As we get older, changes in balance, gait, strength, vision, hearing, and cognition make even the most youthful senior more prone to accidents. Falls can be a health risk for older people. This increased risk of falling is related to:
Aging process (eg, decreased muscle strength, slowed reflexes)
Higher incidence of chronic health problems (eg, arthritis, diabetes) that may limit mobility, agility, or sensory awareness
Side effects of medicine (eg, dizziness, blurred vision)—especially medicines like prescription pain medicines and drugs used to treat mental health conditions
Depending on the brittleness of your bones, the consequences of a fall can be serious and long lasting.
If you are an older adult, you may be able to prevent some home accidents by making simple lifestyle changes and basic modifications and repairs to the home environment. Here are some lifestyle changes that experts recommend:
Have your hearing and vision checked regularly. Be sure to wear prescription glasses that are right for you.
Speak to your doctor or pharmacist about the possible side effects of your medicines. A number of medicines can cause dizziness.
If you have problems with sleep, talk to your doctor.
Limit your intake of alcohol.
If necessary, use a cane or walker to help maintain your balance.
Wear supportive, rubber-soled shoes, even at home. If you live in a region that gets wintry weather, you may want to put special cleats on your shoes to prevent slipping on snow and ice.
Exercise regularly to help maintain muscle tone, agility, and balance.
Always hold the banister when going up or down stairs. Also, use grip bars when getting in or out of the bath or shower, or when using the toilet.
To avoid dizziness, get up slowly from a lying down position. Sit up first, dangling your legs for a minute or two before rising to a standing position.
Overall Home Safety Check
According to the Consumer Product Safety Commision's "Older Consumer Home Safety Checklist," it is important to check for potential hazards in each room. And remember, proper lighting is an essential factor in home safety. If you cannot see clearly, you are more likely to fall.
Important questions to ask yourself include:
Are lamp, electric, extension, and telephone cords placed out of the flow of traffic and maintained in good condition? Have frayed cords been replaced?
Are all small rugs and runners slip resistant? If not, you can secure them to the floor with a special double-sided carpet tape.
Are smoke detectors properly located—one on every floor of your home and one outside of every sleeping area? Are they in good working order? Are batteries replaced at least once a year?
Do you have a well-maintained carbon monoxide detector outside every sleeping room?
Does your furniture layout leave plenty of space to maneuver between and around chairs, tables, beds, and sofas?
Are hallways, stairs, and passages between rooms well-lit? Can you reach a lamp without getting out of bed?
Are floor surfaces well-maintained? Tile floors and polished wood floors can be particularly slippery. Stairs should always have handrails and be carpeted or fitted with a non-skid tread.
Is your telephone easily reachable. Is the cord safely tucked away?
Room by Room
In the Kitchen
Be sure your stove is in proper working order and always make sure burners and the oven are off before you go out or go to sleep.
Keep pots on the back burners, turn handles away from the front of the stove, and keep stove clean and free of grease build-up.
Kitchen ventilation systems and range exhausts should be working properly.
Keep flammable objects, such as towels and pot holders, away from the cooking area except when in use. Make sure kitchen curtains are tied back.
Move cords and appliances away from the sink and hot surfaces. If extension cords are needed, install wiring guides so they do not hang over the sink, range, or working areas.
Look for coffee pots, kettles, and toaster ovens with automatic shut-offs.
Keep a mop handy in the kitchen so you can wipe up spills instantly. You should also have a small fire extinguisher.
Arrange your kitchen with frequently used items on lower shelves to avoid the need to stand on a stepstool to reach them.
Make sure countertops are well-lit to avoid injuries while cutting and preparing food.
In the Bathroom
Use a non-slip mat or decals in the tub and shower, since wet, soapy tile or porcelain surfaces are extremely slippery.
Make sure bathroom rugs are non-skid or tape them firmly to the floor. Bathtubs should have at least one, preferably two, grab bars, firmly attached to structural supports in the wall. (Do not use built-in soap holders or glass shower doors as grab bars.)
Tub seats fitted with non-slip material on the legs allow you to wash sitting down. For people with limited mobility, bathtub transfer benches allow you to slide safely into the tub.
Raised toilet seats and toilet safety rails are helpful for those with knee or hip problems.
In the Bedroom
Make sure you use a nightlight and that the area around your bed is clear of potential obstacles.
Be careful with electric blankets and never go to sleep with a heating pad, which can cause serious burns even if on a low setting.
Use fire-resistant mattress covers and pillows, and NEVER smoke in bed.
Keep a phone next to the bed that is programmed to dial 911 at the push of a button.
If you have a chronic condition, you may want to sign up with an automatic call-in service. Typically the system includes a small pendant that connects directly to an emergency medical voice-response system. You should also make arrangements to stay in contact with someone—friend, neighbor, family member—on a regular schedule.
When cooking, wear short-sleeved clothing, never a bulky long-sleeved robe.
Check basements, garages, workshops, and storage areas for fire hazards, such as volatile liquids, piles of old rags, or clothing and overloaded circuits.
Never smoke in bed or when lying down on a couch or recliner chair.
Small portable electric or kerosene heaters are responsible for many home fires and should be used cautiously if at all. If you do use one, be sure to keep them away from flammable materials.
In case of a fire, make sure you have a pre-established emergency exit plan.
Have a professional check your fireplace and other fuel-burning appliances yearly.
Talk with your doctor or assisted living personnel about items that may help you to be safe as you go about your day. These may include bathing and mobility aids, household security devices, ergonomically designed knives and peelers, and faucet valves and knobs for temperature control. Medical supply stores and organizations are also good sources of information about products that improve your quality of life and ensure your safety.
Falls in the elderly. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated March 4, 2011. Accessed March 7, 2011.
Older consumer home safety checklist. Consumer Product Safety Commission website. Available at:
Universal design: home modification devices. American Association of Retired Persons (AARP) website. Available at:
5/28/2010 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed/what.php: Haran M, Cameron I, Ivers R, et al. Effect on falls of providing single lens distance vision glasses to multifocal glasses wearers: VISIBLE randomised controlled trial. BMJ. 2010;340:c2265.
3/7/2011 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed/what.php: Panel on Prevention of Falls in Older Persons, American Geriatrics Society and British Geriatrics Society.
Summary of the Updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons.
J Am Geriatr Soc. 2011;59(1):148-57.
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