Windows and balconies in Senior Living facilities can be a potential hazard which can result in falls and injuries among elderly residents.
Even a fall from ground-floor window can be dangerous, especially for the elderly, and falls from windows on the first floor upwards can often be fatal.
Unfortunately in India there is not much architectural information on the best practices for Anti-fall bars or Window Guards in residential care settings.
The Health and Safety Executive (HSE) UK, identifies the following three broad categories of falls from windows in residential care homes.
1) Accidental falls — these occur where a person unintentionally falls through or from a window. Such an accident can occur because the person sat on the window sill and lost his or her balance, for example, or where the person did not realise the window was open and leaned against it.
2) Falls arising out of a confused mental state — a significant number of reports of window-related accidents in the care sector refer to the mental state of individuals as a factor in the cause.
Confused or disturbed residents may be inclined to try to escape from a perceived hostile environment, or use a window believing it to be a door, possibly unaware that they are not at ground level. Unfamiliarity with new surroundings may also cause confusion, as might uncomfortable temperatures, broken sleep and effects of certain medication.
3) Deliberate falls — cases have been recorded of people deliberately exiting a window as a form of self-harm or suicide.
The HSE guidance states that care home managers must adequately manage the risk of falls from windows or balconies by carrying out appropriate risk assessments of both the premises and service users.
Risk assessments should take into account:
- The mental state of residents with dementia, learning disabilities or illness.
- The effect of drink and drugs (both prescribed and illegal).
- Confusion and depression or any history of self-harm or suicide.
- The size, condition and design of each window.
- The height of the window sill (i.e how easy it would be to climb out or topple out).
- The availability of items to climb up to gain access.
- The nature of the surface below the window.
The attached HSE information sheet (HSIS5) provides advice on controlling risks to people who use health and social care services associated with falls from windows or balconies.
Since most care homes and retirement homes in India are being built vertically, hence it is important that national standards and guidelines should be incorporated into the National Building Code w.r.t Senior Citizen Care Homes.
The document can be accessed here https://www.hse.gov.uk/ or can be downloaded here (Falls from windows or balconies among Elderly) or can be viewed below