Intended for healthcare professionals

Rapid response to:

Analysis

Shifting the focus in fracture prevention from osteoporosis to falls

BMJ 2008; 336 doi: https://doi.org/10.1136/bmj.39428.470752.AD (Published 17 January 2008) Cite this as: BMJ 2008;336:124

Rapid Response:

Falls and the designs of our standard homes

I read with interest the article " Shifting the focus in fall
prevention from osteoporosis to falls" and the comments in the Editors
choice regarding strategies for prevention of falls in the recent BMJ .
As a SpR(Specialist Registrar) in Old Age Psychiatry, the major portion of
my job entails assessment of the elderly patients at their homes. I have
been acutely aware of the risks to fall which our home designs pose to
this vulnerable group of patients. A fall may mean the difference between
continuing to live independently in the community to being forced to give
up their loved homes of last 40- 50 years and to go and live among
strangers in a completely align environment which is no doubt very
distressing .

I had the first hand experience of unfriendliness of our home designs to
our elders when my mother who is 75 years old recently visited me from
overseas and stayed for 2 weeks with me. She has arthritis of knee and
mild heart failure and uses diuretics (not uncommon in this age group).
Her basic requirement was a bedroom and a toilet downstairs. I have a
standard four bed room house which I was very proud of. I hastily
converted the tiny study into a bed room for her and was embarrassed by
the discomfort she faced during her stay due to the lack of storage space
and the risk of falls this narrow room caused. I have come to despise the
concept of cloak rooms, the limited space in them limits the mobility of
the elderly people and the question of bathing remained unresolved. I had
to be with her each time she climbed stairs to have a bath as the
arthritis of her knees not only made it difficult but risky to climb
stairs. I wonder if most of you had similar experiences when you dared to
invite your parents. I now can understand very well when even loving
families are unable to take their parents to stay with them for few days
on occasions such as Christmas from residential or nursing homes ,and the
sadness which it can cause to the parents and the guilt which their
children experience from it.

When my mother left, I had a good look at my beloved home and asked myself
“Will I be able to live with safety and dignity in this house when I
eighty?” I am afraid I could not say yes to it, no matter how much I wish
to live and die with dignity in my own home, just like most of my patients
I wonder why the professionals who are involved in the designing of our
standard homes and not just the elderly home, don’t realise that most of
us would like the design of our homes to enable us to continue to live in
our own homes as we grow old and perhaps be able to invite our parents to
come and stay with us occasionally, rather than creating ghastly
alterations and adding chair lifts with their inherent risks. After all we
are the elders of the future.

References:

1.Godlee F. Absolute risk please. Editors choice. BMJ 2008(19th
January)Volume 336

2..Teppo L N Jarvinen et al . Shifting the focus in fracture
prevention from osteoporosis to falls. BMJ 2008(19th January),124-
126,Volume 336.

Competing interests:
My mother was the one to suggest thinking about the designs of the standard houses in UK

Competing interests: No competing interests

23 January 2008
Roohi Afshan
SpR Psychiatry
H. Khan ( My mother)
Springfield university hospital SW17 7DJ