Analysis of Differences in Awareness and Implementation of Home Modifications Among Older Adults by Fall Experience

This study aimed to analyze the changes in physical characteristics and housing environments of older adults before and after experiencing falls, and to compare the perceptions of fall-preventive housing between older adults with and without fall experience. Surveys and in-depth interviews were conducted with 60 older adults aged 60 or older (30 with fall experience, 30 without) residing in the Xinjiang Uygur Autonomous Region, China. The results indicated that experiencing a fall significantly worsened the general health status and frailty of older adults, yet their housing environments often remained largely unchanged post-fall. Older adults with fall experience exhibited significantly higher fear of falling and felt more burdened about going outdoors compared to those without fall experience. Both groups recognized the high importance and necessity of fall-preventive home modifications. Specifically, those with fall experience perceived a greater need for modifications such as removing high thresholds, addressing uneven floor surfaces, and replacing unsuitable furniture. However, in-depth interviews revealed that economic burdens, difficulty in finding professional modification services, and concerns about daily life disruptions during construction were the main barriers preventing actual implementation. Consequently, home modifications were often performed by non-professionals, such as family members, rather than experts. These findings suggest that to promote fall-preventive housing, it is essential to introduce “visiting safety diagnostic services,” expand financial subsidies, and establish a professional support system tailored to the specific housing characteristics of China.