As described in Chapter 5, older people have an increasing vulnerability to falling, to the extent that 1 in 3 adults over age 65, and nearly half of those over 80, fall each year (Prudham and Evans 1981). Approximately half of all recorded fall episodes occurring among independent community dwelling older people happen in their homes and immediate home environments (Lord et al. 2001). Estimates for the United Kingdom, based on the Home Accident Surveillance System (HASS), indicated that 373,000 older people in the United Kingdom received injuries from a fall in the home in 2002, severe enough to require attendance at a hospital accident and emergency department (DTI 2003). Within these figures, older people falling on stairs in their homes comprise a significant category, resulting in excess of 500 deaths and 51,000 hospital casualty department attendances each year. These statistics do not include patients seeing their general practitioner or those not seeking treatment. A similar pattern exists in the United States (Startzell 2000). Worldwide, it has been argued that falls on stairs rival road accidents as a leading cause of accidental injury and death (Pauls 1991; Templer 1992).