Ways Families Can Help Reduce Fall Risk
Reduce clutter in the room and bathroom
- Take home items no longer needed by the resident.
- Keep pathways clear at all times.
- Watch for telephone and electrical cords in the walking area.
- Keep the over bed table across the bed.
- Make sure that the furniture you bring is stable and doesn't tilt if the resident leans on it. Don't bring in cardboard furniture, pedestal tables or tables with three legs. When you leave the room, take a quick look around. Do you see any clutter, cords, furniture or other items in pathways? Remove items or call for help from staff. Make sure the call light and personal items are within easy reach of the resident when you leave.
Safe shoes and slippers
- All shoes and slippers should fit well and have a firm shape. Shoes should have a low, even heel. While some carpets may cause problems for residents who wear shoes with deep tread, generally speaking, all shoes and slippers should have some form of tread on the sole. Examples include tennis shoes with Velcro fasteners, oxford style shoes and canvas or leather slip-on shoes.
- If a resident cannot wear safe shoes or slippers, use gripper socks instead.
- Use gripper socks at night.
Safety during transfer and bathroom use
- Always call for help from staff when you are unsure about helping your family member get out of bed or go to the bathroom. Do not transfer an unsteady resident alone.
- Bring in easy-to-manage clothing such as pants with elastic bands, easy to pull up skirts and dresses, and items with Velcro fasteners.
- Lock wheelchair brakes before transfer.
- Use all prescribed seating items for a resident when she is in the wheelchair.
Help the patient to use low blood pressure precautions
- Before the resident gets out of bed, ask her to sit on the edge and dangle her feet for a few minutes.
- Encourage the resident to flex her feet backwards several times while sitting.
- Remind the resident not to tilt her head backwards.
- After meals and anytime the resident has been sitting for a while, encourage her to get up slowly and to use assistance. Report any complaints of dizziness.
Return to Appendix B Contents
Reducing Falls: A Safety Checklist for the Home
Accidents in the home are a major cause of injury. One in three people 65 years and older fall every year and most of these falls happen in the home. This checklist helps to identify safety problems and provides easy tips for making your home a safer place. Use your common sense and take action to correct the problems you find. Most solutions are not expensive. If you cannot fix the problem yourself, ask a family member or friend to help.
Put a check beside each safety problem you find in your home. Then read the suggestions for improving the problem.
Do you have:
__ Unsafe stairs? Broken or worn stairs?
Repair broken or worn steps. Edges of stairs should be clearly visible with coverings in good condition and securely fastened down. Never store items on steps. Keep them free of clutter.
__ Broken or missing railings?
Porch and stair railings should be checked regularly. Make certain they are secure. Repair or install handrails on both sides of the stairs. Handrails should continue for the entire length of the staircase.
__ Poor lighting around stairs or dark hallways?
Increase the wattage of bulbs to the maximum allowed by the fixture. Add illuminated light switch plates to make it easy to find switches in the dark. Make sure that light switches are located at both the top and bottom of stairways. Add bright strips of tape to the edge of each stair.
__ Throw rugs?
Either remove them or fasten them securely to the floor with adhesive, double-stick tape. Do not use loose rugs anywhere, especially at the bottom of stairs.
Keep pathways clear. Put away shoes, newspapers, books, and other items and keep them off the floor. Make sure that electrical and telephone cords are not in pathways. Keep cords out from underneath carpet. Coil or attach cords to the baseboard. Have an electrician add another outlet if needed. Arrange furniture in order to give plenty of walking room.
__ Hard to reach items?
Cabinets and closets often have shelves that are too high to reach safely. Store frequently used items on the lowest shelf, at waist level. Avoid using stools and never stand on a chair to reach high items. If you do use a stool, use a steady step stool with a bar for support. Use a long-handled grasper to reach high objects.
__ A slippery bathroom floor, bathtub or shower?
Use a non-skid mat in the shower and bathtub. Use a rubber mat or nonskid strips in front of the sink, bathtub and shower to avoid slipping on wet spots. If you bathe in a shower, consider installing a non-skid shower chair and hand-held shower head so you can sit while bathing.
Avoid pulling up on the sink, a towel rack or soap dish to get up from the toilet or bathtub. These are not intended to support your weight and may come off the wall. Install grab bars or handrails in the shower, on walls around the bathtub, and beside the toilet. Make sure they are securely fastened to the wall to support your weight. There are specially designed commode chairs that can improve safety as well.
__ Not enough lighting? Too much glare?
Use maximum wattage bulbs allowed by each fixture. Use lights that shine directly on your work area for specific tasks. Use frosted bulbs, globes and shades on fixtures to reduce glare. Avoid shiny surfaces that may increase glare. If overhead lighting is not enough, add lamps. Consider installing motion detector lights that turn on automatically. Install easy-access light switches at the entrance to a room so you do not have to walk in the dark in order to turn on the light.
Always use a night light in the bathroom. Use a night light that automatically turns on in low-light situations. Make sure that you can light the path from your bed to the bathroom easily while en route. Keep a flashlight by your bed.
Make sure there is adequate lighting outside by walkways and entrances. Use a motion sensor light that will turn on whenever there is movement.
__ Furniture that is difficult to get out of?
Sit on furniture that has good back support. Firm chairs with sturdy armrests provide more support when rising. Add pillows to the back of the chair so that your feet rest firmly on the floor.
__ Unstable furniture?
Use tables that have four legs. Do not use tripod or pedestal tables. Repair the legs or add stabilizers to furniture that rocks or tilts when you lean on it.
__ Loose carpet or linoleum?
Tack down loose carpeting everywhere in your home, especially on stairs. Make sure that there are no curled or frayed edges. Replace missing linoleum or any tile that is broken or loose.
__ Spills or wet spots?
Wipe up spills immediately. Clean up any liquid, grease, or food spilled on the floor.
__ Gutters or windows that need to be cleaned?
If you use a stepladder, make sure someone is bracing it for you. Don't overextend your reach.
__ Cracks or uneven places in cement walks or stairways? Slippery pavement?
Patch cracks with filler before they spread. Avoid broken sidewalks. Be very careful on wet or icy pavement. Make sure your walkways are shoveled and cleared of ice and snow in the winter. Use salt or an ice-melting product to keep surfaces clear of ice.
Don't let a pet catch you by surprise by running through your feet. Always be aware of your pet's location.
When someone in your home uses a wheelchair, there are many things that can be done to improve access. Narrow doors can be enlarged and heavy or hard-to-open doors can be altered. Ramps can be added to entrances. Changes in the kitchen and bathroom can be made to accommodate wheelchairs as well.
This brochure does not include all potential causes of falls. It is not intended as medical advice and should not be a substitute for professional advice from your health care provider. Contact your doctor or health care provider if you have questions or need help making changes. Remember to keep a phone with emergency numbers within easy reach.
- The Fall Prevention Project, Southeast Senior Housing Initiative, Baltimore, MD, 1997.
- Safe at Home, Magee Rehabilitation Jefferson Health System, Philadelphia, PA, 2002.
- Home Solutions, American Association of Retired Persons, Washington, DC, 1999.
- Home Care of the Elderly, Sheryl Zang and Judith Allender, Philadelphia, PA, 1999.
- Home Safety Checklist, American Academy of Orthopaedic Surgeons, Des Plaines, Illinois, 2000.
- Check for Safety, Centers for Disease Control, Atlanta, Georgia, 1999.
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Living Space Inspection
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