Promoting home safety with older adults: a systematic review of occupational therapy interventions

Purpose: Due to the projected increase in the older adult population, occupational therapy providers will have an increasing role in supporting health outcomes for older adults in the coming years. The purpose of this systematic review was to determine the effectiveness of occupational interventions to promote home safety in older adults. Design/methodology/approach: This systematic review followed the Preferred Reporting Items of Systematic reviews (PRISMA) guidelines. Articles were double screened by separate researchers, then exported and managed in EndNote. The Risk of Bias Table determined certainty of evidence for themes. Findings: Three main preliminary themes were identified from the 17 included articles. Themes include multimodal interventions (n= 6), exercise interventions (n= 9) and home modifications (n = 2). None of the articles explicitly defined home safety, but distal outcomes related to safety included: increased strength, balance improvement and functional mobility. Research limitations/implications: Importantly, an absent consensus for a definition of home safety limits the results of this systematic review while at the same time providing opportunity for future research. Practical implications: Exercise combined with nutrition provided the strongest intervention evidence for physical functionality. Additionally, home modifications alone may be insufficient to result in improved home safety. Social implications: An occupational therapy’s (OT) holistic approach benefits older adults through evidenced-based interventions improving home safety, independence in functional tasks and overall quality of life. Originality/value: Findings provide clinicians with information on the effectiveness of interventions within the scope of OT that can be implemented within the home to promote home safety.