Falling is a serious and common problem among older people.Falls may lead to a pain, slight or sever injuries , may increase the duration hospital stay , cause patient discomfort and effect quality of life . The purpose of this study was to estimate the risk of falls among elderly in residential care facilities. The aims of this study were to :  determine the gait and balance status of older people living in institutions,  examined and assessed environmental risk of factors in institutions.
In the present descriptive study we investigated environmental risk factors associated with falls in 10 institution , and investigated one hundred adults 65 years age or older who  were able to walk. We examined demographic variable, cognitive and functional status, past  and current medical history and drugs . Balance and gait status were evaluated by Tinetti Performance Oriented Mobility Assessment Tool ( POMA) . The results showed that the total score of gait and balance test on POMA were 19 – 24 score in 31% cases (high risk) and 25 – 28 in 37% cases(low risk ) and 32% werenot in risks of falling.
The finding indicated a statistically significant correlation between age and the score of balance and gait tests and total score (gait and balance) (P = 0/002, γ = 0/303) . Also the relationship between current physical and psychological disease, pervious physical disease and using aid divices,whit the score of balance and gait test and total score (gait and balance test) were significant( P =.0) .Therfore the results of this research showed that elderly people who living in instituations are in risk of falling and risk factors identification can useful for atargeted multiple intervention.