A fall at home rarely starts anywhere dramatic. It starts on a loose stair tread, or in a dark hallway on the way to the bathroom.
Preferred Care at Home of MetroWest Boston wrote this checklist for families in Framingham and the towns around it. Home is where memories have been made, and are still being created, and a few changes keep your loved one’s dignity and independence intact there.
This is fall prevention at home in the order you’d actually move through it. Bring a notepad and a flashlight, start at the front steps, finish in the bedroom, and fix what you can that same week.
Why One Afternoon Is Worth It
More than one out of four older people falls each year, according to the Centers for Disease Control and Prevention.
Falling once doubles the chance of falling again, the CDC reports. Falls are also the most common cause of traumatic brain injuries for older adults, per the same CDC data.
The CDC counts about 4.5 million emergency department visits a year from older adult falls. Yet less than half of the older people who fall tell their doctor, the agency adds.
That’s why we start with the house. A family can move a rug or add a rail without waiting for anyone to admit a close call, and a home safety checklist for seniors only works if someone walks it with a pen in hand.
Start at the Front Door, Ice and All
Stairs and steps, indoors and outdoors, open the CDC’s Check for Safety checklist, and so do we. In a New England January that means the front steps, where the walk freezes overnight and the sun is down before most people get home from work.
- Every outdoor step is even, with no loose or crumbling treads
- A sturdy handrail runs the full length of the steps
- An outdoor light covers the steps and the path to the driveway
- A bucket of sand or ice melt sits just inside the door before the first storm
- Someone is lined up to shovel and salt after every snowfall
- Packages and boots stay off the steps
We’d rather see an older adult wait an hour for the walk to be sanded than step onto fresh ice to get the mail. Plan the shoveling now, while the ground is still bare.
Stairs Get Two Rails and a Switch at Each End
Handrails belong on both sides of the stairs and as long as the stairs themselves, per the CDC checklist. It also calls for an overhead light with a switch at the top and at the bottom.
- Both handrails stay tight when you pull on them hard
- Carpet is firmly attached to every step, or replaced with non-slip rubber treads
- The switches work from both ends (the CDC notes you can buy switches that glow)
- No stairway bulb is burned out
- Nothing waits on the steps to be carried up later
Changing a stairway bulb means a ladder, and that’s the first job to take off an older adult’s list. The CDC’s own advice is to have a friend or family member do it.
Clear the Floors in the Living Room and Kitchen
Furniture and cords are the floor questions on the CDC checklist: do you have to walk around one or step over the other to cross a room? If the answer is yes, the room needs rearranging before it needs anything new.
- A clear path through every room, with chairs and side tables moved aside
- Throw rugs removed, or held down with double-sided tape or a non-slip backing
- Lamp and extension cords coiled or taped along the wall
- Newspapers and shoes picked up and kept off the floor
In the kitchen, the CDC asks whether the things you use often sit on high shelves. Move everyday dishes and the coffee to the lower shelves, about waist high, as the checklist suggests.
A step stool that stays in the house should have a bar to hold on to, and a chair should never stand in for one, the CDC says. Once the everyday things come down, put the stool in the garage for good.
The Bathroom Is Where Grab Bars Earn Their Keep
Grab bars go next to and inside the tub, and next to the toilet, according to the CDC checklist. A towel bar is not a grab bar, and nobody should pull on one to stand up.
- A non-slip rubber mat or self-stick strips on the tub or shower floor
- Grab bars at the tub, inside the tub and beside the toilet
- A shower chair if standing through a whole shower is tiring
- A bath mat with a rubber backing on the floor outside the tub
- Towels and soap within reach from a seated position
Water on tile makes this the room where a fix pays off fastest. If you only have an hour, spend it here.
The Bedroom and the Walk in the Dark
A lamp close to the bed and a nightlight on the path to the bathroom are the CDC checklist’s two bedroom fixes. Both matter more in a New England December, when it’s dark before dinner and still dark at breakfast.
- A lamp you can switch on while still lying down
- Nightlights along the whole route to the bathroom (some go on by themselves after dark, the CDC notes)
- Slippers and laundry baskets cleared from that route
- A phone or emergency call device that reaches the bed
A nightlight in every outlet on that route beats anything else on this list for the money. It’s the easiest fix in the house.
Shoes, Pills and the Next Doctor Visit
Every medicine deserves a review by a doctor or pharmacist, even over-the-counter ones, says the CDC’s What You Can Do to Prevent Falls brochure. Some medicines, or mixes of them, can make a person sleepy or dizzy, the brochure warns.
- Bring every pill bottle and sleep aid to the next appointment
- Ask the provider whether vitamin D makes sense
- Book an eye exam once a year and update glasses if needed
- Have feet checked once a year and talk about footwear
- Trade backless slippers for well-fitting shoes with good support, indoors and out
Tell a provider right away about any fall, or any new feeling of being unsteady. A stumble in the kitchen is news worth one phone call.
Balance Classes Around MetroWest
Tai Chi is the CDC brochure’s example of an exercise that improves balance and makes legs stronger. Its Check for Safety checklist sends readers to a local community or senior center for fall prevention programs.
In MetroWest, that means your town’s council on aging. The Massachusetts Department of Public Health helped found the Massachusetts Falls Prevention Coalition in 2006, and councils on aging are part of it.
The coalition now counts nearly 100 member organizations. A weekly class beats a video at home, because a room full of neighbors keeps people coming back in February.
What a Caregiver Keeps Up After the Audit
Our caregivers are screened through our 7-step process and matched to your loved one by personality. They’re experienced and trained caregivers, including CNA and HHA professionals.
Once the audit is done, a caregiver keeps the house the way you left it:
- Picking up shoes and mail before they reach the stairs
- Offering a steady arm on the walk to the car and at appointments
- Giving assistance with bathing and transfers, the moments the bathroom list is built around
- Medication reminders at the times the doctor set
- Spotting the new hazard, like a burned-out bulb or a rug that’s started to curl
Our personal care covers assistance with bathing, dressing and moving safely around the house. For families facing memory loss, our dementia care adds safety monitoring and fall prevention from caregivers trained in memory care approaches.
Care runs from one hour a day to 24 hours, with 24/7 availability for urgent needs, and we accept long-term care insurance. Families who live farther away can follow visits and caregiver notes in our Transparency of Care portal.
Start with a few hours a week around showers and errands rather than letting a fall set the schedule. Call Preferred Care at Home of MetroWest Boston at (508) 375-7174, or Get Care Now with our Framingham office at 945 Concord St.
