About one-half of all falls suffered by elders take place within the familiar surroundings of one’s home (i.e., occurring in the bedroom, bathroom, living room, on the stairs, etc.). Falls generally don’t happen while performing gravity defying feats, such as attempting to change a ceiling light bulb and balancing on a rickety chair stool at the same time. Rather, most mishaps occur during everyday routine activities (i.e. walking; getting up from bed, chairs, or toilet; going up and down stairs; reaching or bending to place or retrieve objects; etc.)

Unfortunately, many elders only become aware of potential fall hazards in their home (e.g. low lighting, slippery floors and rugs, clutter, etc.) when they take bad spill. The best approach to home safety is to appreciate why elders are susceptible to falls and, most importantly, to correct any hazards.

As we grow older, the onset of age –related physical changes and chronic health conditions (e.g., diabetes, Parkinson’s disease, arthritis, etc.) can result in difficulties with everyday activities, thereby placing elders at risk of falling. For example, a decline in vision might cause one to misjudge distances, such as steps. Muscle weakness can affect one's balance, thus increasing the chances of falling when getting up from a chair or stepping into the shower. A stiffening of the knees may result in walking with a ‘shuffle’, which can lead to trips and slips. Likewise, unsafe environments by themselves can lead to problems with everyday activities and fall risk. For example, poor lighting can lead to trouble seeing slip and trip hazards. Getting up from low-seated chairs or toilets can easily cause balance loss in elders with limited muscle strength. 

Potential fall hazards in the home are easy to overlook but easy to fix. Use the following two checklists to fix hazards in your home.

This is checklist of ‘good home safety practices’ for all elders regardless of health conditions.

Hazard
Inadequate lighting

Solutions
Keep lights on in rooms that you are walking through. The lighting in your home must be bright so you can avoid tripping over objects that are not easy to see.

Consider a nightlight for dark passageways.

During the day, open curtains/shades to let more sunlight in.

Install extra lighting along the pathway from bedroom to bathroom; by steps/stairways.

Hazard
Sliding throw rugs

Upended/curled carpet edges

Solutions
Check all rugs/mats to make sure they are slip-resistant. Consider either buying new rugs with non-slip backing or applying nonskid matting to backs of existing rugs to make them secure.

Use carpet tape to keep carpet edges from curling up.

Hazard
Clutter

Solutions
All pathways should be clear of objects/furnishings.

Hazard
Inadequate step/stairway lighting

Step/stairway clutter

Solutions
Make sure stairs are well lit/free of clutter.

Use stairway handrails for going up and down steps.

Pick up things on the stairs. Always keep objects off stairs/steps.

This checklist can be used as a self-assessment tool to identifying unsafe activities leading to fall risk. Recommended ways to eliminate hazards or obstacles interfering with safety are provided.

DO YOU HAVE ANY DIFFICULTY OR TROUBLE…?
Walking about your home?

Solutions

Keep "traffic lanes" free of clutter/obstacles; allow plenty of walking room.

Make sure all rooms have sufficient lighting.

Remove slippery scatter/throw rugs or use rubber pads to keep them in place.

Secure all carpet edges.

Wear shoes/slippers with non-slip soles that grip the floor.

Consider using a cane to help maintain balance.

Walking to the bathroom at night?

Solutions

Install nightlights in the bedroom/bathroom

Keep a light within reach of the bed.

Keep a clear path from the bedroom to the bathroom

Getting up from chairs?

Solutions
Use sturdy chairs with armrests to help get up/sit down.

Add firm foam pads to seats of chairs/sofas to help get up.

Getting up from beds?

Solutions
Move beds against the wall to prevent the bed from sliding away when getting up.

Replace existing mattress with one thinner in width to lower bed height or thicker in width to raise bed height.

Use a handrail to assist with getting up from bed.

Getting up from toilets?

Solutions
Consider an elevated toilet seat and grab bars to help sit down and get up.

Getting in and out of bathtubs or showers?

Solutions
Consider using a tub/shower chairs and grab bars to help get in and out. Towel bars are not designed to be used as grab bars.

Place nonskid rubber mats or decals on the floor to prevent slipping.

Getting objects from kitchen cabinets and closet shelves?

Solutions
Store everyday dishes/kitchen supplies within easy reach. Consider keeping items no lower than waist level or no higher than shoulder height to avoid excessive bending, stooping or reaching.

If you must use a step stool, get one with a bar to hold on to. Never use a chair as a step stool.

Walking up and down steps or stairs?

Solutions
Don't rush when climbing up or down stairs. Take your time and look directly at each step.

Don’t carry large packages or baskets that obstruct your vision when going up or down stairs.

Watch were you are stepping when using stairs, place your foot firmly on the steps. 

Don’t place items on stair steps, these can create a hazard when going up or down a staircase.

Add hand rails to all steps/stairs, if possible. Using hand rails to go up and down steps/stairs is easier and safer.

Consider installing extra lighting at the top/bottom steps; many falls are due to not seeing steps properly.

To learn more about fall prevention in elders,tune in to our Empowering Family Caregivers Radio Show with Dr. Rein Tideiksaar on Tuesday, May 24th, at 2PM EST.

Rein Tideiksaar Ph.D., PA-C (or Dr Rein as he is commonly referred to) is the president of FallPrevent, LLC, Blackwood, NJ, a consulting company that provides educational, legal and marketing services related to fall prevention in the elderly. Dr Tideiksaar is a gerontologist (health care professional who specializes in working with elderly patients) and a geriatric physician's assistant. He has been active in the area of fall prevention for over 30 years, and has directed numerous research projects on falls and has developed fall prevention programs in the community, assisted living, home care, acute care hospital, and nursing facility setting. To learn more, check out the Dr’s professional profile on LinkedIn:http://www.linkedin.com/pub/dr-rein/6/759/592. If you have any questions about preventing falls, please feel free to e-mail Dr. Tideiksaar at drrein@verizon.net.