Supporting Older Adults in Houston: Ramps, Rails and Toilets

May 2018


By Deborah A. Moore, Assistant Director, Human Services Division, Houston Health Department and Scott Packard, Chief Communications and Public Affairs Officer, Houston Health Department

When you think of Older Americans Month, toilets probably aren’t the first thing to come to mind. But at the Houston Health Department, commodes are a major component of one of the Harris County Area Agency on Aging’s most gratifying programs.

Allow me to take a step back to explain.

Most people are aware of the serious threat of falls for those age 65 and older, the group of people commonly referred to as older adults. However, it’s often not until the statistics are highlighted that the staggering scope of the threat is truly recognized.

According to CDC, in 2014 approximately 2.8 million older American adults were treated in emergency departments for fall-related injuries, with 800,000 of them requiring hospitalization. For 27,000 of those people, the fall ended up being fatal.

Recognizing the severity of the issue, we looked at our local numbers. It turned out more than 62% of older adult falls in Harris County in 2013 resulted in hospitalization. In fact, our statistics showed Harris County had 600% more people hospitalized from falls than the next highest of the 13 counties we examined.

That’s where our Healthy Homes Fall Prevention Program comes into play. Six-in-ten falls occur in the home, so the program reaches out to older adults, assesses their homes for fall hazards, and makes modifications like installing grab bars, rails, ramps and – yes – elevated toilets.

Since the program’s inception in 2014, we’ve assisted 343 older adults with safety modifications to their homes and provided fall prevention training to more than 2,000.

The program, like many successful public health initiatives, starts with outreach. Our team visits places like senior centers, churches, and assisted living facilities to identify those in need of help. The first step is what we call the Fall Risk Assessment and Screening Tool, FRAST for short. This 15-question assessment not only evaluates fall risk, it also looks at exercise, medications and even mood.

From there we identify older adults whose conditions and homes present the greatest risk of falls. We visit them, conduct an assessment to identify the greatest threats, and address what we find through home modifications.

Our efforts don’t end once the construction tools are packed away. We re-engage at six weeks, six months and one year. We often discover that not only has the person’s fall risk significantly decreased, we find people with a much better overall mood and quality of life.

Fear of falling can be paralyzing to an older adult’s lifestyle. Living in fear, they lose confidence, rarely leave home and minimize movement as much as possible. The home modifications through the Healthy Homes program, combined with the fall prevention training we provide, often give a renewed sense of self, resulting in a more active lifestyle.

We also notice when older adults feel more confident, there is a positive and impactful family wrap-around effect. Given the ability to be more active and leave home, older adults can better engage with family, resulting in more family interaction and support. This ties directly into the theme of this year’s Older Americans Month, “Engage at Every Age.”

The Healthy Homes program is only part of the great work of the Harris County Area Agency on Aging, the largest of the 28 such agencies in Texas. We provide an array of other services like meals at home and in congregate settings, hearing, dental and vision services, home repairs, care coordination, veteran support, benefits counseling and more. Being the only Area Agency on Aging in Texas to be tied to a governmental agency, we have the opportunity to collaborate with our public health and EMS colleagues.

As we recognize May as Older Americans Month, it’s important to point out the amazing work of organizations supporting our aging population. If you have the time, we encourage you to check with your local agency to see how you can help, whether through volunteering or donation.

And the next time you see a toilet, hopefully you’ll also think of the needs of older adults and those working to support them.