Fall Prevention at Home

Preventing Falls at Home

Falls are one of the biggest fears of the elderly. A fall can easily cause significant injury and put an end to the ability to live at home independently. Millions of elderly fall each year. The good news however, is that there is much that can be done to help reduce the risk.

Clearly preventing falls at home is critical and a prevention program should be devised. Engaging the physician is a crtical first step but there are many things you can do to modify the home environment to help assure an elderly loved one's safety.

For millions of us who are caring for parents or grandparents, there is a lot to learn, but this page will give you a start.

Eliminating Hazards

One of the first steps to take if your goal is preventing falls at home, is to assess the home environment, identify things that may create risks, and eliminate them. It's certainly wise to have a professional home evaluation done, which a physician can order, but certainly it can be beneficial even if you just do it yourself.

1. Clear pathways
Identify walkways and make sure they are unobstructed. Boxes, cords, chairs, and so forth, should not be located in walkways or sitting near doorways where they can cause a person to trip and fall.

2. Make sure floor coverings are secure.
It's often best to remove small rugs that create a height difference, can turn up, or catch a toe. All carpeting and other floor coverings should be glued down. Try to eliminate any height difference or uneveness. For instance raised sills can be a problem.

3. Remove/replace unstable furniture.
Chairs that roll or swivel are particularly hazardous. They can move as a person tries to sit down or get up, causing them to tumble to the floor. Rocking chairs can also be a problem. Chairs with arms can help elderly people get up more easily.

A bed that is too high to allow a person to place their feet on the floor when sitting near the edge is also hazardous. To prevent falls at home, a bed that is too high should be replaced or lowered.

Be sure to remove any small benches that might tip over easily.

Make Basic Home Modifications

Fall prevention often requires home modifications. Some modifications are minor but others may require a bit more. Reducing clutter in general is a good starting point, but there is more evaluation of the home environment necessary.

1. Start with the bathroom.
The most common place for a fall to occur is in the bathroom. Installing grab bars can help a person steady themselves when entering or exiting the shower or bathtub. It's critical that these be mounted securely on wall studs so that they can bear the weight of an adult. (The suction cup style grab bars aren't recommended.)

Flooring should be secure and have a non-skid surface. Decals can be put in tubs and showers to create a non-skid surface. A shower seat is best in the shower. Some showers come with an included seat or you can purchase a shower chair/bench. A shower with no step up is preferred.

Tubs can be problematic due to the high step up to enter/exit them. There are specialty walk-in tubs available if the budget allows. A tub bench helps individuals who have difficulty either getting down into the tub or up out of it.

A raised toilet seat performs a similar function with the toilet, many of these have arms to help as well.

Install a small nightlight in the bathroom.

2. Look at Bedrooms
Keep items at bedside that will allow an elderly individual to have them close at hand without having to get out of bed quickly. A lamp, telephone, tissues, and so forth are common.

There are stabilizing arms or rails available to install on beds to help a person get out of bed if necessary. As indicated above, the bed should be low enough that the person can put their feet flat on the floor when sitting on the edge of the bed. (This is true of all chairs as well)

3. Do an Assessment of the Kitchen.
Either remove any small rugs or secure them to the floor. Make sure that all shelving is secure and that items are not stacked such that they might tumble out when opening a cabinet door. Try to get everything where it is within reach so that a ladder or stool won't be necessary to get to them.

4. Other home modifications.
To prevent falls at home, small nightlights can help to prevent accidents as a result of tripping or bumping into walls due to the lack of illumination. In addition, assuring that light switches are near doorways can help since entering a darkened room creates a significant fall risk.

Handrails on stairways are a necessity; don't forget this is true of outdoor steps as well. Of course, ideally it is best to avoid stairs altogether. A one story home is preferrable. Moving is sometimes the best option if a home is two story, but if this isn't possible, then modifications to move critical items to the main floor may be needed. There should be a bedroom and bathroom available on the main floor. Ideally, laundry rooms and other necessities should not require the person to use stairs either.

Don't forget to consider the outdoor environment also if you a striving to prevent falls. Look for uneven pavement in the drive way, sidewalks and so forth. Again outdoor steps should have a hand rail. Curbs leading to a mailbox can present problems too, if the mailbox can't be relocated then at least painting the curb might draw attention to the height change. Be sure any hoses and so forth aren't left across a pathway .

Consult the Physician

A good fall prevention program at home requires input from professionals. A physician can provide useful information and make referrals where necessary to help an elderly individual stay at home safely.

1. Problems with both vision and hearing can increase the likelihood of a fall. Both should be assessed.

2. Balance and strength are important components of avoiding a fall. A physician can assess these and recommend therapy as needed to improve them.

3. Adaptive or assistive aids can be ordered by the physician and can often be covered by Medicare/insurance. A walker or a special cane can provide more stability in many cases. These devices are excellent tools in preventing falls.

4. The influence of medications can also be assessed by the physician. Many elderly people take multiple medications and over time they may have a negative influence as far as fall safety. Only a physician can assess this and make any necessary changes.

Making Other Minor Changes

Beyond modifying the home environment there are other small changes that can be important in fall prevention at home.

1. Consider footwear.
A sturdy shoe with rubber soles will help reduce the risk of a fall. Walking in socks and other shoes that have little grip is a risk factor. Difficulty tying shoe strings can result in strings that drag along the floor, velcro is sometimes a better option. Of course other clothing matters too. Wearing pants that are too long or a robe that drags on the floor can certainly precipitate a fall.

2. Use extra care with getting up out of bed.
Going from a position of lying down to standing, can sometimes cause dizziness and ultimately a fall. For this reason, a good fall prevention measure is to sit up on the side of the bed and remain there for a minute before proceeding to stand up.

3. Continue to be active.
Exercise is the best way to maintain good strength and balance and an excellent way to be proactive in fall prevention. Weight bearing exercise in particular, such as walking is often recommended. However, stability must be sufficient in order to do this safey. As indicated above, consulting with the doctor is recommended before any increase in activity is undertaken.

4. Consider an action plan if a fall does occur.
Despite your best efforts a fall could occur, or of course some other emergency. It's best to be prepared by knowing how the individual will get help, and get it quickly. A fall is bad, but laying there unable to get help for hours or even a day or two will make the problem, much, much worse. One possible solution is a medical alert system that would allow the individual to summon help immediately. They are generally very affordable and provide the 24 hour security that's needed.

Comments 3 comments

PegCole17 profile image

PegCole17 6 years ago from Dallas, Texas

Mulberry1, This is so completely true. . . you have really hit the nail squarely here. Much of what you write about here has come to pass in my Mom's house.

You're right, the bathroom is the first place to begin looking. We started out installing the hand rail in the bathtub to help in getting out of the tub. That progressed to an elevated toiled seat with arms to make things easier there. Then came the shower seat which later became a shower transfer seat after a fall in the home required hip surgery.

These tips are valuable for everyone, including the elderly and those who look out for their safety. Sometimes it's difficult to step in and make things happen - not waiting for the elderly parent to decide it's time to fix things. Reducing the risks of falling will really improve the chances for living on your own even into your 80s and 90s!


Support Med. profile image

Support Med. 6 years ago from Michigan

Valuable suggestions! Voted-up/rated!


Nell Rose profile image

Nell Rose 6 years ago from England

Hi, these are great ideas. I think that most people do a small area but forget about other parts of the house. I always remember putting a proper rail on the stairs for my parents, but we forgot to do one in the bathroom for a while. but eventually we sorted it out. great rated up. nell

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