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Home Safety Checklist for the Elderly



Home is meant to be a haven of safety and comfort, but for adults 65 and older, hazards in a home pose a serious threat to their health and independence. The Centers for Disease Control and Prevention (CDC) reports that half of all falls in older adults happen at home and every 35 minutes, someone in this population group dies as a result of their injuries.

"When I walk into a home, I'm primarily looking at tripping hazards, lack of supports, lighting, accessibility of smoke detectors, and how the older adult performs his or her everyday activities," said Pamalyn Kearney, assistant professor and vice chair of the Department of Occupational Therapy at University of the Sciences in Philadelphia.

Kearney, who specializes in home environment evaluations and works with the Philadelphia Corporation for Aging and Rebuilding Together Philadelphia, offers proven interventions that can reduce home falls and accidents to help older adults live better and longer:

• Bathroom modifications: Install grab bars, shower seats, hand-held showers, and raised toilet seats in the bathroom.
• Stair rails: Install railings on stairs, including basement stairs, and consider railings on both sides of the stairs.
• Lighting: Increase the wattage of light bulbs for ambient and task lighting, while being careful to not increase glare. Add lamps in areas where tasks are commonly performed, such as a dining room table for bill paying or a living room chair for knitting or reading. Add nightlights in the hallway between the bedroom and bathroom, as it takes time for eyes to adjust from darkness to bright light and this transition can increase the risk of falls.
• Reduce glare: Eliminate or minimize glare by changing curtains to filter the sunlight, trying different wattages or styles of light bulbs, putting table cloths on glass tables, using low gloss polish or wax on floors and furniture, and if there is glare on the stairs, adding additional ambient light along the stairs.
• Entrances: Install a shelf at the main entrance door to hold items when locking and unlocking the door and install lever handles, as they require less grip strength and can be opened with an elbow or forearm if the person is carrying items, such as groceries.
• Clear Walkways: Remove things you can trip over, such as papers, books, clothes, and shoes, from stairs and places where you walk, and tack telephone cords and appliance cords along walls to remove them from walkways
• Climbing: Keep items you use often in cabinets you can reach easily without using a step stool. If an older adult does have to climb to reach spaces or for over-head tasks, consider a reacher device or a step stool with a handle that offers more stability than a standard step stool or climbing up on a chair.
• Increase contrast: Avoid low contrasting items, such as a white bathtub surrounded by white tiled walls, and dark plates on dark placemats on a dark table, as this can make it difficult for someone with low vision to find the plate. Adding contrast is as simple as a blue tub mat in a white bathtub or painting the edge of the steps a contrasting color from the rest of the step surface.
• Heat safety: As we move into the summer season, it's also important to check for air conditioners or fans. Older adults are at an increased risk for complications from hot and humid weather, including heat stroke and dehydration.

While these generic modifications to help reduce home falls and accidents can be helpful, Kearney recommends a proper home evaluation. "It is important to look at how the individual performs daily activities in the home environment so that recommendations and modifications are matched appropriately to the individual's habits and routines."




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