الفهرس 
Aim of the studyOnly 14 pages are availabe for public view
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Abstract
Fallings are considered the 5th leading cause of death among
elderly people. They are a very dangerous problem (Asiri et al., 2018).
One in three elderly people aged 65 and older have a fall every year, and
people who have one fall are two to three times more likely to fall again
(Centers for Disease Control and Prevention, 2015). Study by Vieira,
Palmer & Chave, (2016) who studied prevention of falls in older people
living in the community. They reported that 28-35% of elderly people
have a fall each year worldwide according to the World Health
Organization, (≥65 years) and the incidence rises with age.
Falling is the leading cause of both fatal and nonfatal injuries
among elderly people. The complications of fall-related injuries among
elderly above 65-years-olds may include: loss of autonomy, long-lasting
disability and reduce quality of life. Falls are the main cause of fallingrelated injuries, disability, morbidity and mortality in elderly
people(Burns, Stevens & Lee, 2016). Concerning fall-related injuries,
about 10% of falls can cause serious injuries to the elderly, as hip
fracture, some forms of fracture, head trauma, hematoma, and different
injuries that require care hospital; also, 95% of hip fracture in elderly is
result from falling that increases the risk of disability (Asiri et al., 2018).
This study was conducted to examine the effect of home basedintervention on falling risk reduction of elderly in a rural community.
Study sample included 130 elderly people. The researcher selected only
elderly people who have history of falling. The researcher divided them
into two groups (case and control), 65 (case) and 65 (control). According
to the following criteria: Are 60 years or older, both genders (male &
female), Have history of falling and Agreed to participate in the study.
The study was carried out at two villages (Ghemreen and Manshat Sultan
village) from the selected district ( Menouf district).
Data Collection Instruments:-
Instrument I:- A structured Interview questionnaire developed by
the researcher after reviewing the related literature, this
questionnaire covered the following items:
Part one: - Demographic data: such as age, gender, marital status, level
of education, occupation.....etc
Part two:- Data about history of falls: it included questions about the
date of fall, the number of falls, and injuries related to falls… etc
Part three:- Data about history of medication taking: it included
questions about the name and number of medications taken by the
participants… etc.
Part four:- Data about Medical history: it included questions about
medical Problems as presence of chronic diseases… etc.
Instrument II:- Berg Balance scale: developed by Berg et al., (1992) to
measure elderly people body balance. The scale was adopted to
include only 6 items. These six items were describing the elderly
’sitting to standing, standing unsupported , sitting unsupported,
standing to sitting, transferring, and standing on one ’ to be easy and
safe for the elderly to be established ( five-point scale, ranging from
0-4. “0” indicates the lowest level of function and “4” the highest
level of function. Total Score = 24.
Instrument III:-Timed Up and Go test scale: developed by Podsiadlo
et al., (1991) to measure basic functional mobility. The elderly‘
basic” functional mobility was evaluated as ”freely mobile ” if
he/she did these basic functional mobility in less than 10 seconds
(0-9 seconds), ”mostly independent” if he/she did these basic
functional mobility in less than 20 seconds (10- 19 seconds), and
”impaired mobility ” if he/she did these basic functional mobility in
(20 - 30 seconds).
Instrument IV:-Modified Fall Efficacy Scale (MFES): developed by
National Aging Research Institute (adapted from Tinetti et al., 1990)
to verify how confidently clients feel they are able to carry out each
activity. Consisting of 14 activity questionnaire each related to a
particular activity. The questions aim to verify how confidently
clients feel they are able to carry out each activity on a scale of 0
(not confident at all) to 10 (completely confident). Higher scores
indicate more confidence, less fear of falling. Lower scores indicate
less confidence and more fear of falling. Each elderly was
categorized into “low satisfaction” when the he/she achieved (0-46),
“moderate satisfaction” when the he/she achieved (47-93), and
”high satisfaction ”when the he/she achieved (94-140).
Instrument V:- Home Safety Self-Assessment Tool (HSSAT): This
tool developed by Occupational Therapy Geriatric group at the
University at Buffalo (2013) to estimate the number of
environmental hazards in the house. The 38-item list reviewed risks
in the kitchen, bathroom, stairways, bedroom, and living room. A
score of 1 was given for each environmental risk. The scores were
summed at the completion of the evaluation to provide a composite
score of environmental hazards.
The main results of the study revealed that:
younger age groups were predominant than older age groups, 47.7%
were aged 60 - 69 years, 31.5% were aged 70-79 years while 20.8%
were aged 80-90 years.
Approximately, more than half of studied participants (56.9%) were
females.
The majority of the studied elderly demonstrated that the highest
percentages of chronic diseases suffered by them were: joint pain
(73.8%), vertigo (70.8%), kidney disease (53.8%), hypertension
(52.8%) and blurred vision (50.8%).
The majority of the studied elderly were living in risky homes, while
one third 15.4% were living in safe homes.
There was diminished percentage of elderly who were fall from 7-12
times among study group from 21.5% in pre intervention to 0%
immediately after intervention, this difference was highly statistically
significant (P=0.000).
Falling inside home showed diminished percentage from 60% in pre
intervention to 41.5% one year after intervention while the percentage
among the control group was 64.6%, 69.2%, 73.4% pre intervention,
post1 and one year after intervention respectively. This difference was
highly statistically significant (P=0.000).
There was a decrease in complications of falling after intervention as
38.5% of study group has no complications during the period of
follow up (one year after intervention), Hematoma showed
diminished percentage from 33.8% in pre intervention to 6.2% one
year after intervention. Fracture showed diminished percentage from
21.5% to 1.5% to 0% pre intervention, immediately after intervention,
and one year after intervention respectively.
There was diminished percentage in elderly people who have fear of
falling in the future among study group from 66.2% pre intervention
to 33.8% immediately after intervention, and 4.6% one year after
intervention.
There was an improvement in elderly body balance after intervention.
There was improvement in elderly basic functional mobility after
intervention.
There were a decreased number of risky homes as result of
environmental home modification.
Conclusion:
Based on the findings of the current study, it can be
concluded that:-
Implementation of home based-intervention was effective in risk
reduction of falling among study group compared to control group. It was
successful in reducing number of falls and fall related injuries in the study
group than control group. Moreover, it was effective in increasing
functional mobility in the study group than control group.
Recommendations:
Based on the finding of the study, the following important
recommendations are proposed:
1. Awareness programs targeted for all elderly people, their family
caregivers and the general public about exercises and its importance
for strengthen muscles and joints and increase body balance.
2. Careful assessment of elderly homes to identify the risks and the
possibility of overcoming them.
3. Emphasize the need for the elderly to use assistive devices that help to
reduce the risk of falls and its complications.
4. Instruct the elderly people and their caregivers to review the
medication regimen with their physician as it is one of the most
important aspects of decreasing polypharmacy and its complications.