Home safety for aging parents: five small changes that prevent falls I Live and Stay

A house does not stay the same house.

The building does not change, but the person living in it does, gradually and over years, and the house that suited her at sixty is quietly working against her at eighty-five. What makes this difficult to see is that she adapted. She stopped using the top shelf. She started holding the wall on the stairs. She takes the long way round the coffee table now. Each adjustment was so small that nobody noticed it happening, including her.

By the time a family walks through and really looks, there is usually a list. And most of it is fixable in an afternoon with no builder involved.

Here are the five that come up on almost every first visit we do.

One. The rug in the hallway

Loose rugs are the single most common thing we move.

They are also the most defended. That rug has been there for twenty years, it belonged to her mother, and suggesting it goes is not a small conversation. But a rug edge that lifts even slightly is a trip hazard exactly where people move quickly and without looking — hallways, doorways, the turn at the bottom of the stairs.

You do not always have to remove it. Double-sided carpet tape, a proper non-slip underlay, or a low-profile gripper along the leading edge will hold most rugs flat. If it curls at the corners and will not lie down, that one has to go.

While you are down there, look at what else crosses the floor. Phone chargers, lamp flexes, the extension lead that has run behind the sofa since Christmas.

Two. The light between the bed and the bathroom

This is the one to do first if you only do one.

The route from the bed to the bathroom at three in the morning is the highest-risk journey in most houses. She is half asleep, she may have stood up too quickly, her eyes have not adjusted, and she is moving with confidence because she has done it ten thousand times.

Put light on that route. Plug-in motion-sensor lights along the skirting are inexpensive and need no wiring. A lamp within reach of the bed that she can find without sitting up. A nightlight in the bathroom itself so she is not stepping from dark into glare.

Then walk the route yourself with the lights off and see what you actually hit.

Three. Anything kept on a high shelf

Look at what is stored above shoulder height, and then ask which of it she uses weekly.

The tea. The good plates that come down every Sunday. The tin she keeps the biscuits in. If she is reaching, stretching, or standing on something to get to any of it, that item is in the wrong place — and the stool she uses to reach it is worse than the shelf.

This costs nothing but an hour of rearranging. Frequently used things between waist and shoulder height. Rarely used things high or low. If a step stool is genuinely needed for something seasonal, it should be one with a proper handrail, used by someone else.

Four. The chair she actually sits in

Watch her stand up.

If she pushes off the arms, rocks forward to build momentum, or takes two attempts, the chair is too low or too soft for her right now. That chair may have been perfect for a decade. It is not a comment on the chair.

A firmer cushion often solves it outright and takes five minutes. Raising the whole chair on proper furniture risers is the next step. What matters is that she can get out of it under her own power, because a chair that is difficult to leave means she leaves it less often, and moving less is where a great deal of decline begins.

Do the same check on the bed and the toilet.

Five. What she holds onto in the bathroom

Everyone knows bathrooms are the risky room. Fewer people look at what is actually being used for support in there.

Very often it is the towel rail, the basin edge, or the shower screen — none of which were built to take a person's weight, and all of which will give way at the worst possible moment. A properly fitted grab rail in the right position is not a big installation and it is the difference between support that holds and support that comes off the wall.

Add a non-slip mat inside the bath or shower, and check the floor outside it. Tiles plus wet feet is the combination that catches people.

What this is really about

None of the above is about frailty. It is about a mismatch between a person and a building, and mismatches can be corrected.

There is a version of this conversation that goes badly — the one where adult children arrive, declare the house unsafe, and start removing things. It rarely lands well, because what she hears is that she is being assessed and found wanting in her own home.

The better version is slower. Walk through together. Ask what has become annoying rather than what has become dangerous. Fix the annoying things. Most of the safety improvement comes along for the ride, and nobody has had to be told they are declining.

If you want another pair of eyes on it, that is part of what happens on a first visit here. A Care Manager walks the house with you, looks at the actual routes and the actual routine, and tells you what would make the biggest difference. It takes about forty-five minutes and costs nothing.

Live and Stay is a licensed non-medical Home Care Organization serving Northern California since 2008. Formerly Geriatric Care Solution.