Guides


Safety Guide on Preventing Falls in the Home

The following is a Guide on Preventing Falls in the Home. Practicing safety begins in the home. People with disabilities often face challenges in balance, mobility, hearing, vision, and endurance that can affect their ability to live independently in the home. Keeping your home safe becomes even more important when faced with these challenges. Falls can cause broken bones or have an affect on your health that can lead to losing your ability to live independently. Broken bones, especially for older people who may not heal as quickly, can be the start toward greater immobility which excacerbates other health problems. As there are many people and caregivers who face this safety issue, we are including this guide in the hope it will benefit our readers.

The purpose of this guide is to provide information for people with disabilities ages 18-59, however, it is important for those with disabilities and elderly to assess their home safety as well.

New Horizons Un-limited assumes no responsibility in guaranteeing the services, programs or conditions as described. The information provided to you is for educational purposes only. It is not intended to take the place of your doctor or other healthcare professional. This resource is intended to help you make decisions and get the most from the medical services available to you. A licensed physician should be consulted for diagnosis and treatment of all medical conditions. If you are interested in a resource listed below call or contact the resource to verify the current situation. Evaluate information and make your own decisions when using the guide.

To Begin....

  • Assess your abilities and be aware of changes in your abilities.
  • Stay as active as you can.
  • Be ready to make some simple changes around the home to make areas safe.
  • Check with your doctor or other health care professionals for other specific recommendations for your home.
  • Check out home modification resources for ideas and products.
  • Assess your resources. Who can you ask to help you make the changes; family and friends?
  • If the change will require a home repair, assess your financial resources. Check to see if you qualify for financial assistance for home changes.

Begin by assessing your situation:

    Balance - Finding and keeping our balance is a key component in getting around safely. Unfortunately there are many conditions that can upset our balance and make it more difficult for us. Understanding the factors that can lead to your experiencing balance instability is very important. For instance, Vestibular Disorders are disorders of the inner ear that cause imbalance, vertigo, dizziness, tinnitus, and hearing loss. People who lose function of balance can compensate with other sensory input, however, keeping the sensory input clear of obstacles will be very important to maintaining your balance. Other conditions such as diabetes, heart disease, or problems with you thyroid nerves, feet or blood vessels can affect your balance.

    • Removing or replacing loose area rugs with securely mounted carpet may become necessary.
    • Keeping hallways and pathways clear of obstacles may become mandatory.
    • Installing handrails and grabbars in showers, tubs and around toilets can prevent many falls.
    • Stand up slowly from a sitting or lying position as changing quickly can cause a drop in blood pressure that can have an effect on your balance.

    Mobility - Your ability to be mobile may be dependent on support products such as a cain, walker or a wheel chair. Make sure your supports are the right size for you and are constructed well. Many of these products may require specific floor conditions. Obstacles can greatly hinder your mobility.

    • Keeping hallways and pathways clear of obstacles may become mandatory.
    • Special considerations may be needed for flooring materials.
    • Removing or replacing loose area rugs with securely mounted carpet may become necessary.
    • Be aware when out and about for uneven walkways.

    Hearing - If you are beginning to have hearing problems or have a hearing impairment that is changing, you may not be able to tell direction of sound. This can put you at a greater risk for falling. You may not be able to hear someone coming toward you or you may change direction too quickly, or someone else can move too quickly and startle you. The result will be you find yourself bumping into something or someone that causes you to fall because you did not hear them.

    • Have your hearing tested.
    • If you have a hearing aid make sure it is calibrated correctly and that you wear it.

    Endurance - Keeping an overall health and physical activity can help improve muscles and keep you strong and flexible. Activities assist your body to be able to lift your feet over obstacles and balance on one foot or the other when transferring your weight while moving.

    • Walking or climbing stairs are particularly helpful to stay active.
    • If you struggle with your gate or standing for long periods, ask your doctor for mobility equipment listed above. It is better to use an assistive device than risk a fall.
    • Being tired or fatigued can have a greater risk for falls so be sure to get enough sleep.
    • Be careful with alcohol consumption as alcohol can affect your balance and your reflexes.

    Visibility - Changes in vision can increase your risk for falling. Changes in your eyeglass prescription can be hard to get used to.

    • Be sure to look where you are going and not assume your path is clear, especially on stairs and uneven flooring or walkways.
    • Turn on lights to ensure a well lit path at all times.
    • Keeping pathways clear of obstacles is important and discussed below.

    Medications: Medications can have an affect on your balance and create more of a risk factor for falls. It is important to continue with your physician prescribed medication. Tell your doctor or pharmacist if you are experiencing effects such as being dizzy or sleepy when using medications.

    Reach: - It is when we have to reach beyond our endurance that we can risk a fall. If you have to reach too far for your slippers at night, you may fall out of bed or topple over from a sitting position. If you have to reach too high or out in front of you, you may transfer your body weight and tumble down.

    • Keep items that you use often within reach, on a bedstand in the bedroom, in a convenient drawer in the kitchen, or on a table in the living room.
    • Obtain a reach device or have several throughout the house, if necessary for picking up items off the floor or on shelves.
    • If you need to reach something higher and unsure of your step, be sure to use a good step stool with a handrail.
    • Do not carry an item up the stool, but have someone help you once you are on the stool and avoid moving something heavy.
    • Avoid using ladders or stools if you are unsure of your balance.
    • Ask someone for help.

    Unexpected barriers: - It is the obstacle on the floor, a table leg or a misplaced piece of clothing or furniture that can cause a fall. Pets and leashes are also hazards to falling. Be aware of your pet when walking, especially when you turn around in a room or stand to leave a chair. Animals may fall asleep or lay down underfoot.

Identify your needs:

What kind of simple changes do you need to make around the home to make areas safe and prevent falls.

  • Bathroom -

    • Floors - install a nonskid surface, remove loose area rugs and install nonskid mats on areas that may get wet. Remove spills.

    • Showers and tubs - Add the following to the shower or tub: grab bars, padded shower seat, and hand-held shower. Add a stool or bench if you need to sit while bathing.

    • Toilet areas - Install grab bars for safety at the toilet.

    • Remember to use lights. Turn night lights on before retiring.

  • Bedroom -

    • Floors - Remove loose area rugs, or be sure carpet is secured to the floor, remove clothing or other objects from the floor before retiring to prevent tripping on obstacles in the night.

    • Lighting - Locate lamps to be reached from bed. Turn on nightlights before retiring for egress to bathroom or kitchen. Remember to use lights!

    • Emergency - Locate telephone or other identification communication within reach of the bed. Keep emergency numbers in large print in convenient locations.

    • Clothing - Do not wear long nightwear or robes on which you may trip. Wear skid free slippers.

    • Keep items that you may need during the night within reach of the bed - such as glasses, tissue, book, shoes or slippers.

  • Kitchen -

    • Floors - remove loose area rugs

    • Cabinets - Arrange frequently used items within reach. Acquire a sturdy stool or ask someone to reach objects that are too high

  • Living Room -
    • Floors - remove loose area rugs or be sure carpet is secured to the floor.

    • Arrange electrical cords safely out of the way.

    • Arrange furniture so you can move around easily.

  • Stairways, hallways

    • Remove loose rugs and be sure carpet is secure. If your stairs are carpeted,wear non-skid shoes or slippers.

    • Keep stairs or any where you walk clear of obstacles. Keep all floor pathways clear of books, toys, clothes, bags, shoes, or electrical cords.

    • Make sure that the stairs or long hallways are well lit with access to switches at both floor levels. Remember to use lights!

    • Install handrails on both sides of the stairs if necessary. If you are carrying items on the stairs do not let the object block your view of the stairs and hold it in one hand and use your other hand to hold on to the handrail.

    • Look where you are going!!! Pay attention to walking on the stairs and do not be distracted by others talking or be in a hurry or using a phone. Do not assume any step, including the last step. Many falls occur at the bottom of the steps because people think they are done too early and have to step too far, roll their foot on the edge of a step, or fall forward because the bottom comes more soon than they expect. Again look where you are going and be sure of each footing!!!

    • Add brightly colored tape to the edge of the steps to make them more visible.

  • Entrances -

    • Keep floors dry and clean of water or soaps that can be slippery.

    • Spread sand or salt on icy areas of outdoor walkways. Be sure to wear non-skid footwear outdoors when it is necessary.

    • When moving from one surface to another be mindful of different heights or surface conditions of thresholds, porches, steps, ramps.

Adaptive Products

The following adaptive products may help you in making any of the above changes.

  • Grab bars - are bars mounted on the wall secured within the studs or structure of a wall securely to assist with accessibility for people with disabilities. When placed near a toilet, they are used for people to grab for stability when transferring to or from the toilet. When placed in the shower they assist a person with stability and ease of movement. Grab bars can be mounted vertically, horizontally, or at an angle.

  • Stools - strong, sturdy and anti-tip and anti-slip are the design considerations for any stool. Visit the following websites to get an idea of what may be a solution for a stool-Saf-T-Stool, Duro Med Step Stool with Handle

  • Night lights - a night light on your bed stand, in the bathroom and kitchen will help you find your way safely in the night. There are the stand alone, the kind that plug into an electrical outlet or you may need one that you tap on when needed.

  • Identification

  • Padded shower seats - The shower is the most commo place to fall in a home, because of slipping. Prevent falls by allowing one to sit during a shower. Padded shower seats should be sturdy and water proof. There are shower benches that allow you to transfer as well.

  • Hand held showers - allows one to bathe while sitting on a shower chair or bench.

  • Handrails - Add handrails to all steps, stoop for stability and safety. Build handrails beyond bottom step for extra safety.

  • Safety kit

    • Your safety kit may include:

      • Flashlight and Batteries

      • Battery operated Radio

      • First Aid Kit with pain medication or any prescription medication, and an ice pack.

      • Fire Extinguisher

      • Canned Food or bagged food, Bottled Water, Juices, non-electric can opener or tool.

      • Sturdy Shoes, work gloves and blankets

      • Spare Key for the Car

      • Cellular phone if you have one or emergency signaling system.

    • For information on how to set up your own safety preparedness kit in case of emergency situations that require evacuation, see the Easter Seals Evacuation Planning Support Key Safety Considerations for People with Disabilities. Easter Seals created a national public education campaign, S.A.F.E.T.Y. first: Working Together for Safer Communities as a response to their growing national concern for personal safety. It's a set of key questions, resources and an excerpt from BOMA's, Are Your Tenant's Safe? that gives everyone a place to start. Their emphasis is on learning from specific solutions of people with disabilities and other special needs. Using the S.A.F.E.T.Y. first kit as a guide, the first step is for businesses to work directly with employees that have disabilities and special needs to develop a personal evacuation plan. As individual needs will vary, people with disabilities are best suited to identify their specific evacuation needs. Once identified, those needs can be integrated into existing evacuation plans — likely providing new insights and essential changes to existing plans. For more information on the S.A.F.E.T.Y. first kit, check out this website.

  • Medical or Home Alert - Do you live alone? Have you considered a medical alert system? You wear a button on your wrist or around your neck, that will use a device in your home to transmit an emegency signal to the medical alert company with whom you contract. You can find "medical alert"services in your yellow pages. This device and monitoring system will cost and insurance companies and Medicare do not cover these systems.

Identify your resources:

    Identify your resources and begin to gather information from these resources. Contact your doctor or other health professionals for any additional recommendations for you in your home. Contact your local Center for Independent Living or other agencies or demonstrations homes for assistive technology assistance, ideas or specific products for changes for the home. Ask family and friends to help you in making the changes required. If you are going to have to make some home repair, identify your financial resources and state and county home repair programs.

    • Doctor, hospital
    • Friends, neighbors, and family
    • State and county home repair programs
    • Insurance or financial resources
    • Area agencies on aging
    • Local library
    • Yellow pages either online or local telephone book
    • Disability organizations
    • Clergy or religious organizations

Home Modification Resources

Insurance or Financial Assistance:

  • Do you need to seek insurance coverage or government financial assistance for a home repair?

  • There are financial options available for making home modifications. See NHU's Guide to Buying a Home for People with Disabilities: Accessible Homes and Accessible Home Modifications.

  • If you are seeking financial assistance from the government or your insurance company, check that the home repair you need is covered. Apply as soon as you can to the government financial assistance program and check whether you will ever actually be served by the assistance for which you apply, or you may end up for many years on a government financial assistance program waiting list.

State and County Home Modification Programs:

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