DwellSafe Fall-Prevention Pilot Cut Fear of Falling for Over 85% of Participants

An NCOA-funded pilot with McDowell County paired DwellSafe’s home-safety scans with in-home paramedic visits in one of North Carolina’s highest-risk counties for falls.

DwellSafe has released results from a fall-prevention pilot in McDowell County, North Carolina, where more than 85% of participants said they felt less fear of falling after taking part. The pilot, funded through a National Council on Aging (NCOA) grant, ran in partnership with the McDowell County Senior Center and the McDowell County EMS Community Paramedic Program.

McDowell County ranks fourth in North Carolina for fall-related hospitalizations. Over a recent twelve-month period, local EMS crews answered more than 1,000 fall-related 911 calls, many of them repeat visits to the same households.

Community paramedics brought DwellSafe into residents’ homes, with referrals coming from the senior center’s meal program, EMS fall calls, healthcare providers, and residents themselves. On a first visit, the paramedic used an iPad to scan each room, and DwellSafe analyzed the scans for fall risks – uneven flooring, poor lighting, cluttered walkways, unsafe bathroom setups – with an occupational therapist reviewing the report and adding recommendations. The paramedic then returned to review the findings with the resident and build a safety plan, and where needed, installed the changes: grab bars, ramps, better lighting, raised toilet seats. A final visit confirmed the work was complete.

More than 60 residents took part in the first phase. Among those who completed the program, more than 85% reported less fear of falling, measured with a questionnaire given at the first and final visits.

One resident had stopped using her back porch after a fall left her wary of the step down to the yard. After the team installed threshold ramps and a grab bar, she returned to using it.

In April, McDowell County staff presented the pilot to the county Board of Commissioners as part of an update on services for older residents.

“Falls are one of the most preventable causes of hospitalization for older adults, and the home is where most of them happen,” said Jonathan Hills, co-founder of DwellSafe. “What gets missed is the fear of falling – when people are afraid, they move less, and that inactivity chips away at the strength and balance that keeps them on their feet. Helping someone feel safe at home is how you interrupt that cycle. That’s what our work with the McDowell team is built to do.”

The pilot is an early-stage program, and DwellSafe anticipates a wider rollout of the model with additional communities and health systems.