Assessment of Elderly People Knowledge Regarding to Home Fall Prevention

Background: Elderly falls are a major public health problem; home environmental hazards appear to pose the greatest risk for falls accidents among elderly people. Falls are defined in numerous ways; one commonly used definition is that of the “an event which results in a person coming to rest inadvertently on the ground or floor or other lower level". Result: The Statistically significance correlation was found between socio demographic profile of the studied subjects related to elderly people knowledge' related to falls preventive measures. Conclusion & recommendations: it concluded that majority of elderly people more knowledgeable about home environmental hazards & slightly less than half of them exposed to previous history of falls. Community nurse should be developing fall risk assessment/ screening tool, to assess all people above 55 years & more for to identify those with high risk factors.

transfer ring problems, psychoactive medication use, confusion, visual impairment, evidence of stroke or cancer, dizziness and frequent toileting) and optimizing the design of hospital equipment and the hospital environment (Chen, 2016).
Falls happen if the lighting is too dim or the surroundings are unfamiliar, also result from slipping on a throw rug that is not securely affixed to the floor. The second greatest number of injuries occur on stairs and steps, especially during descent. People commonly miscalculate the dimensions of the stair because of poor lighting in the stairwell or trip because of uneven stair heights or clutter on the steps (CDC, 2017). The fear of falling is very powerful and they may not even realize how this fear is limiting them daily activities (Verrall, 2013).
Studies (WHO,2016& Tromp et al., 2001, results showed that, eighty-eight percent of elderly people were able to identify falls as the most common cause of injury and 87% were able to accurately name at least one safety measure. At Canada, according to Division of Aging and Seniors Public Health Agency of Canada, 2015, stated that falls account for more than half of all injuries among Canadians 65 years and over. Recent studies (CDC,2016), the results showed that most falls are the primary cause of injury-related deaths among elderly people, and many of these deaths occur after months after medical care and treatment. Globally, falls are major public health problems, it's the second leading cause of unintentional injury death, after road traffic injuries, also in all regions of the world. Death rates are highest among elderly over the age of 60 years (WHO, 2016).
Assessment of elderly people knowledge regarding home fall prevention consider to be an important issue because of homes environmental hazards which surrounding by most of the elderly people homes. Majority of the accidental falls are leading cause of injury-related death in elderly people. The most common hazards at home includes falls on stair and slips on bathroom, fires, burn, poisoning and choking (ching,2012).
Falls are destructive and common problems among elderly people, causing a massive amount of mortality and morbidity. Most of these falls are associated with one or more identifiable risk factors related that to a connection between biological, social and economic, environmental and behavioral risk factors (Rubenstein,2006). Biological factors, such as medical conditions among elderly people such as weakness, unsteady gait, confusion and certain medications. Environmental hazards, such as slippery floors & lack of hand rails or grab bars. Smoking and poor practicing exercise are considerable behavioral factors (Scott et al., 2010& Rubenstein, 2006.

2.The theoretical framework of this study
The theoretical framework of this study was based on a theory developed by Nurse Ida Jean Orlando in 1958. The nursing process is goal-oriented method of caring that provides a framework to nursing care. It involves seven major steps: Assess, Diagnose, outcome identification, plan, Implement, Rational & Evaluate, figure (1) (Alligood, 2014).
Diagram of the five phases of nursing process (Alligood, 2014) The nurse completes a holistic nursing assessment toward elderly people knowledge regarding to home fall prevention. Assessment is the first step in the nursing process and includes collection, verification, organization, interpretation, and documentation of data. Optimal nursing care can help keep older adults on their feet and in their own homes. A comprehensive nursing assessment can minimize their risks for injury, hospitalization, or longterm-care placement (Black, 2014).
Fall risk assessment includes data obtaining a thorough health history (including chronic diseases, elimination patterns, and medications) and physical assessment, including mental status and gait and home evaluation, assessment (dry floor, bed rails & lights, including night lights). After completing the home safety follow up with client-specific interventions to help older adults address modifiable risk factors and stay safe (Bloch et al., 2010, Rapp, 2009& Lord et al., 2008.

3.Methodology
This study design was a quantitative, exploratory cross sectional and correlation, conducted at King Salman Social Center -Riyadh, Kingdom of Saudi Arabia. The total study subjects were 302 elderly people age 55 years and more (20.5% male and 79.5% female) and Saudi nationality.

4.Results
The elderly subjects were between 55 and more. Majority (72.5%) of them were between age group (55-64 years). Majority (96.4%) of them were live with their families. Majority (83.8%) of them had enough income. About 45.0 % of them had history related to falls. Majority (75.7%& 25.7%) of them mentioned the main causes of falls related to environmental & medical causes respectively. About 69.1% of them had falls complications, (28.7 % & 29.8%) from them had fractures & contusion injuries respectively. Two thirds of elderly people had correctly identified most categories related to fall preventive measures at home. Statistically significance correlation was found between elderly people socio demographic profile & their knowledge' related to falls preventive measures. except income not significant correlation found. The following table show the correlation between socio demographic profile of the studied subjects related to elderly people knowledge' related to falls preventive measures.

5.Conclusion
According to the findings of this study, it is obvious that slightly more than two thirds of elderly people had correctly identified most categories related to fall preventive measures at home. Statistically significance correlation was found between sociodemographic variables for elderly people and their knowledge toward home fall prevention. Elderly people in this study exposed to multiple factors which potentially risk falling accidents such as their environmental surrounding, medical conditions & sleeping problems.