Effective Community Participation in Environmental Risk Management for Household Accident Prevention among Elders
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Published:
Dec 27, 2017
Keywords:
Community Participation Home Environment Risk Management Accident Prevention Elderly People
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Abstract
This research aimed to manage environmental risks in order to prevent accidents at homes of the elderly. A participatory action research (PAR) was implemented by 29 core researchers and 51 participants. Five steps were utilized, including 1) defining issues, goals and preparing research, 2) methodology and data collection, 3) data analysis, 4) risk management, and 5) evaluation. Several tools were developed by the researchers, including interview forms, questionnaires, and home environmental risk checklists. The target population were 51 households with elderly residents. A total of 71 elderly people were interviewed and 34 caregivers were asked to answer self-report questionnaires for caregivers. Each household was surveyed of risk environments and documented of any incidence of accident occurred at home during the years 2013-2015. The process of PAR improved the community awareness of the home environmental risk to the elders and increased the participation on the risk management. Many unsafe environments were found in their home, especially in the bathrooms and kitchens. Accordingly, the risk management plan was proposed. Many activities were included, such as toilet improvement, accident prevention training, motivational walking campaigns, mentoring and counseling on home risk management. Subsequently, the implementation of the plan led to ongoing management of the risks and successful accident reduction. Follow-up visits found that elderly people had their knowledge increased 20.6% (p <.01) and unsafe behaviors decreased 15.2% (p <.01). The caregivers’ knowledge also increased 4.8% (p <.01), and safe elderly care practice increased 8.6% (p <.01). In addition, the use of home safety devices increased 28.2% (p <.01). The home risk factors declined 21.4% (p <.01). The accident incidence fell 63.8%. The environmental risk fell in all areas. The PAR created the community empowerment and a continuity of the risk management process which led to sustainability of the operation.
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References
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Barringer & Associates, Inc. (2006) Risk Matrix. Retrieved on August 16, 2012, from https://www.barringer1.com/nov04prb_files/Risk-Matrix.pdf
Becker, C., Kron, M., Lindemann, U., Sturm, E., Eichne,r B., Walter-Jung, B & Nikolaus, T. (2003) Effectiveness of a multifaceted intervention on falls in nursing home residents. Journal of the American Geriatrics Society 51(3), 306-313.
Blair, T. & Minkler, M. (2009) Participatory Action Research With Older Adults: Key Principles in Practice. The Gerontologist 49(5), 651-662.
Borst, H. C, Miedemaa, H. M. E., Vries, S. I., Grahama, J. M. A. & van Dongena, J. E. F. (2008) Relationships between street characteristics and perceived attractiveness for walking reported by elderly people. Journal of Environmental Psychology 28(4), 353–361.
Bureau of Epidemiology. (2012) Annual epidemiological surveillance report 2012. Retieved on July 25, 2017, from https://www.boe.moph.go.th/Annual/AESR2012/main/AESR55_Part1/file10/5755_SIDAF.pdf
Carter, S. E., Campbell, E. M., Sanson-Fisher, R. W., Redman, S. & Gillespie, W. J. (1997) Environmental hazards in the homes of older people. Age and Ageing 26(3), 195-202.
Close, J., Ellis, M., Hooper, R., Glucksman, E., Jackson, S. & Swift, C. (1999) Prevention of falls in the elderly trial (PROFET): a randomized controlled trial. The Lancet 353(9147), 93-97.
Cumming, R. G., Thomas, M., Szonyi, G., Salkeld, G., O’Neill, E., Westbury, C. & Frampton, G. (1999) Home visits by an occupational therapist for assessment and modification of environmental hazards: a randomized trial of falls prevention. Journal of the American Geriatrics Society 47(12), 1397-1402.
Day, L., Fildes, B., Gordon, I., Fitzharris, M., Flamer, H. & Lord, S. (2002) Randomised factorial trial of falls prevention among older people living in their own homes. British Medical Journal 325(7356), 128-131.
Donmez, L. & Gokkoca, Z. (2003) Accident profile of older people in Antalya City Centre, Turkey. Archives of Gerontology and Geriatrics 37(2), 99-108.
Edwards, J. (2002) Risk-Era: The Swedish Rescue Service’s Tool for Community Risk Management. Esri conference 2002 Paper #00307. Retrieved on August 16, 2012, from https://proceedings.esri.com/library/userconf/proc02/pap0307/p0307.htm
Gilhooly, M. L. M. (2011) Home Accidents amongst Elderly People: A Locality Study in Scotland. Retrieved on August 6, 2011, from https://www.gerobilim.com/index.php?id=23
Gitlin, L. N., Winter, L., Dennis, M. P., Corcoran, M., Schinfeld, S. & Hauck, W. (2006) A randomized trial of a multicomponent home intervention to reduce functional difficulties in older adults. Journal of the American Geriatrics Society 54(5), 809-816.
Hamzaoglu, O., Ozkan, O. & Janson, S. (2002) Incidence and causes of home accidents at Ankara Cigiltepe apartments in Turkey. Accident Analysis and Prevention 34(1), 123–128.
Hendriks, M. R., Bleijlevens, M. H., Van Haastregt, J. C., Crebolder, H. F., Diederiks, J. P., Evers, S. M., Mulder, W. J., Kempen, G. I., van Rossum, E., Ruijgrok, J. M., Stalenhoef, P. A. & van Eijk, J. T. (2008) Lack of effectiveness of a multidisciplinary fall-prevention program in elderly people at risk: a randomized, controlled trial. Journal of the American Geriatrics Society 56(8), 1390-1397.
Hogan, D. B., MacDonald, F. A., Betts, J., Bricker, S., M. Ebly, E., Delarue, B., S. Fung, T., Harbidge, C., Hunter, M., J. Maxwell, C. & Metcalf, B. (2001) A randomized controlled trial of a community-based consultation service to prevent falls. Canadian Medical Association Journal 165(5), 537-543.
International Risk Management Institute, Inc. (2012) domino theory. Retrieved on November 27, 2012, from https://www.irmi.com/online/insurance-glossary/terms/d/domino-theory.aspx
Jensen, J., Nyberg, L., Gustafson, Y. & Lundin-Olsson, L. (2003). Fall and injury prevention in residential care effects in residents with higher and lower levels of cognition. Journal of the American Geriatrics Society 51(5), 627-635.
Kannus, P., Sievänen, H., Palvanen, M. Järvinen, T. & Parkkari, J. (2005) Prevention of falls and consequent injuries in elderly people. The Lancet 366(9500), 1885-1893.
Keall, M. D., Baker, M., Howden-Chapman, P. & Cunningham, M. (2008) Association between the number of home injury hazards and home injury. Accident Analysis and Prevention 40(3), 887–893.
Kemmis, S. & McTaggart, R. (2007) Participatory Action Research. Retrieved on June 28, 2015, from file:///C:/Users/ajtex/Desktop/journal/PARTICIPATORY ACTION RESEARCH.pdf.
Klitzman, F., Caravanos, J., Belanoff, C. & Rothenberg, L. (2005) A multihazard, multistrategy approach to home remediation: Results of a pilot study. Environmental Research 99(3), 294–306.
Koski, K., Luukinen, H., Laippala, P. & Rothenberg, L. (1996) Physiological factors and medications as predictors of injurious falls by elderly people. Age and Ageing 25(1), 29-38.
Lan, T. Y., Wu, S. C., Chang, W. C. & Chen, C. Y. (2009) Home environmental problems and physical function in Taiwanese older adults. Archives of Gerontology and Geriatrics 49(3), 335–338.
Larsen, E. R., Mosekilde, L. & Foldspang, A. (2004) Correlates of falling during 24 h among Elderly Danish community residents. Preventive Medicine 39(2), 389–398.
Lee, V. M. S., Wong, T. W. & Lau, C. C. (1999) Home accidents in elderly patients presenting to an emergency department. Accident and Emergency Nursing 7(2), 96-102.
Lim, J. Y., Jang, S. N., Park, W. B. Oh, M. K., Kang, E. K. & Paik, N. J. (2011) Association between exercise and fear of falling in community-dwelling elderly Koreans: results of a cross-sectional public opinion survey. Archives of Physical Medicine and Rehabilitation 92(6), 954-9.
Lin, J. T. & Lane, J. M. (2005) Falls in the elderly population. Physical Medicine and Rehabilitation Clinics of North America 16(1), 109–128.
Lyons, R. A., John, A., Brophy, S., Jones, S. J., Johansen, A., Kemp, A., Lannon, S., Patterson, J., Rolfe, B., Sander, L. V. & Weightman, A. (2009) Modification of the home environment for the reduction of injuries (Review). The Cochrane Collaboration. Retrieved on June 1, 2012, from https://www.intmed.aubmc.org.lb/downloads/geriatrics/geriatrics I-E.pdf
Mahoney, J. E., Shea, T. A., Przybelski, R., Jaros, L., Gangnon, R., Cech, S. and Schwalbe, A. (2007) Kenosha County falls prevention study: a randomized, controlled trial of an intermediate-intensity, community-based multifactorial falls intervention. Journal of the American Geriatrics Society 55(4), 489-498.
McKenzie, J. F, Pinger, R. R. & Kotecki, J. E. (2002) An Introduction to Community Health. 4th Ed. London: Jones & Bartlett Publishers International.
Morgan, R. O., DeVito, C. A., Stevens, J. A., Branche, C. M., Virnig, B. A., Wingo, P. A. & Sattin, R. W. (2005) A self-assessment tool was reliable in identifying hazards in the homes of elders. Journal of Clinical Epidemiology 58(12), 1252–1259.
Nikolaus, T. & Bach, M. (2003) Preventing falls in community-dwelling frail older people using a home intervention team (HIT): results from the randomized Falls-HIT trial. Journal of the American Geriatrics Society 51(3),300-305.
O’Meara, D. M. & Smith, R. M. (2006) The effects of unilateral grab rail assistance on the sit-to-stand performance of older aged adults. Human Movement Science 25(2), 257–274.
Pardessus, V., Puisieux, F., Di, P. C., Gaudefroy, C., Thevenon, A. & Dewailly, P. (2002) Benefits of home visits for falls and autonomy in the elderly: a randomized trial study. American Journal of Physical Medicine and Rehabilitation 81(4), 247-252.
Phatthalung Provincial Health Office. (2012) Population Data 2008-2012.Retrieved on December 3, 2012, from https://203.157.229.18/pop2555/rep_pop_agegrp_area.php
Poorves, S., Tammarattanapruek, P. and Poung, C. (2008) Knowledge of elderly. 2nd ed. Bangkok: Ministry of Social Development and Human Security.
Reason, P. & Bradbury, H. (2008) The Sage Handbook of Action Research: Participative Inquiry and Practice. CA: Sage.Robertson.
Rocket, I. R. H. & Smith, G. S. (1989) Homicide, suicide, motor vehicle crash, and fall mortality: United States? experience in comparative perspective. The American Journal of Public Health 79(10), 1396-1400.
Rodriguez, J. G., Baughman, A. L., Sattin, R. W., deVito, C. A., Ragland, D. L., Bacchelli, S. & Stevens, J. A. (1995) A standardized instrument to assess hazards for falls in the home of older persons. Accident Analysis and Prevention 27(5), 625-631.
Ruleworks (2012) The risk management guide. Retrieved on August 16, 2012, from https://www.ruleworks.co.uk/riskguide/risk-profile.htm
Sorysang, L., Khompraya, J. & Natetanasombut, K. (2014) A study of fall prevention guideline in older adult living in mitraphappatana community. Journal of the Royal Thai Army Nurses 15(1), 122-129.
tevens, M., Holman, C. D., Bennett, N. & de Klerk, N. (2001) Preventing falls in older people: outcome evaluation of a randomized controlled trial. Journal of the American Geriatrics Society 49(11), 1448-1455.
Thai elderly research and development foundation. (2009) Situation of the Thai elderly 2008. Bangkok: TQP Company Limited.
Tinetti, M. E., Baker, D. I., McAvay, G., B. Claus, E., Garrett, P., Gottschalk, M., L. Koch, M., Trainor, K. & Horwitz, R. I. (1994) A multifactorial intervention to reduce the risk of falling among elderly people living in the community. New England Journal of Medicine 331(13), 821-827.
Turner, S., Arthur, G., Lyons, R. A., Weightman, A. L., Mann, M. K., Jones, S. J., John, A. & Lannon, S. (2011) Modification of the home environment for the reduction of injuries (Review). The Cochrane Collaboration. Retrieved on June 1, 2012, from https://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003600.pub2/pdf/standard
UNEP. (1992) Hazard Identification and Evaluation in a Local Community. Paris: United Nation Publication
United Nations. (2004) Population Age Composition. Department of Economic and Social Affairs. Retrieved on May 6, 2012, from https://www.un.org/esa/population/publications/WPP2004/WPP2004_Vol3_Final/Chapter2.pdf
United Nations. (2010) World Population Prospects, the 2010 Revision. Department of Economic and Social Affairs. Retrieved on May 6, 2012, from https://esa.un.org/unpd/wpp/population-pyramids/population-pyramids.htm
Van Haastregt, J. C. M., Diederiks, J. P. M., van Rossum, E., de Witte, L. P., Voorhoeve, P. M. & Crebolder, H. F. (2000) Effects of a programme of multifactorial home visits on falls and mobility impairments in elderly people at risk:randomised controlled trial. British Medical Journal, 321(7267), 994-998.
Vetter, N., Lewis, P. & Ford, D. (1992) Can health visitors prevent fractures in the elderly people. British Medical Journal 304(6831), 888-890
Wang, J., Chen, Z., & Song, Y. (2010) Falls in aged people of the Chinese mainland: Epidemiology, risk factors and clinical strategies. Ageing Research Reviews 291(9), 5.
Watters, J., Comeau, S. & Restall, G. (2010) Participatory Action Research: An Educational tool for Citizen-Users of Community Mental Health Services. MB, Canada: School of medical Rehabilitation, University of Manitoba.
Weatherall, M. (2004). Multifactorial risk assessment and management programmes effectively prevent falls in the elderly. Evidence-Based Healthcare and Public Health 8(5), 270–272.
World Health Organization. (2011) What are the public health implications of global ageing?. Retrieved on May 6, 2012, from https://www.who. int/features/qa/42/en/index.html
World Health Organization. (2012) Ageing. Retrieved on May 6, 2012, from https://www.who.int/topics/ageing/en/
Baraff, L. J., Della, P. R., Williams, N. & Sanders, A. (1997) Practice guideline for the ED management of falls in community-dwelling elderly persons. Annals of Emergency Medicine 30(4), 480-489.
Barringer & Associates, Inc. (2006) Risk Matrix. Retrieved on August 16, 2012, from https://www.barringer1.com/nov04prb_files/Risk-Matrix.pdf
Becker, C., Kron, M., Lindemann, U., Sturm, E., Eichne,r B., Walter-Jung, B & Nikolaus, T. (2003) Effectiveness of a multifaceted intervention on falls in nursing home residents. Journal of the American Geriatrics Society 51(3), 306-313.
Blair, T. & Minkler, M. (2009) Participatory Action Research With Older Adults: Key Principles in Practice. The Gerontologist 49(5), 651-662.
Borst, H. C, Miedemaa, H. M. E., Vries, S. I., Grahama, J. M. A. & van Dongena, J. E. F. (2008) Relationships between street characteristics and perceived attractiveness for walking reported by elderly people. Journal of Environmental Psychology 28(4), 353–361.
Bureau of Epidemiology. (2012) Annual epidemiological surveillance report 2012. Retieved on July 25, 2017, from https://www.boe.moph.go.th/Annual/AESR2012/main/AESR55_Part1/file10/5755_SIDAF.pdf
Carter, S. E., Campbell, E. M., Sanson-Fisher, R. W., Redman, S. & Gillespie, W. J. (1997) Environmental hazards in the homes of older people. Age and Ageing 26(3), 195-202.
Close, J., Ellis, M., Hooper, R., Glucksman, E., Jackson, S. & Swift, C. (1999) Prevention of falls in the elderly trial (PROFET): a randomized controlled trial. The Lancet 353(9147), 93-97.
Cumming, R. G., Thomas, M., Szonyi, G., Salkeld, G., O’Neill, E., Westbury, C. & Frampton, G. (1999) Home visits by an occupational therapist for assessment and modification of environmental hazards: a randomized trial of falls prevention. Journal of the American Geriatrics Society 47(12), 1397-1402.
Day, L., Fildes, B., Gordon, I., Fitzharris, M., Flamer, H. & Lord, S. (2002) Randomised factorial trial of falls prevention among older people living in their own homes. British Medical Journal 325(7356), 128-131.
Donmez, L. & Gokkoca, Z. (2003) Accident profile of older people in Antalya City Centre, Turkey. Archives of Gerontology and Geriatrics 37(2), 99-108.
Edwards, J. (2002) Risk-Era: The Swedish Rescue Service’s Tool for Community Risk Management. Esri conference 2002 Paper #00307. Retrieved on August 16, 2012, from https://proceedings.esri.com/library/userconf/proc02/pap0307/p0307.htm
Gilhooly, M. L. M. (2011) Home Accidents amongst Elderly People: A Locality Study in Scotland. Retrieved on August 6, 2011, from https://www.gerobilim.com/index.php?id=23
Gitlin, L. N., Winter, L., Dennis, M. P., Corcoran, M., Schinfeld, S. & Hauck, W. (2006) A randomized trial of a multicomponent home intervention to reduce functional difficulties in older adults. Journal of the American Geriatrics Society 54(5), 809-816.
Hamzaoglu, O., Ozkan, O. & Janson, S. (2002) Incidence and causes of home accidents at Ankara Cigiltepe apartments in Turkey. Accident Analysis and Prevention 34(1), 123–128.
Hendriks, M. R., Bleijlevens, M. H., Van Haastregt, J. C., Crebolder, H. F., Diederiks, J. P., Evers, S. M., Mulder, W. J., Kempen, G. I., van Rossum, E., Ruijgrok, J. M., Stalenhoef, P. A. & van Eijk, J. T. (2008) Lack of effectiveness of a multidisciplinary fall-prevention program in elderly people at risk: a randomized, controlled trial. Journal of the American Geriatrics Society 56(8), 1390-1397.
Hogan, D. B., MacDonald, F. A., Betts, J., Bricker, S., M. Ebly, E., Delarue, B., S. Fung, T., Harbidge, C., Hunter, M., J. Maxwell, C. & Metcalf, B. (2001) A randomized controlled trial of a community-based consultation service to prevent falls. Canadian Medical Association Journal 165(5), 537-543.
International Risk Management Institute, Inc. (2012) domino theory. Retrieved on November 27, 2012, from https://www.irmi.com/online/insurance-glossary/terms/d/domino-theory.aspx
Jensen, J., Nyberg, L., Gustafson, Y. & Lundin-Olsson, L. (2003). Fall and injury prevention in residential care effects in residents with higher and lower levels of cognition. Journal of the American Geriatrics Society 51(5), 627-635.
Kannus, P., Sievänen, H., Palvanen, M. Järvinen, T. & Parkkari, J. (2005) Prevention of falls and consequent injuries in elderly people. The Lancet 366(9500), 1885-1893.
Keall, M. D., Baker, M., Howden-Chapman, P. & Cunningham, M. (2008) Association between the number of home injury hazards and home injury. Accident Analysis and Prevention 40(3), 887–893.
Kemmis, S. & McTaggart, R. (2007) Participatory Action Research. Retrieved on June 28, 2015, from file:///C:/Users/ajtex/Desktop/journal/PARTICIPATORY ACTION RESEARCH.pdf.
Klitzman, F., Caravanos, J., Belanoff, C. & Rothenberg, L. (2005) A multihazard, multistrategy approach to home remediation: Results of a pilot study. Environmental Research 99(3), 294–306.
Koski, K., Luukinen, H., Laippala, P. & Rothenberg, L. (1996) Physiological factors and medications as predictors of injurious falls by elderly people. Age and Ageing 25(1), 29-38.
Lan, T. Y., Wu, S. C., Chang, W. C. & Chen, C. Y. (2009) Home environmental problems and physical function in Taiwanese older adults. Archives of Gerontology and Geriatrics 49(3), 335–338.
Larsen, E. R., Mosekilde, L. & Foldspang, A. (2004) Correlates of falling during 24 h among Elderly Danish community residents. Preventive Medicine 39(2), 389–398.
Lee, V. M. S., Wong, T. W. & Lau, C. C. (1999) Home accidents in elderly patients presenting to an emergency department. Accident and Emergency Nursing 7(2), 96-102.
Lim, J. Y., Jang, S. N., Park, W. B. Oh, M. K., Kang, E. K. & Paik, N. J. (2011) Association between exercise and fear of falling in community-dwelling elderly Koreans: results of a cross-sectional public opinion survey. Archives of Physical Medicine and Rehabilitation 92(6), 954-9.
Lin, J. T. & Lane, J. M. (2005) Falls in the elderly population. Physical Medicine and Rehabilitation Clinics of North America 16(1), 109–128.
Lyons, R. A., John, A., Brophy, S., Jones, S. J., Johansen, A., Kemp, A., Lannon, S., Patterson, J., Rolfe, B., Sander, L. V. & Weightman, A. (2009) Modification of the home environment for the reduction of injuries (Review). The Cochrane Collaboration. Retrieved on June 1, 2012, from https://www.intmed.aubmc.org.lb/downloads/geriatrics/geriatrics I-E.pdf
Mahoney, J. E., Shea, T. A., Przybelski, R., Jaros, L., Gangnon, R., Cech, S. and Schwalbe, A. (2007) Kenosha County falls prevention study: a randomized, controlled trial of an intermediate-intensity, community-based multifactorial falls intervention. Journal of the American Geriatrics Society 55(4), 489-498.
McKenzie, J. F, Pinger, R. R. & Kotecki, J. E. (2002) An Introduction to Community Health. 4th Ed. London: Jones & Bartlett Publishers International.
Morgan, R. O., DeVito, C. A., Stevens, J. A., Branche, C. M., Virnig, B. A., Wingo, P. A. & Sattin, R. W. (2005) A self-assessment tool was reliable in identifying hazards in the homes of elders. Journal of Clinical Epidemiology 58(12), 1252–1259.
Nikolaus, T. & Bach, M. (2003) Preventing falls in community-dwelling frail older people using a home intervention team (HIT): results from the randomized Falls-HIT trial. Journal of the American Geriatrics Society 51(3),300-305.
O’Meara, D. M. & Smith, R. M. (2006) The effects of unilateral grab rail assistance on the sit-to-stand performance of older aged adults. Human Movement Science 25(2), 257–274.
Pardessus, V., Puisieux, F., Di, P. C., Gaudefroy, C., Thevenon, A. & Dewailly, P. (2002) Benefits of home visits for falls and autonomy in the elderly: a randomized trial study. American Journal of Physical Medicine and Rehabilitation 81(4), 247-252.
Phatthalung Provincial Health Office. (2012) Population Data 2008-2012.Retrieved on December 3, 2012, from https://203.157.229.18/pop2555/rep_pop_agegrp_area.php
Poorves, S., Tammarattanapruek, P. and Poung, C. (2008) Knowledge of elderly. 2nd ed. Bangkok: Ministry of Social Development and Human Security.
Reason, P. & Bradbury, H. (2008) The Sage Handbook of Action Research: Participative Inquiry and Practice. CA: Sage.Robertson.
Rocket, I. R. H. & Smith, G. S. (1989) Homicide, suicide, motor vehicle crash, and fall mortality: United States? experience in comparative perspective. The American Journal of Public Health 79(10), 1396-1400.
Rodriguez, J. G., Baughman, A. L., Sattin, R. W., deVito, C. A., Ragland, D. L., Bacchelli, S. & Stevens, J. A. (1995) A standardized instrument to assess hazards for falls in the home of older persons. Accident Analysis and Prevention 27(5), 625-631.
Ruleworks (2012) The risk management guide. Retrieved on August 16, 2012, from https://www.ruleworks.co.uk/riskguide/risk-profile.htm
Sorysang, L., Khompraya, J. & Natetanasombut, K. (2014) A study of fall prevention guideline in older adult living in mitraphappatana community. Journal of the Royal Thai Army Nurses 15(1), 122-129.
tevens, M., Holman, C. D., Bennett, N. & de Klerk, N. (2001) Preventing falls in older people: outcome evaluation of a randomized controlled trial. Journal of the American Geriatrics Society 49(11), 1448-1455.
Thai elderly research and development foundation. (2009) Situation of the Thai elderly 2008. Bangkok: TQP Company Limited.
Tinetti, M. E., Baker, D. I., McAvay, G., B. Claus, E., Garrett, P., Gottschalk, M., L. Koch, M., Trainor, K. & Horwitz, R. I. (1994) A multifactorial intervention to reduce the risk of falling among elderly people living in the community. New England Journal of Medicine 331(13), 821-827.
Turner, S., Arthur, G., Lyons, R. A., Weightman, A. L., Mann, M. K., Jones, S. J., John, A. & Lannon, S. (2011) Modification of the home environment for the reduction of injuries (Review). The Cochrane Collaboration. Retrieved on June 1, 2012, from https://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003600.pub2/pdf/standard
UNEP. (1992) Hazard Identification and Evaluation in a Local Community. Paris: United Nation Publication
United Nations. (2004) Population Age Composition. Department of Economic and Social Affairs. Retrieved on May 6, 2012, from https://www.un.org/esa/population/publications/WPP2004/WPP2004_Vol3_Final/Chapter2.pdf
United Nations. (2010) World Population Prospects, the 2010 Revision. Department of Economic and Social Affairs. Retrieved on May 6, 2012, from https://esa.un.org/unpd/wpp/population-pyramids/population-pyramids.htm
Van Haastregt, J. C. M., Diederiks, J. P. M., van Rossum, E., de Witte, L. P., Voorhoeve, P. M. & Crebolder, H. F. (2000) Effects of a programme of multifactorial home visits on falls and mobility impairments in elderly people at risk:randomised controlled trial. British Medical Journal, 321(7267), 994-998.
Vetter, N., Lewis, P. & Ford, D. (1992) Can health visitors prevent fractures in the elderly people. British Medical Journal 304(6831), 888-890
Wang, J., Chen, Z., & Song, Y. (2010) Falls in aged people of the Chinese mainland: Epidemiology, risk factors and clinical strategies. Ageing Research Reviews 291(9), 5.
Watters, J., Comeau, S. & Restall, G. (2010) Participatory Action Research: An Educational tool for Citizen-Users of Community Mental Health Services. MB, Canada: School of medical Rehabilitation, University of Manitoba.
Weatherall, M. (2004). Multifactorial risk assessment and management programmes effectively prevent falls in the elderly. Evidence-Based Healthcare and Public Health 8(5), 270–272.
World Health Organization. (2011) What are the public health implications of global ageing?. Retrieved on May 6, 2012, from https://www.who. int/features/qa/42/en/index.html
World Health Organization. (2012) Ageing. Retrieved on May 6, 2012, from https://www.who.int/topics/ageing/en/