Main causes of falls within the home
Stairs
Stairs are a common cause of falls. Even small details like busy carpet patterns can make seeing where to place your feet more difficult, especially for those with poorer vision. Ensure any carpet is tightly fitted with no ridges. If at all possible, only fit plain light-coloured carpet as this makes it easier to see the individual steps. Make sure the staircase is well-lit. A second-hand rail can dramatically reduce the risk of a fall and can normally be obtained through your local authority after a short Occupational Therapy assessment. This can be arranged through your or your loved one’s GP or through the local authority’s Social Care Department.
Furniture
Prevent trips over smaller pieces of furniture, furniture legs or coffee tables. Encourage the use of mobility equipment and not to “Furniture Walk” especially using light furniture for support like a dining chair. Arrange living spaces with plenty of space to move around the room and to allow easy access for those with walking frames etc: This might be best achieved by putting furniture against walls or even removing some furniture particularly those items rarely used.
Flooring and rugs
It’s important that all floorings are in good condition, with no loose floorboards or poorly laid carpet. Ensure that carpet is laid tight and that there are no ridges in it. Ensure that carpet grippers and room dividers are well-fitted and not loose. Rugs can also be an easily overlooked trip hazard. It might be a rug that you have had for many years and not really noticed that it is turning up a little through age, or a thick rug in front of the fire for example that someone could easily catch their feet under.
Clutter
Clutter such as stacks of newspapers and magazines or wires across the room are easy to trip over. Remove unrequired furniture like small tables or move tables or lamps against the wall to make more room and open up passageways. Keep the floor space as clear as possible, using storage and cable tidies.
Lighting
It is so important that there is adequate lighting around the home, especially in halls that connect commonly used rooms at night i.e. between a bedroom and bathroom. There’s a wide variety of additional lighting available, from touch lighting to motion sensor lights. These can help those with impaired vision and those that may have cognitive impairment who would not think to turn on a light for themselves.
Temperature
Not many people think about temperature and falling, but if it is too hot, it can cause dehydration which leads to dizziness. Similarly, being too cold in your home can cause illness, which again makes you more susceptible to falling or fainting. Set central heating thermostats to maintain a constant temperature during colder months. Have thermometers around the home to indicate the temperature (these are readily available from a number of charities and are free of charge). If using electric or oil-filled plug-in heaters, ensure they are in a safe position with no trailing wires (tape them to the floor if necessary) and are unplugged when not in use. During hot weather ensure there is plenty of ventilation by opening windows. If using electric fans, as with heaters, ensure there are no trailing wires.
Pets
Pets can be great companions to older people and there are many studies that link the benefits of pet ownership to reduced blood pressure and stress. Unfortunately, pets like dogs and cats can “get under the feet” of their frailer owners and can cause falls. Put pets in a room that is not going to be entered by the person at risk before they mobilise and only let them back in once the person has sat back into their chair.
Low plug sockets
Many falls take place when elderly or frail people are turning off or removing plugs from their sockets. Most houses have plug sockets in the living and bedrooms that are at skirting board height. Consider remote-controlled plug socket adaptors. These plug into the socket and the appliance then plugs into the device. This allows the power to be turned on and off from the appliance using a small remote-control device which negates the need to bend down and remove plugs which are very often located in difficult places.
Weather
The weather can be unpredictable, especially in the UK! Rain, ice, and snow can all cause mobility problems and make an otherwise safe pathway very slippery. The weather outside can also be transferred indoors and cause slippery floors. Be sure to wear sensible shoes with rubber soles for better traction. Use floor mats when entering your home to soak up moisture from your shoes to prevent yourself or others from slipping. A handrail beside any steps or leading up to the house can provide additional support.
Footwear
Inappropriate shoes and slippers are a major contributor to trips and falls. Sturdy slippers with a rigid sole and Velcro fastenings ensure a good fit and improve stability and grip indoors. Outdoor shoes with a rubber sole and without laces reduce the risks of falls, and of laces becoming undone.
Bathrooms
Many falls take place in the bathroom and not normally because of wet floors although obviously this can be a contributing factor. Slips and falls in the bath or shower are very common and difficulty getting on and off the toilet is another high-risk manoeuvre for someone who is elderly, frail, or has mobility problems for another reason. There are many aids and adaptations that can reduce this risk and make personal care much safer for anyone who falls into this category. Also, many bathroom doors open inwards and therefore when closed can trap someone who has fallen in the bathroom making them non-accessible.
Bathroom doors
Leave the bathroom door open when taking a bath or shower. If dignity is a problem, remove the door and fit a concertina door into the existing framework and save the original door for refitting at a later date.
Bathroom general
Raised toilet seats or toilet frames can make getting on and off the toilet much easier and safer. Bath steps reduce the height of the bath or the step into a high shower tray and reduce the need for stretching. Shower seats, chairs or bath boards enable someone to shower whilst sitting down making it a much safer environment. Strategically placed grab handles make it safer for a person to keep their balance whilst entering a bath or shower and therefore much less likely to take a fall. They can make it easier to get off the toilet as well and prevent the use of much riskier manoeuvres like grabbing hold of a towel rail or hot radiator to assist.