Risk Factors Fall in the Elderly at Panti Werdha Sejahtera

Banjarbaru

Meilya Faridka Indah

and Rudi Hartono

Public Health Faculty, Universitas Islam Kalimantan, Jl Adyaksa No 2 Kayu Tangi Banjarmasin, Kalimantan Selatan,

Indonesia.

Engineering Faculty, Universitas Lambung Mangkurat, Jl Ahmad Yani KM. 35 Banjarbaru, Kalimantan Selatan,

Indonesia

Keywords: anthropometry, spatial design, elderly, fall risk, safety

Abstract: Spatial design influences human behaviour conducting activities within. These influence includes attitude,

action, psychological condition, safety feeling, and lenience in doing activities. Anthropometry is essential

in spatial design. The objective of this study is to define the impact of incorrect anthropometric spatial

design on elderly fall risk, to know identify accident level occurring as result of incorrect anthropometric

spatial design, and to provide spatial design solution appropriate for elderly safety. This study is designed as

a qualitative descriptive study with whole 110 habitants of Panti Sosial Tresna Werdha “Budi Sejahtera”

population. Purposive sampling method is used with consideration on the elderly’s ability to respond in

communication. Data are analysed using descriptive statistic method. The spatial design of Panti Sosial

Tresna Werdha “Budi Sejahtera” does not fully accommodate safety factors for elderly. This is supported by

the frequence fall accidents happened there, espesially female elderly. The spatial design should pay more

consideration on safety factors for the elderly by taking inhabitants’ anthropometric characteristics into

consideration.

1 INTRODUCTION

One indicator of the success of Health Development

in Indonesia is the increasing Life Expectancy Age.

In National Medium Term Development Plan,

Rencana Pembangunan Jangka Menengah Nasional

(RPJMN) 2014 Life Expectancy Age was expected

to increase from 70.6 years in 2010 to become 72

years in 2014. As a result of the increasing age of

life expectancy, the age structure of the population

will change.

Nowadays, Indonesia is included in top five of

countries with highest number of elderly, which

reaches 18.1 millions in 2010 or 9.6% of the total

population. National Development Agency, Badan

Pembangunan Nasional (Bappenas) predicted that

the number of elderly will be doubled in 2025

reaching 36 millions (BPS, 2009). International data

by the U.S Census Bureau indicates that the number

of elderly in Indonesia shows significant growth. In

2007, the number of elderly was 18.96 millions and

became 20.54 millions in 2009. it is predicted that in

2025 the number will reach 27 millions. This

increasing Life Expectancy Age is indicated by the

increasing number of he population who reached age

60 years or above (Balitbang Kemenkes RI, 2013).

The increasing number of elderly rises several

problems. When a person reaches the age of elderly,

he or she will experience degradation of biological,

physiological, psychological, and spiritual

conditions. These degradation create some health

problems for elderly. One of the problems is the

increasing fall risk. It has been reported that more

than one third of elderly who reached age 65 or

more experienced fall every year. One of every three

cases was recurrence (Gai et al, 2010).

Health effort for elderly is complete basic health

effort. This includes enhancement, preventive,

curative, and rehabilitative health (Darmojo, 2009).

In Indonesia, approximately 30-50% elderly who

reached age 65 years or more ecperienced fall every

year (Probosuseno, in Widuri, 2010). Tuti’s study

(2013) shows that in Panti Sosial Tresna Wredha

Unit Abiyoso, Pakem, Sleman, Yogyakarta, from 46

elderly being observed 52,2% had experienced fall.

Tuti (2013) indicates that risk factor of falls are age

618

Indah, M. and Hartono, R.

Risk Factors Fall in the Elderly at Panti Werdha Sejahtera Banjarbaru.

DOI: 10.5220/0009024900002297

In Proceedings of the Borneo International Conference on Education and Social Sciences (BICESS 2018), pages 618-621

ISBN: 978-989-758-470-1

and gender, mainly happened in the age group of 75-

90 years (55%), and happened to male (58,8%) more

than female.

Based on interview with polyclinic officers of

Panti Werdha “Budi Sejahtera” Banjarbaru, it can be

indicated that fall accident in elderly is quite high.

Hartono and Indah (2012) states that the result of

anthropometric study on the inhabitants of Panti

Sosial Tresna Werdha “Budi Sejahtera” shows that

there are some significant gaps between the result of

the study on body proportion of the elderly from the

standard stated in Minister of Public Works

Regulation Peraturan Menteri Pekerjaan Umum

Number: 30/PRT/M/2006. Minister of Public Works

Regulation Number: 30/PRT/M/2006 contains the

standard of accessibility for environment and

building. Accessibility factors include safety,

easiness, function, and independence for building

users to be able to do activities within. The problem

in this study is derived from this condition: is fall

experienced by the elderly resulted from spatial

design that does not considere the anthropometric

characteristics of the inhabitants.

2 RESEARCH METHOD

The study is conducted in Panti Sosial Tresna

Werdha “Budi Sejahtera” located in Jl. A. Yani Km.

21.700 Kelurahan Landasan Ulin Tengah

Banjarbaru. This study is conducted in several

stages: preparation, data collection, analysis, and

data synthesis. The population is all 110 inhabitants

of Panti Werdha “Budi Sejahtera”. Purposive

sampling methode is used to choose 83 samples that

have good abilities to respond in communication.

The variables in the study are respondents

characteristics: anthropometric characteristics, age,

gender, and physical conditions, respondents fall

risk characteristics: fall history and fall location and

spatial design of the facilities.Data collection

technique is applied as follows: Primary Data, These

data includes anthropometric characteristics, fall

risk, and spatial design. Anthropometric

characteristics and spatial design data are collected

through direct observation and direct measure. Fall

risk data is collected from health record and

interview with both inhabitants and polyclinic

officers. Secondary Data, These data include age and

health condition of the inhabitants. They are

collected from polyclinic record. The analysis is

conducted by tabulation and percentage calculation

then being analyzed using qualitative descriptive

method.

3 RESULT

From 83 samples of 110 inhabitants of Panti Werdha

“Budi Sejahtera, there are 46 males and 37 females.

Age distribution can be seen in the following table:

Table 1. Respondents’s age group

Age Group Total Percentage

60 - 65 year 23 28%

66 - 70 year 15 18%

71 - 75 year 21 25%

76 - 80 year 13 16%

More than 80 year 11 13%

The result of anthropometric measure shows that the

average height of respondents is different to the

average height of Indonesian which is 170 cm as

indicated in Minister of Public Works Regulation

Number : 30/Prt/M/2006 on Facility Technical

Guidelines and Accessibility in Building and

Environment page 13 as followed:

Figure 1. Average height according to standard

The result of anthropometric measure show that the

average height of male respondents is 149.6 cm and

138.9 cm for female residents. The result of the

measure is shown in following table:

Table 2. Result of respondents’ anthropometric measure

Gender Body

Position

Part being

Measured

Average

Result

(cm)

Male Standing

Height 149,6

Hand fist height 65

Chest 32,5

Ability to lift up

foot

11,7

Sitting Height 94,8

Risk Factors Fall in the Elderly at Panti Werdha Sejahtera Banjarbaru

619

Squatting Knee Height 39,3

Female Standing

Height 138,9

Hand fist height 59,2

Chest 35,3

Ability to lift up

foot

11,6

Sitting Height 66,6

Squatting Knee Height 35,1

Based on interview and confirmed by polyclinic

record, between 2015 – 2016 there were 31 cases of

fall. This means 15-16 accidents every year or 1.3

accidents per month. From the accidents, 11 cases

(35%) involved male respondents, and 20 cases

(65%)involved female respondents. There 9

respondents who experienced recurrence, the

following table shows fall accidents related to age

group.

Table 3. Fall accidents based on age group

Age Group Total

Case

Percentage

compared to

total

Respondent

Percentage

compared to

number of

elderly in age

group

60 - 65 year 14 45% 61%

66 - 70 year 2 6% 13%

71 - 75 year 6 19% 29%

76 - 80 year 3 10% 23%

More than

80 year

6 19% 55%

Table 3 shows that fall accidents occur mostly in the

age group of 60-65 year (61%) and the age group of

more than 80 year (55%). It is interesting that fall

accidents mostly occur in the youngest age group.

One factor that influences it is the fact that most

respondents within the youngest age group have

lived in the facility for not a long time. Thus, they

are still in the process of adapting to the

environment of the facility.

Fall can happen anywhere. Fall accidents mostly

occurred in toilet (65%), followed by dish washing

room (26%). The following table shows the location

of fall accidents in Panti Werdha Budi Sejahtera.

Table 4. Location of fall accidents

Location

umber of

Acciden

Percentage

Toile

20 65%

Dish washin

roo

8 26%

Bedroo

2 6%

Terrace 1 3%

The result of direct observation on spatial design of

the facility shows, the height of steps from outside to

the terrace is 25 cm, floor is covered with smooth-

textured ceramics. It is slippery not only when it is

wet, hand-railing inside building is 80 cm high,

while railing outside building along pedestrian way

is 90 cm high, the floor in the toilet is very slippery

and not well-maintained. The difference between the

floor peil and closet peil is 30 cm. The height of

water tank is 80 cm, the floor of dish washing room

is made of smooth-textured wood. Some parts are

covered with mould. Thus it is very slippery,

especially when it is wet. The height of the water tap

is 70 cm.

4 DISCUSSIONS

This study indicates that most fall accidents occurred

in area related to water, namely toilet and dish

washing room. The slippery condition of the floor is

the main cause of fall accidents.

Toilets are covered with ceramics that are not

abrasive enough. Thus, the slipperiness increases

when it is wet. The difference of main room floor

peil with toilet floor peil is about 5 cm. There is no

different floor texture and color. This increases the

fall risk since there is no texture and color difference

for clue of different peil height. With the sippery

condition of toilet floor, toilet users will have to

experience the slipperiness without warning of

different texture and color of the floor. It is

suggested that toilet floor uses more abrasive tiles

with contrast color different form those of the main

room. The different of floor peil of the toilet and

main room is suggested to be 2 cm. This to avoid

tripping.

The difference between toilet floor peil and the

closet peil is 30 cm. It is different from the standard

that states 15 – 19 cm. Anthropometric study of the

respondents shows that the ability for respondents to

lift up their feet is 11,64 cm for female and 11,71 cm

for male. The peil difference of 30 cm makes it

difficult for respondents to use closet and

unsupportive to their physiological condition. Even

the standard height of 15 – 19 cm is not supportive.

The ideal height should be 10 cm. This poor

condition is worsen by the unavailability of hand-

railing. Hand-railing should be installed with the

height of 35 cm around the closet and 55 cm and 70

cm around the toilets. These heights are in

accordance with the anthropometric measure.

Water tank’s height is 80 cm. It is not supportive to

the respondents’ physiological ability. Based on thi

BICESS 2018 - Borneo International Conference On Education And Social

620

study, the height of hand fist in standing up position

is 59,23 cm for females and 64,95 cm for males. It is

suggested that the height of water tank is maximum

70 cm. For lavation, the height of water tank should

be 35 cm in accordance with the height of squatting

position. Thus, the water tank is divided into two

parts, the one with the height of 70 cm for bathing

needs and the other one for lavation with the height

of 35 cm.

The floor of dish washing area is made of soft-

textured wood planks. Some parts are covered with

mould. Thus, it is slippery. This poor condition is

worsen by the unavailability of hand-railing for

users to hold. It is suggested that the floor covering

should be made of concrete block which has more

abrasive surface. The floor color should be made

contrast to the color of back terrace floor as a clue

for different floor peils. The different of floor peil of

the terrace and dish washing area is suggested to be

2 cm. The height of water tap is already in

accordance to the anthropometric study which is 70

cm. Hand-railing should be installed with the height

55 cm and 70 cm around the dish washing area.

Hand-railing inside building is 80 cm high, while

railing outside building along pedestrian way is 90

cm high. According to standard, hand railing should

be installed doubled with the height of 65 cm and

80 cm. The result of anthropometric study requires

the hand railing installed with the height of 55 cm

and 70 cm supportive to the height of hand fist in

standing position 64.95 cm for male and 59.23 for

female.

The height of steps from outside to the terrace is 25

cm. it is not in accordance with the standard that

requires the height of 15-19 cm. The standard itself

is not supportive to the physiological condition of

the respondents who have the ability to lift up their

feet only for 11,64 cm female and 11,71 cm for

male. Thus, it is suggested that the height of the

steps are not more than 10 cm.

Fall accidents mostly occurred inthe age group of

60-65 year and more than 80 year. It cannot be

concluded that fall risk increase by the increasing of

age as stated by Tuti (2009). Tuti (2009) finds that

fall accidents occur mostly in the age group of 75-

90 years (55%). Tuti also indicated that fall

accidents more likely happen to male (58.8%) rather

than female. This study shows different result. Fall

accidents are more likely to occur among female

(65%). rathen than male.

5 CONCLUSIONS

It can be concluded that anthropometric study shows

that the average height of respondents is under the

average of Indonesian according to standard. Human

anthropometry plays an essential role in spasial

design. In this case of study, government standard

cannot be applied to the spatial design of fasilities in

Panti Werdha Budi Sejahtera.

This study also shows that most fall accidents in

Panti Werdha Budi Sejahtera are related to slippery

floor, the existence of water, and hand railing

factors, both unavailability and its installment that is

not in accordance with the anthropometric condition

of respondents. The correct decision of flooring

materials can help the safety of the inhabitnts in a

building. Abrasive surface can prevent falling.

Applying different floor color on surfaces with

different peils can halp users to be more aware of the

difference of floor peil. Hand railing is essential

factor in spatial design to support accessibility and

safety for elderly. It is shown that anthropometric

consideration in spatial design is influential to

elderly’s fall risk.

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