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Rural Health Information Hub

Home Modification Programs to Prevent Falls

Certain hazards within and outside of the home can increase the risk of tripping and falling, especially among older adults. Individuals or programs may use a home safety assessment checklist to help identify and address potential hazards within the home. The National Institute on Aging also recommends several strategies to remove hazards within the home, including:

  • Clearing walkways of loose items, cords, and furniture
  • Securing rugs, mats, and floorboards
  • Storing commonly used items within easy reach
  • Improving lighting, especially at the top and bottom of stairs

Community programs that focus on making home repairs and installing assistive devices have been effective in reducing falls among older adults. Home modification interventions may include installing:

  • Handrails on both sides of the stairs or long hallways
  • Grab bars in bathrooms near toilets and showers or tubs
  • A shower chair or handheld showerhead
  • Colorful tape on stairs that helps differentiate each step
  • Toilet seat risers
  • Night lights

The Administration for Community Living's Eldercare Locator estimates that minor home repairs can cost between $150 and $2,000 per house. Federal funding may be available to help older adults make modifications to their homes:

The National Council on Aging compiles evidence-based home modification programs and practices being implemented in communities around the country to prevent falls. For additional information about housing considerations for rural older adults, see the Rural Aging in Place Toolkit.

Examples of Home Modification Programs

  • The Home Hazard Removal Program (HARP) from Washington University School of Medicine in St. Louis uses an occupational therapist to deliver an in-home assessment, educate about fall prevention, and assist in removing home hazards for older adults. Home modifications average less than $200 and are done in partnership with nonprofit organizations.
  • The Rural LISC Healthy Housing Initiative provides grant funding to community-based organizations to complete housing-related projects, such as construction or rehabilitation. Rural LISC partners with organizations to deploy services to rural areas in all 50 states.
  • The Meals on Wheels in-home safety initiative helps adults identify and address hazards in their homes to prevent falls. Home repair services may be provided directly by local Meals on Wheels programs or by referrals to local home repair partners. Meals on Wheels also partners with the Home Depot Foundation to operate the Helping Homebound Heroes (HHH) program, which offers home repairs and modifications to rural and urban veterans. Meals on Wheels has many local programs across the U.S, including in rural areas.

Implementation Considerations

Programs considering home repairs may explore strategic partnerships with corporate, private, and/or community-based organizations that specialize in home repair services or products. These partnerships may provide resources to support programs in making repairs directly or help create a referral network for home repair services. Programs may also consider partnering with regional Area Agencies on Aging (AAAs) to provide or support home modification services. AAAs receive funding for minor and major home modifications from the Older Americans Act Title III B Supportive Services program, the Centers for Medicare and Medicaid Services, donations, grants, cost sharing, and other sources. It is essential to ensure any home modifications are done correctly by licensed and experienced professionals.

Programs may also need to consider sensitivities involved with entering an individual's home. Some participants may be hesitant to allow others into their home or resistant to changes to their home. While safety is the priority, programs should consider collaborating with the resident and the resident's family to ensure that any changes to the home are approved and understood. It is also important for program affiliates to not judge living conditions and respect the resident's privacy.

Program Clearinghouse Examples

Resources to Learn More

Agriculture for Life: Health Promotion and Successful Farming and Ranching for Ag Families
A resource guide to help farmers, ranchers, and their families on matters related to aging, chronic health issues, and living with a disability. Includes chapters on home, farm, and ranch modifications, as well as aging in place.
Organization(s): Ag4Life, Oklahoma State University Extension

Building Community Capacity to Serve Older Adults: The Role of Area Agencies on Aging in Home Modifications and Repairs
Provides data from the 2019 National Survey of Area Agencies on Aging and describes how Area Agencies on Aging (AAAs) support home modification and repair. Details the population groups served by AAA services and the funding sources used to deliver these services.
Organization(s): National Association of Area Agencies on Aging
Date: 2019

Federal Resources for Home Accessibility in Rural Communities
Presentation Slides
Describes federal programs and initiatives designed to address home accessibility needs in rural communities.
Organization(s): Centers for Medicare & Medicaid Services, Department of Housing and Urban Development, Administration on Community Living, USDA Rural Development
Date: 8/2019

Home Improvement Assistance
Provides resources to guide older adults with home improvements, modifications, and repairs to prevent accidents and keep them in their homes. Offers a search function to find home improvement assistance by ZIP code, or city and state.
Organization(s): Administration for Community Living, Administration on Aging

Home Safety Assessments: Evidence Based Strategies to Decrease Falls and Improve Mobility
Presentation Slides
Describes the impact and cost associated with falls experienced by older adults. Highlights Medicare and CDC recommendations for fall risk screening and intervention. Summarizes the evidence supporting home safety evaluations and modifications.
Author(s): Welke, K.
Organization(s): Home Therapy Solutions, LLC

Meeting the Needs of Older Adults Living in Rural Communities: The Roles of Area Agencies on Aging
Presents information and data about services offered by Area Agencies on Aging (AAAs) in rural areas including home modification and repair, transportation services, and health and wellness programs. Provides rural-urban comparisons for AAAs' services, geographic service area, organizational structure, budgets, and workforce.
Organization(s): National Association of Area Agencies on Aging
Date: 3/2021

National Directory of Home Modification and Repair Resources
A searchable directory of home modification and repair programs, service providers, funding, and consumer materials by state and across the U.S.
Organization(s): University of Southern California, Leonard Davis School of Gerontology