A STANDARDIZED INSTRUMENT TO ASSESS HAZARDS FOR FALLS IN THE HOME OF OLDER PERSONS

Hazards in the home are implicated in up to half of all falls among ol der persons. Yet, the instruments used to identify these hazards usual ly have been unstandardized, have lacked specific definitions of hazar ds, and have not been evaluated. Therefore, in 1988, as part of the St udy to Assess Falls among the Elderly, in Miami Beach, Florida, the au thors evaluated the reliability of a standardized instrument used for assessing the training of evaluators and assessing home environments. Based on up to 176 observations for each potential hazard, the intervi ewers' assessment of hazards such as throw rugs, tripping hazards, lig ht switch hazards, and hazardous bath surfaces had good overall reliab ility (kappa=0.65-0.92). Their assessment of grab-bars and hazardous f urniture was unreliable (kappa=0.18-0.35). Variations in the reliabili ty reflect the difficulty in creating definitions that are simple to b e understood and used, yet detailed enough to produce sensitive and sp ecific survey items. Investigators studying falls among older persons should use standardized definitions to train evaluators and assess env ironmental hazards.