University of Miami Leonard M. Miller School of Medicine
- To identify safety concerns in and around the home that place an older adult at risk for falls and other unintentional injuries and make them more susceptible to becoming victims of crime.
- To make targeted recommendations to address safety concerns identified.
This checklist is designed for medical students, primary care residents, and other healthcare trainees and professionals who participate in the evaluation of older adults in the home. It is helpful if the learner has received basic instruction on home safety evaluation as this will help them complete a more in-depth assessment. This checklist can also be used as a patient education tool. Prior to going to an older adult's home to complete the safety assessment, we recommend users review the following online training module: Home Safety Assessment.
Although many schools have an elderly home visit experience in the pre-clinical years, often the only outcome obtained is student or elder satisfaction with the encounter. This checklist allows the student to make specific recommendations regarding improving the safety of their elder volunteer in and around their home. The content of the checklist is clearly linked to that of the home safety assessment training module. As shown above, we have measured an increased awareness of safety factors in students' reports as well as an increased number of recommendations made to the elder volunteers.
At the University of Miami Miller School of Medicine, first year medical students (in pairs) complete three home visits with active older adults residing in the community. During their final visit they complete a home safety assessment using a home safety checklist. Subsequently each student independently completes an online report in which they answer several questions related to their elder's safety. One of the questions asks them to describe their elder's home environment and strategies to reduce fall risk. Students are instructed to include a description of specific environmental observations and modifications useful in reducing fall risk.
This home visit has been part of the curriculum for eight years. Prior to 2005 students attended a one-hour lecture on home safety assessment before making the home visit. They used a pre-existing checklist which allowed them to check off problem areas; recommendations were provided on separate pages. For the past two years, students have used the home safety assessment training module as advance preparation for the home visit and this new checklist during their visit. To evaluate the effectiveness of the curricular changes, we compared the written reports of two cohorts: cohort 1 completed the curriculum immediately before revisions and cohort 2 received the new curriculum.
To rate the written submissions, we developed a 33-item checklist containing a broad range of home-safety elements (e.g., handrails, throw rugs, stairs, lighting). We then marked whether one or both student in a pair (cohort 1 N = 75 and cohort 2 N = 86) commented on the presence or absence of the element, and whether they documented specific recommendations. The average number of elements documented in the reports increased from 4.8 to 8.2 and the average number of recommendations mentioned increased from 2.5 to 3.3.