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Making the home environment safe for older adults

PostedFebruary 24, 2023
UpdatedFebruary 24, 2023
Byidfuiveirbuwoikwx

Summary

Safety adjustments often need to be made to home environments to accommodate conditions such as frailty, limited mobility, poor vision, and dementia. This article lists the main home injury risks for older adults. It then offers general and room-by-room suggestions for making the home environment safer.

Home injury risks for older adults

Safety adjustments often need to be made to home environments to accommodate conditions such as frailty, limited mobility, poor vision, and dementia. Even homes that would usually be considered safe can present hazards as an older adult’s abilities change.

Injuries that can occur in the home include the following:

  • Falls leading to broken bones or head trauma 
  • Wrenches and sprains from reaching, twisting, or walking on uneven surfaces
  • Bruises from bumping into things
  • Burns
  • Electrical shock
  • Eyestrain from inadequate lighting

Making a home safe involves addressing both overall home elements and hazards specific to each room.

Address fall hazards 

Older adults make 3 million emergency-department visits for fall-related injuries each year, and 36,000 older adults die directly or indirectly from falls each year.1

Two major fall-prevention steps are to reduce trip and slip hazards to lower the chances of people losing their balance.

To reduce slip and trip hazards:

  • Keep rooms and stairs decluttered.
  • Take out raised floor separators between rooms.
  • Remove rugs and runners, or make sure they are firmly tacked down.
  • Get rid of any unnecessary furniture, and make sure the remaining furniture is out of the main traffic corridors.
  • Secure electrical cords against walls.
  • Make sure floors are kept dry.
  • Keep family pets and their toys and dishes out from underfoot. 
  • Put fluorescent tape at the front of each step, and consider installing rubber treads on stairways.
  • Mark any changes in floor level with fluorescent tape.
  • Invest in comfortable non-slip socks, and make sure that all footwear has non-slip soles.
  • Make sure only non-skid wax is used on any uncarpeted floors. 

To lower the chances of a person losing their balance:

  • Install grab bars and railings. These can go in the tub/shower, next to the toilet, and on walls on commonly traveled routes, such as to the kitchen and bathroom.
  • Move lamps and other devices with switches to positions where a person can easily reach them without stooping or stretching.
  • Put dishes and other household items on lower, easily reachable shelves.
  • Provide a hand-reacher device (also called a grabber tool) to reduce the need for risky movements.

Add lighting

The better a person can see, the better they can get around without tripping or bumping into the corners of furniture. Poor vision is a major contributor to in-home falls.2

To improve lighting:

  • Add lamps and boost the wattage in existing lights.
  • Install “cooler” lights, which are perceived as brighter and can also offset the yellowing of older people’s vision.3
  • Swap out existing light switches for illuminated ones.
  • Make sure there’s a nightlight in bathrooms and corridors to them.

Create rest stations

If a person is still able to move about the house, make sure they do not get fatigued by putting a chair or stool in every room. Wall-mounted fold-down seats work well in tight areas such as hallways. Walkers with a seat can serve as rest stations as well; make sure the brakes are on once the walker is in place.

Put some form of high, non-slip seating in the bathroom, so that a person does not feel obliged to sit on the toilet or the edge of the bathtub when they need a rest.

Modify home elements

If possible, replace standard bathtubs with walk-in showers or tubs. If the bathing area doesn’t have a bench, get a shower chair with anti-slip feet. Make sure non-slip mats are present in tubs.  

If finances allow, install a stair lift and purchase a lift armchair that tilts forward to help the person stand up and sit down. Less expensive options are a stair-climbing aid (a handle that attaches to the stair railing and glides along with the person as they go up and down the stairs) and stand-assist devices that provide handles and grab bars for standing up from sofas and chairs.

If an older adult feels comfortable with it, obtain a commode or urinal for nighttime use so that they don’t need to get to the bathroom as often.

Bedroom safety

About one-third of at-home falls happen in the bedroom4—more than any other room in the house. The main culprit is the process of getting in and out of bed.5

Here are some key tips for making the bedroom safer:

  • Position lamps where they are easy to reach, and put in a nightlight.
  • Make sure that any other high-use devices, such as TV remotes, phones, tablets, and chargers, have an easily accessible home next to the bed, so that a person does not need to stretch to reach them.
  • Invest in a large, adjustable overbed table (a wheeled table that slots over the bed), to provide both a secure surface for hot food and drink and a comfortable place for activities such as doing puzzles and using a tablet.
  • Install a bedrail or bed assist (a shorter rail that is inserted between the mattress and box spring, also called a bed grab bar) to give the older adult something to hold onto while getting in and out of bed. For older adults with more mobility, a bed handle can provide assistance without taking up room. 
  • Keep canes and walkers close to the bed, where they can be reached without stretching.
  • Consult with an occupational therapist about the benefits of a fall mat to place beside the bed if a person cannot get out of the bed independently.
  • Avoid smoking in bed or in the presence of oxygen tanks due to extreme risk of fire.
  • Put a working flashlight where it is easy to access.
  • Make sure the room temperature does not fall below 65°F, as this can cause hypothermia.6

Bathroom safety

Although fewer falls take place in the bathroom than in other areas such as the hallway or garden,7 these falls tend to cause more serious injury because of the hard surfaces in the bathroom. This is why the bathroom is often considered the most dangerous room in the house for older adults.

Some key adjustments for bathroom safety are to:

  • Install plenty of grab bars, including next to the toilet and in the shower.
  • Add a shower bench or chair; if possible, replace the standard tub with a walk-in.
  • Always have a non-skid mat in the bath and/or shower.
  • Make sure the person always wears their waterproof fall-alert device into the shower or bath with them.
  • Put a night light in the bathroom.
  • Use bathmats with non-slip backing.
  • Lower the hot-water temperature, to prevent burns.
  • Put in a toilet seat raiser, ideally with handles.

Kitchen safety

The kitchen presents its own set of dangers, such as the risk of burns and cuts. In addition, older adults are more than twice as likely as younger people to die in a kitchen fire.8 And while falling may not be the main concern in the kitchen, falls here can have serious consequences due to the hard surfaces.  

Key steps to take for kitchen safety are to:

  • Move dishes and commonly used foods to lower shelves to keep the person from having to stretch or stand on a stepstool.
  • Find a place well away from the stove for dish towels, potholders, and all other flammable materials. 
  • Make sure the smoke detector and fire extinguisher are in good working order and that the person knows how to use the extinguisher. 
  • Invest in kettles, coffee machines, etc., that turn themselves off automatically.
  • Put in an easy-to-use timer as a reminder to turn off the burner.
  • Make sure the lighting is bright and switches are easy to access.
  • Put in non-slip mats.
  • Put in a chair for the person to rest in and hold onto for balance if needed.
  • Make sure the kitchen step stool is sturdy and has handles.

Hall and stairway safety

Some research suggests that stairs are the place that older adults fall the most often.9 To reduce the risk of stair falls:

  • Make sure handrails are present and secure.
  • Have light switches installed at both the top and bottom of the staircase.
  • Put a rubber tread on the steps, and mark the front with fluorescent tape.
  • Consider installing a stair lift.

Outdoor safety

The front porch, yard, and driveway should not be forgotten when making safety adjustments, as slippery exterior steps and walkways can be very hazardous. 

Some tips for outdoor safety are to:

  • Install motion-sensor lights.
  • Make sure steps are in good repair and hand railings are present and secure.
  • Make sure there is a clear path to the car, mailbox, etc.; trim any overgrown hedges.
  • Stay hydrated and wear a hat and sunglasses when working in the yard, as falls can happen from getting overheated, dehydrated, and disoriented or dizzy.

Related information

Aging well: Making your home fall-proof

Caring for an older adult with limited mobility

Caregiving: Making a home safe

Checklist for preventing falls at home

How to get up safely after a fall

Low vision accommodations in your home

Preventing falls in older adults

Preventing falls: Exercises for strength and balance

Preventing falls: Use a home safety checklist

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