Falls Prevention in the Elderly: A Simple Checklist to Follow

preventing accidents

Falls prevention among the elderly is a serious issue to address.  The NHS reports that hip fractures alone cost an eye watering £2.3 billion every year.  There are many things you can do to help prevent falls in the home along with making it safer and easier for your parents or relatives to stay there longer.

Some changes are really simple and cheap, or you could go the whole nine yards…. you will need to assess how much needs doing, depending on their current health and mobility, and their home considering stairs, safety gates and rails and upkeep of gardens etc.

Home Assessment

The first part of falls prevention in the elderly is a home assessment which can be arranged if your relative is in hospital or if the GP is advising them to look at options for care. This is called a home assessment’ and is carried out by a team from social services and occupational therapy. Some or all of any changes could be funded by the local authority, such as a toilet frame, bed hoist, and alterations such as grab rails and ramps. 

Checklist for Adapting the House

It doesn’t have to be an exhaustive list, but making a few small changes may help with making life easier at home and preventing falls.  Some of it is not very pretty to look at unfortunately, and may make your family home resemble more of a care home, but needs must – and definitely worth it for independence at home.

Front Door and general access

If climbing the steps to the front door is difficult then a ramp would give better access. Although, make sure the ramps have a non-slippery surface, and of course make any “joins” into the front door or on to a garden path/driveway are as smooth as possible.  For someone living with dementia or with anxiety about their mobility and walking with a frame or sticks, different surfaces can be confusing, so minimising these are really important.

General Accessibility

As well as replacing steps with ramps you could make the doorways in the house the larger standard size, so you can get a wheelchair through; don’t forget to make the front door extra wide too.

External Key Safe

A ‘must have’ so you or a neighbour/carer can get access to the house quickly and safely if necessary (make sure the door cannot be locked from the inside with the key left in the lock – or put a key hook hidden, but near the inside of the front door for the keys if it is locked from the inside). A keysafe is also the obvious place to store the spare front door keys so they don’t go missing!  Its a good idea obviously to make the access code easy to remember – and known by those who need it, but not so easy for unauthorised access.

Raised Post Box

Simple changes like installing a raised post box can really help – no more bending down to pick up letters from the doormat every day – a bonus if you’re  a bit creaky or unsteady.

Personal Alarm System (linked to a local helpline)

Personal Alarms are a great help for elderly people who have falls regularly, and huge peace of mind for the rest of the family. With alarm pendants to be worn – and activated – so help is not so far away.  Alarms like these are called Telecare – and we’ve a section on all the different types that are available.

A stairlift or a lift

If climbing the stairs becomes an increasing concern, then a stairlift or a small internal lift might be the answer.  There are many different types and at different price points too, so shop around.  The clothes designer Zandra Rhodes apparently has a customised zebra-print painted stairlift – so you could always follow her lead!  Household lifts are also worth investigating as many don’t require enormous amounts of room to install.  However, it might be worth considering that should a wheelchair be used – a bigger lift area might be needed.

Downstairs Bedroom

If going upstairs to bed is becoming a chore or a challenge then maybe it’s time to have a bed downstairs, particularly if a stairlift or lift are not possible.  In some circumstances the NHS or care services provide hospital beds.  You might also be able to install a mobile wetroom in a downstairs loo – these are available to rent – and might be a good short term solution if moving downstairs is required.

Telephone with big buttons and loud speaker

There is lots of tech available – phones with good volume control and a loudspeaker, along with big buttons and easy to see numbers. Phones whether for landlines or mobiles should be as simple as possible, with no fancy features which are just confusing. Find some more ideas in Top Tips.

Lighting

You need lots of lighting, especially good ‘task lighting’ for reading, doing puzzles, sewing etc.  The new eco bulbs aren’t necessarily always great – so get those with the highest amp available.

Door Bells and access

Loud door bells and/or entryphones are a good idea.  Like phones, there’s lots of tech available in this area – but simple is good!  You can get doorbells that also light up if the hearing is really poor.  An entryphone so that you can see who is on the front door step is well worth considering.

Adapting the Bathroom

Wetroom/bathroom/loo

One of the most vulnerable places in the home is the bathroom. Wet-rooms are much more the norm these days so it might be easy to convert an existing bathroom into one, or to install one in a downstairs cloakroom or loo.  There are also mobile wet rooms available to rent – which could be a short-term solution.  A single flat slipfree surface throughout is best; maybe consider enough space for a wheelchair, along with additional grab rails  by the shower/bath/loo; also enough room to store and use a shower stool if someone is unable to stand up to wash very easily.  Shower curtains really get in the way- so maybe a glass door;ou might also need to put a raised seat over the loo and have enough room around it for wheelchair or zimmer/mobility assistance.  An occupational therapist will be able to advise on all of these for you – including where to site specific items.

Step-in bath

If your parent hates taking a shower, but can no longer get in and out of the bath safely, then you’ll wish you had one of those funny step-in baths.

Loo roll holders

It may sound silly but install those ones you just slide the loo roll on and off. Something so simple and easy will help a lot.

Adapting the Kitchen

Glass fronted kitchen cupboards

These can really help for obvious reasons- much less rootling around in the back of dark cupboards!

Hobs

Ceramic hobs stay hot dangerously long after you have turned them off (that’s if you remember to); naked flames on gas hobs are scary. But just as important is a hob with easy to use knobs. Do your research and make sure you go and try out the knobs before you buy, they need to be easy to twist with clear markings.   If you install an induction hob be sure to test out the saucepans first as they can be really heavy to lift.

Lots of kitchen drawers

Drawers are much easier to use as they make it easier to find things rather than at the back of cupboards.  Below the counter drawers are great for crockery, easier to lift and carry from a drawer below than a cupboard above.

Oven Knobs

Like the induction hob, the same goes for these; they have to be easy to turn for fingers with arthritis.

 Microwave

Increasingly essential particularly for ready meals or for heating small amounts of food. Big buttons and easy to read dials/instructions.

Floor Surfaces

A  useful idea is to have a single hard floor surface throughout the home (e.g. wood, with no threshold to trip over); this is particularly helpful for mobility for someone living with Dementia or Alzheimer’s, as changes in floor surfaces can be confusing and cause stumbling. And to be really practical, if there are regular accidents in the bedroom or kitchen, a hard surface is much easier to clean than a carpet.

Along with adaptations, you might also want to think about more care at home. Another good place to look for things which can help make life easier as people get older is Spring Chicken.

Have you got some good ideas for making it safer and easier to live at home, or want to see what others are suggesting? Join the conversation and share your knowledge in the Age Space Forum.