Background Falls are a common health hazard among older people and have become a major cause of disability. The risk of falling increases with age and many older people need extended hospital stays as a result of a fall, and some may be admitted to residential care after a fall. The interaction between the older adults with dementia, their living environment and fall is an area of concern from occupational therapy. Method This is a pioneer study composed of a home falls and accident screening and with two types of intervention in a 12-month longitudinal randomized controlled trial. In the first month, participants received the psychoeducation program on home safety and fall prevention in their own home. Then for the following eleven months, participants were randomized to either control group which participants will receive bi-weekly reviews of home safety and fall prevention. Experimental group will have regular training on the use of VR-based home safety alertness for near miss. Result 100 community dwelling moderate dementia subjects (CDR> 2) were recruited, 25 of them reported with five or more home hazards and labelled as high risk group. 32% of subjects reported with hazards which labelled as “Home Environment and Furniture”, 28% of recruited population reported with hazards in “Capability in Activities of Daily Living” and 32 % reported with hazards in “Use of devices”. In one-year follow-up, both experimental group showed significantly lower incidence of fall of 5 % when compared with 18% in general dementia population. Conclusion Results indicated home safety and fall prevention screening is effective to reduce home hazards. Application of VR can be a reinforcing strategy for people with dementia and can help alleviate stress of caregivers.