Developing an audit checklist to assess outdoor falls risk

Falls by older people (aged 65+) are linked to disability and a decrease in mobility, presenting a challenge to active ageing. As such, older fallers represent a vulnerable road user group. Despite this there is little research into the causes and prevention of outdoor falls. This paper develops an understanding of environmental factors causing falls or fear of falling using a walk-along interview approach with recent fallers to explore how older people navigate the outdoor environment and which aspects of it they perceived facilitate or hinder their ability to go outdoors and fear of falling. While there are a number of audit checklists focused on assessing the indoor environment for risk or fear of falls, nothing exists for the outdoor environment. Many existing street audit tools are focused on general environmental qualities and have not been designed with an older population in mind. We present a checklist that assesses aspects of the environment most likely to encourage or hinder those who are at risk of falling outdoors, developed through accounting for the experiences and navigational strategies of elderly individuals. The audit checklist can assist occupational therapists and urban planners, designers and managers in working to reduce the occurrence of outdoor falls among this vulnerable user group.