allotted, says Gill. For instance, the study "points to the importance of home assessment with regard to older people," he says. "Already, many Medicare recipients are eligible for home care services. As part of that, a home safety assessment could be ordered.
Analyzing the data along with Gill and Tinetti were Christianna S. Williams, the supervising data analyst, and Julie T. Robison, a former research affiliate at the department of epidemiology and public health.
In addition to grants from the National Institute on Aging, work on the study was funded by an award from the Gaylord Rehabilitation Research Institute.
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Gila Reinstein
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