Academic journal article Generations

Home-Safety Checklists for Elders in Print and on the Internet

Academic journal article Generations

Home-Safety Checklists for Elders in Print and on the Internet

Article excerpt

While the importance of making our homes childproof to prevent injuries is well accepted, an equivalent attention to home safety for our growing older population is only beginning to evolve. The Department of Health and Human Services (2001) reports that, in 1998, unintentional injuries accounted for the deaths of 18,538 young persons between the ages of 1 and 24 years, and for the deaths of 32,975 Americans age 65 years and older. Falls account for approximately 75 percent of unintentional injuries among community-dwelling older adults, followed by burns (8 percent) and improper dosages of prescription medications and other mishaps (17 percent). Most of these injuries occur in the home environment (Roberts and Irons-Georges, 2000). The majority of home environments are not "elder-friendly" to individuals with limitations in mobility or perceptual ability associated with aging (Lanspery, Hyde, and Hendricks, 1997; Houts and Rubenstein, 2002).

A multitude of judgment-based home-safety checklists, designed for use by elderly people in their homes, provide practical tools for assisting them in making their home environments safer. The checklists vary in number and severity of risk factors addressed, practicality and product cost of proposed solutions, and apparent overall quality. Because of this wide spectrum of available lists, and their potential importance in addressing this major problem, we undertook a content analysis of home-safety checklists for elders available in the consumer literature and on the Internet. (see Appendix.)


We conducted a systematic search of scientific and consumer literature as well as Internet sites for checklists and itemized hazard lists focused on preventing unintentional injuries among community-dwelling elders. This project involved an extensive electronic library search and use of several Internet search engines. Our analysis of checklists began with an itemization of extrinsic risk factors, which we classified into six broad categories: physical accessibility issues, lighting, general assistive devices, safety devices, emergency preparedness, and hazard containment.

Our analysis focused on content and "elder friendliness"-factors affecting the checklists' acceptability to older adults. Because of the visual and other physical changes that occur with aging, larger typefaces, easy-to-read graphics layouts, and succinctness are important characteristics. Out of respect for the older person, the tone of the guides should be one of presenting material to an informed consumer, offering resources and alternatives, rather than patronizingly presenting directives. Further, we assessed the overall difficulty and estimated costs of implementing each safety recommendation based on Bakker's "Resource Guide" (1997) and our respective experiences as homeowners.


Our content analysis revealed many extrinsic risk factors that were identified repeatedly on checklists-for example, grab bars in bathrooms (98 percent overall) and handrails and stairs in good repair (91 percent overall). Certain risk factors were more commonly found on Internet lists than on published lists (e.g., smoke detectors, 74 percent versus 31 percent), and some were more common on published lists (e.g., nonskid wax, 22 percent versus 61 percent). List recommendations varied widely in both the complexity and the expense (e.g., from arranging a buddy system with a neighbor to hiring a professional help-response system). Accompanying texts, including illustrative examples, advice, referrals, and testimonials, further enhanced the value of many of these checklists and referred readers to additional nonprofit resources (e.g., toll-free numbers or websites). Indeed, 65 percent of the Internet checklists offered searches within the site where the checklist was located.

Readability of the Internet checklists and their corresponding texts was quite variable. During the course of our search and analysis of elder home-safety checklists, we discovered significant duplication; when possible, we traced each list to its original author. …

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