The Application of the Home Falls and Accidents Screening Tool (HOME FAST) in Malaysia to Address Falls Risk among Older Malaysians

Abstract

The older population in Malaysia is rapidly increasing. A lack of healthcare professionals in Malaysia has limited the service efficacy for falls prevention and intervention–especially in relation to home hazards assessment and management. This responsibility should be shared by community members to accelerate the uptake of falls prevention. However, research on this topic is negligible in Malaysia or Southeast Asia. Moreover, factors associated with home hazards have been inadequately studied even at an international level. Several studies were conducted in this thesis. A systematic review found the HOME FAST can potentially be applied in Malaysia compared to other instruments. The use of the HOME FAST with lay individuals was found to be feasible; there is potential for it to be adopted by Malaysian occupational therapists. This was confirmed with good inter-rater and test-retest reliability using a group of lay individuals. With this evidence, the HOME FAST was used in a population study called the Malaysian Elders Longitudinal Research. Older people with a lower education level, Chinese ethnicity, having more people living in the same house, poor financial status, living in traditional house, poor vision and younger age were associated with high home hazards; other potential factors were culture, higher degree of fear of falling, poor perception of own health status and memory, and not owning the home. Factors associated with low home hazards were living in an apartment; other potential protective factors were better independence in activities of daily living, better instrumental daily living functions and having a maid. Older people at high risk of having home hazards should be targeted by healthcare professionals and community members through home assessment, using the HOME FAST to identify the hazards available.