More recently, Campbell and colleagues reported a significant reduction in falls after withdrawal of psychotropic medication in older people. The role of the occupational therapist and home environment modification has not been established. A recently published study by Cumming et al showed a reduction in falls in patients having a home environment assessment by an occupational therapist on discharge from hospital. Interestingly, the observed reduction was for both indoor and outdoor falls, raising questions as to the mechanism of the observed effect. Perhaps modifying the home environment enhances safety awareness generally.
Older people presenting to emergency departments are an easily identifiable, high-risk population.
Studies have reported that, among older people discharged from emergency departments, up to half show an increase in dependency, usually secondary to trauma. 9 Falls contribute significantly to the emergency department workload, as highlighted by Bell and colleagues in this issue of the Journal. They report data on older people presenting after a fall to an inner-city teaching hospital in Sydney. Their results emphasise the multifactorial nature of falls. A UK inner-city teaching hospital with comparable baseline demographics has produced evidence of the benefits of a structured interdisciplinary assessment of such patients.