Fall Prevention & Home Safety Checklist

Falls are life-changing events for the elderly.

A fall changes everything for the elderly. A fall usually results in fractures, which means hospitalization, time in rehab, physical therapy and major changes in their living situation.   In many cases a fall means it is impossible for the aged person to remain independent at home, which means moving to an institutionalized setting.  In many cases a fall triggers the start of a dangerous decline in elderly person’s health.

Preventing falls needs to be taken seriously.  Check your elderly loved one’s home for safety hazards that increase their risk of falls and accidents.  A thorough home evaluation is a great way to prevent senior falls and serious injury and is a good place to start when considering elder proofing the home.  Taking steps to make the home suitable for those of advanced age will help ensure your loved one can remain independent and safe at home much  longer.  

Use these questions as a guide to making the home a safe place for your elderly loved one.

Exterior:

1.         Are step surfaces non-slip?

2.         Are step edges visually marked to avoid tripping?

3.         Are steps even and in good repair?

4.         Are stairway handrails present?

5.         Are handrails securely fastened to fittings?

6.         Are walking paths covered with a non-slip surface and free of tripping hazards?

7.         Are walking paths clear, safe and even with no holes in the concrete?

8.         Is sufficient lighting available to provide safe ambulation at night?

9.         Are leaves and snow cleared away?

10.       Are tools and yard equipment safely and securely stored?

Helpful tips

• Poor lighting often contribute to trips and falls.  Install light switches at the top and bottom of stairways to avoid using stairs in the dark.
• Install lights or colored tape on each step highlight the distinction between each step. 
• Paint door sills a different color than the floor.

       

Interior (Entry and Main Living Area):

1.         Is the entryway clear of clutter with at least 36” wide access?

2.         Do the door locks operate smoothly?

3.         Does the porch light adequately light the porch and the door?

4.         Are the light switches located near room entrances?

5.         Are the lights bright enough to compensate for limited vision?

6.         Are the lights glare free?

7.         Are stairways well lit?

8.         Are handrails present on both sides of stairway?

9.         Are the handrails securely fastened?

10.       Are the stairways free of objects?

11.       Are there light switches at top and bottom of stairs?

12.       Are the stairs marked to highlight the distinction between each step?

 13.      Are steps slip resistant?

14.       Are steps even and uniform in size and height?

15.       Are there smoke and carbon monoxide detectors present with fresh batteries?

16.       Are all electrical outlets cool to the touch?

17.       Are electric cords properly plugged in and safely tucked away?

18.       Are there nightlights in halls and stairwells?

19.       Are electric heaters placed away from rugs, curtains and furnishings?

20.       Is the fireplace chimney clear of accumulation and inspected annually?

21.       Are carpets in good repair with edges tacked or taped down?

22.       Are linoleum and plastic stair treads secure?

23.       Are throw rugs secured with non-slip backing and taped down?

24.       Are floors finished in a non-slip way? Has high polish been avoided?

25.       Are rooms uncluttered to permit unobstructed mobility?

26.       Is water temperature reduced to prevent scalding?

27.       Are water faucets clearly marked hot and cold?

28.       Is the furnace checked yearly?

29.       Are there established house-smoking rules?

30.       Does room furniture allow easy access to doors and windows?

31.       Do the doors, drawers and windows open and shut easily?

32.       Is the furniture strong enough to provide support during transfers?

33.       Are telephones easily accessible?

34.       Are flashlights available in every room?

35.       Is glow tape stuck on important items to identify them in dark?

36.       Are cleaners and poisons clearly marked?

37.       Are window and door locks sturdy and operational?

38.       Are medications properly stored and usage instructions written down?

39.       Is a first aid kit available with up-to-date supplies?

Helpful tips

•   Improve the lighting in your home by using brighter bulbs, at least 60 watts.
•     Use lampshades or frosted bulbs to reduce glare.
•     Use uncut, low pile carpeting instead of thick pile to reduce tripping potential.
•     Replace windows with polarized glass or apply tinted material to eliminate glare.
•     Use chairs with seating at least 14 –16 " from the floor and sturdy armrests to              provide leverage while sitting or rising.

Kitchen:

1.                  Are dishes and food stored on lower shelves for easy access?

2.                  Is step stool sturdy and have a high handle for support?

3.                  Are step stool treads slip resistant and in good repair?

4.                  Is lighting sufficient, especially over the stove, sink and counter-tops?

5.                  Are towels and curtains kept away from the stove?

6.                  Are electric appliances and their cords kept well away from the sink?

7.                  Is flooring non-slip?

8.                  Are the “Off” indicators on stove and appliances clearly marked with brightly colored tape?

9.                  Is there a telephone in the kitchen? Are emergency telephone numbers displayed including family contacts?

10.              Is there a fire extinguisher within easy reach and in good order?

11.              Are whistling teakettles and food timers in use?

12.              If the pilot light on the stove goes out, is the gas odor strong enough to alert the homeowner?

13.              Is food properly stored?

14.              Are refrigerator and cupboards free of spoiled or expired food?

15.              Are pots and pans of a lightweight type?

16.              Are potholders and oven mitts available?

17.              Are the appliances, including refrigerator and stove, in good working order?

18.              Are pet dishes set out of walking area?

19.              Are table and chairs strong and secure enough to provide support when leaning, standing or sitting?

Helpful tip

• A well-organized kitchen will make cooking and cleaning easier and prevent falls.  Re-arrange frequently used items to avoid excessive bending and reaching. Use a hand-held reaching tool for hard-to-reach objects.

Bedroom:

1.                     Are lamp and light switches within reach of the bed?

2.                     Is the electric blanket in good working order?

3.                     Is the telephone accessible from the bed?

4.                     Is there an emergency telephone list near the telephone?

5.                     Is there a flashlight and a whistle near the bed?

6.                     Are medications stored away from the nightstand?

7.                     Is the bed an appropriate height for easy transfer?

Helpful tips

•  It can be challenging, not to mention expensive, to keep fresh batteries in flashlights. Try purchasing flashlights that plug into the wall and remain constantly charged. Some rechargeable flashlights even have built in nightlights to make them easy to locate in the dark.
• Stand slowly when getting out of bed. Give your body time to adjust to an upright position.
•  Wear well-fitting slippers and avoid nightwear that drags on the ground.
•  Tie the belt on your robe.
•  Keep pathways between the bed and bathroom and the bedroom door unobstructed by clutter or furniture.
•  The bed should be at least 18” high (from the top of the mattress to the floor) to allow more comfortable and safe transfers.
• The edge of the mattress should be firm enough to support a seated person without sagging.

Bathroom:

1.                  Is the door wide enough for unobstructed access with a cane, walker, or wheelchair?

2.                  Is the threshold low enough to avoid being a tripping hazard?

3.                  Does the floor have a non-slip surface?

4.                  Are floor rugs secured with non-slip backing and carpet tape?

5.                  Are grab bars securely fastened next to the toilet and in the tub and shower areas?

6.                  Are there non-skid strips, decals or rubber mats in the tub or shower?

7.                  Is there a tub or shower seat available?

8.                  Is the toilet seat elevated for easy transfers?

9.                  Is there sufficient, accessible, glare-free light available?

10.              Is there telephone access available in the bathroom?

Helpful tips

•  If you are on strong medication or in a frail or delicate condition, do not bathe by yourself. Have someone assist you in and out of the bath and check on you periodically.
• Use a bath chair, grab bars and hand held shower to provide stability when bathing.
• Do not use towel bars for support.
• Check water temperature with your hand before entering the tub or shower.

Other Preventative Measures

Exercise regularly. Regular exercise increases strength, stamina, balance and coordination. It also helps to increase bone density and balance hormone levels. It improves circulation, blood pressure, and heart and lung health.

Do an annual Brown Bag Review.  Simply place all medications, prescribed and over the counter medications, along with any herbal, nutritional and natural health supplements into a brown paper bag. Take it in to your doctor or pharmacist to review the medications for potential interactions or side effects like dizziness or sleepiness.  The more information gathered about medications taken, the less likely there will be negative side effects from conflicting medications.

Have vision and hearing checked once a year.  Both vision and hearing problems can increase fall risks.

Keep glasses clean.

Wear sturdy, well-fitting shoes with non-skid soles.  Take care of the feet.  Consult a  doctor about any pain, numbness, tingling or any wounds that are not healing properly.

Most home health agencies will perform a home safety inspection and make recommendations for insuring the safety of your loved.  Occupational therapists will also make suggestions on how to improve safety at home.  

www.homeaidhealthcare.com

www.prairiehomeassistedliving.com

Kate McCarthy is Director of Operations for HomeAid Health Care which provides services for the elderly who wish to remain safe and independent at home.  HomeAid is sister company to Prairie Home Assisted Living which has served the physical, spiritual, mental and health needs of their Residents since 1999.  Together the two family owned companies provide comprehensive care for the elderly in the Fox Valley of Wisconsin.

Source: CBS News, The Senior's Choice

Elder Proof the Home

Make the home a safe place for your elderly loved one.

Marge’s falls usually occurred in her bathroom.  She frequently ended up bumped, bruised and scolded for not being more careful.  The time her head narrowly missed the porcelain tub got her family to really take a look at what was causing the problem.  It turned out that the doorway was unusually narrow and the door opened into the bathroom room making it even more difficult for Marge to enter.  In addition, the lever on the bathroom door would constantly catch on Marge’s bathrobe sleeve as she made her way into the room which threw her off balance.  A simple fix of changing the hinges so the door opened outward increased the space and eliminated the possibility of the lever catching on her clothes.  To the relief of Marge and her entire family, the falls stopped.

Most elderly live in fear of falling.  Falls and other household accidents put elders at risk and are often the reason staying at home independently becomes impossible.  Renovating the home so it is a safe place allows your elderly loved one’s to age in place at home rather than having to move to an institutionalize setting.   Most folks think nothing of child-proofing their home when their families are young.  The same concept holds true for the aging.  A couple of simple and relatively inexpensive renovations can make all the difference in the overall safety for your elderly loved one.

Bathroom:

The combination of smooth floor surfaces and water make the bathroom one of the most dangerous rooms in the house, so it is important that this room be updated to safely accommodate the elderly. 

·        Install bathrooms doors to open outwards so there is room to maneuver through thresholds.  Doorways should be 32” to 36” in width to accommodate those in wheelchairs or using walkers.

·        Lower the height of cabinets, countertops and mirrors a few inches to accommodate those in wheelchairs or with walkers.  Insulate hot pipes under the countertops so those confined to wheelchairs don’t burn themselves when seated near the sink.

·        Allow 30” to 48” of open space in front of all fixtures in the bathroom, including sinks, toilet, tub and shower.

·        Install grab bars parallel to the floor (or at a slight diagonal) next to the toilet and in the tub and shower.  Install a vertical grab bar near the shower door for entering and leaving the shower stall.

·        Raise toilet seats to at least 17” or fit with seat extenders.  Toilets should not be placed in small alcoves or too close to vanities, shower stalls or fixtures so there is plenty of maneuver room near the commode.

·        Install a walk-in tub with water sealed door or install tub grab bar to provide balance when stepping into the tub. Get a stable 17” tub seat, a non-slid tub matt and a hand held showerhead, all which make taking a shower safer and easier for the elderly.

·       Turn on a night light in the bathroom at night.

Kitchen:

Kitchens need to be accessible to the elderly which means re-arranging cabinets so commonly used items are in easy reach.   Trying to reach items in high cabinets or crouch down to retrieve low for items on the bottom shelves can be very difficult and so organizing the kitchen with elders in mind is a priority.

·        Lower wall cabinets by 3” to 5” making shelving accessible.  Counter tops should be at 28”- 34” for wheelchair accessibility and at 40” for someone who has trouble bending.

·        Move commonly used kitchen items to lower cabinet shelves.

·        Install easy access features such as rolling carts and baskets, lazy Susan devises and full extension drawer glides.

·        Choose glare-free surfaces so elderly can easily find handles and knobs.

·        Install shallow sinks so those in wheelchairs can reach inside. 

Lighting:

By the time a senior is in his 60’s, they need nearly 15% more light to properly see.  Adding more light to hallways and stairs can help avoid falls which can be especially dangerous on stairs.

·        Install fixtures which use higher wattage bulbs and use brighter LED lights for added illumination.

·        Use ceiling lights that reflect light to the entire room without glare.

·        Install sensor light switches which turn on and off when people enter or exit a room. Use dimmer controls which can ease glare for elderly with light sensitivity issues.

·        Have hand-held remote controls for a centralize control center near the bed or easy chair.

·        Control lights from wall switches with large tilt plates or overhead pulls which are easy to grasp.  If a lamp uses a knob, be sure it is large and turns easily.  Wall switches should be installed no higher than 48” from the floor so they are accessible to someone confined to a wheelchair.

·        Use florescent lights in kitchens to illuminate work spaces.

·        Install night lights in hallways and bathrooms.

·        Use lighter colored lamp shades that emit a brighter ambient light.

Floors & Stairs

It is important to pay attention to the condition of floors and stairs.  Slips and falls can be reduced dramatically when basic precautions are put in place,

·        Secure carpets or area rugs with grip tape so they don’t shift or move.  Never allow area rugs over wall to wall carpeting as the rug will edges curl and not sit flat. Remove all area rugs from top or bottom of stairs where a trip may result in serious injury. In many cases it is best to remove area rugs altogether because they are often the culprit when there is a fall.

·        Position furniture so there is large easy pathways to navigate through.  Make sure all transitions from room to room are flat and seamless. 

·        Get rid of all clutter, electrical cords, hanging tablecloths, draping curtains or pulls from blinds that could get tangled in feet and cause trips and falls. 

·        Keep small pets out from underfoot.

·        Ensure all steps and stairs are even in height and are deep enough to place the entire foot for proper balance. 

·        Be sure there is a sturdy handrail available for all stairs and steps.

·        Install anti-slip tape on stair treads for extra traction.

·        Ensure carpeted stairs are properly installed and the carpeting is not sagging or loose.

·        Consider a stair lift for people with mobility, strength or balance issues.

·        Invest in well fitting shoes with skid-free soles, no to low heels and Velcro straps. Discourage walking on hardwood floors in stocking feet or soft slippers.

·       Consider replacing tile or hardwood floors with safer non-skid flooring especially in the bathroom and kitchen areas.

With the cost of institutionalized elder care dramatically increasing, it is a good idea to invest a little now to safeguard your elder’s home.  Reduce the risk of accidents and falls for your loved one and they can remain safe and independent at home, the place we all prefer to be.

www.homeaidhealthcare.com

www.prairiehomeassistedliving.com

Kate McCarthy is Director of Operations for HomeAid Health Care which provides services for the elderly who wish to remain safe and independent at home.  HomeAid is sister company to Prairie Home Assisted Living which has served the physical, spiritual, mental and health needs of their Residents since 1999.  Together the two family owned companies provide comprehensive care for the elderly in the Fox Valley of Wisconsin.

Sources:

“Accident Prevention Tips” by the Editors of consumer Guide, www.home.howstuffworks.com 10/21/13

“Home Improvements for Senior Citizens” by Wendy Dickstein, www.realitor.com 10/22/13

“How to Create a Safe Haven for Independent Living”, www.safetytubs.com. 10/21/13.