Occupational Therapists as Leaders in Fall Prevention: Insights from a Rural Implementation Study

Occupational therapists (OTs) play a critical role in helping older adults stay safe at home, particularly through environmental assessment and modification to prevent falls. A recent pilot implementation study in regional Australia demonstrates how embedding fall prevention into routine OT practice can make a sustained difference for high-risk older adults.

Highlights from the Study

The research investigated a fall prevention program led by OTs in a regional hospital’s community service. Key findings showcase the program’s value:

• High Prevalence and Risk: Among participants (aged 65+ at high fall risk), 71% had at least one fall in the previous year, and 60% of those with multiple risk factors died during the study—emphasizing the urgent need for intervention.
• Strong Protocol Adherence: During and after the training period, 80% of clients received a fall prevention environmental assessment when indicated, rising to 97% two years post-implementation.
• OT Delivery Excellence: When assessments were needed, OTs delivered interventions at 100% fidelity.
• Sustainability: These assessments continued for at least 30 months after the initial project, proving that OT-led fall prevention can become a lasting part of practice.
• Positive Staff Feedback: Staff reported improved knowledge, attitudes, and confidence after training, though gains were modest and not statistically significant.

Why Environmental Assessment Matters

OTs use person-centered evaluations—observing how older adults perform daily activities at home to identify hazards, then partnering with clients to prioritize changes. This process can reduce fall risk by about 38%, especially in those already at high risk.

Common Risks OTs Address

• Poor lighting, loose rugs, and clutter
• Difficulties with mobility or balance
• Barriers during dressing, cleaning, or other household tasks

Actionable Recommendations for Occupational Therapists

1. Be Precise and Proactive:
Use structured assessments to identify who is most likely to benefit—especially those with multiple fall risk factors.

2. Embed Fall Checks into Routine Care:
Include environmental assessments in all cases where falls are a concern; regular follow-ups help reinforce changes and encourage adherence.

3. Educate and Empower Clients:
Discuss safety strategies collaboratively and encourage input from clients and caregivers, fostering engagement and long-term success.

4. Train and Support Your Team:
Ongoing staff education and practical training boost confidence and ensure assessments are delivered as intended.

5. Advocate for Sustainability:
Track and share results with leadership to support making fall prevention a standard, ongoing service.

Call to Action: Champion Fall Prevention in Your Community

This study demonstrates that OTs can successfully lead and sustain fall prevention programs, especially when these practices are embedded in everyday clinical routines. The positive outcomes seen here pave the way for broader, national adoption.

Take a step forward: Start integrating structured environmental assessments into your OT practice. Connect with colleagues, train your team in fall prevention, and make lasting change for vulnerable older adults.

REFERENCE:

Pighills, A., Melchert, S., Brondello, T., Eden, A., Rickman, E., & Tynan, A. (2025). Occupational therapy-led environmental assessment and modification-A quantitative evaluation of a pilot implementation study in a regional/rural setting. Australian occupational therapy journal, 72(4), e70039. https://doi.org/10.1111/1440-1630.70039