Health-Related Safety: A Framework to Address Barriers to Aging in Place

Abstract

Maintaining safety in the home and community is a national public health concern, especially for older adults who "age in place." In this article, we introduce a multicausal concept called "health-related safety," which is defined as the minimization of the probability of preventable, unintended harm in community-dwelling individuals. Derived from the modern patient safety movement, health-related safety attributes adverse health events in the home and community to systematic breakdowns in the societal system, not to the commission of errors by particular individuals. Extending beyond health care institutions, the health-related safety framework is composed of multiple levels: micro (consumers and providers); mezzo (homes and communities); and macro (policies). Because the societal system is complex with inherent risks, health-related safety will require a culture shift and system redesign, new tools of risk assessments and management, and continuous safety improvement. We propose a research agenda to further refine the health-related safety framework by using empirical evidence and to develop appropriate mathematical and practical models from safety sciences to support this initiative. This article moves the field forward by applying systems thinking and safety sciences to health-related safety in the home and community, thereby paralleling what researchers have begun to do with patient safety in health care systems.

Effect of an infection control programme on bacterial contamination of enteral feed in nursing homes

“…Health-related safety is defined as minimization of the probability of preventable, unintended harm. 24 An effective ICP can reduce hazards and create a safe nursing home environment, allowing health maintenance and good chronic disease management.…”

Advice from Rural Elders: What it Takes to Age in Place

“…This is a concern described by Lau et al (2007) that will increase as more older adults prefer to age in place. A CHW could address the issues described by Lau et al (2007) as threats to health-related safety by conducting home inspections and arranging for home modifications to reduce falls, educating and mentoring in chronic disease self-management and medication management, and serving as an advocate in obtaining health and social services.…”

“…And skilled care is reimbursed only for as long as the acute medical condition persists. Medicare does not provide continuous long-term services needed to meet chronic health and safety needs of older adults (Lau, Scandrett, Jarzebowski, Holman, & Emanuel, 2007). Additionally, decreased federal funding for senior housing has not been accompanied by adequately increased funding for supportive, assistive services for residents staying in their home communities, especially those in rural communities (Pine & Pine, 2002).…”

Informal and Formal Support among Community-Dwelling Japanese American Elders Living Alone in Chicagoland: An In-Depth Qualitative Study

“…As the older adult population in the U.S. continues growing, many will seek to age independently at home to the greatest extent possible (Akhter and Levinson 2003;Lau et al 2007). To successfully "age in place," older adults rely on informal (unpaid) and/or formal (paid) support from their communities to meet healthcare, nutritional, social, housing, transportation and/or functional needs (LaPlante et al 2004;Marek and Rantz 2000).…”