Everyday home-safety questions for families

Falls are a serious risk for older people. The World Health Organization reports that adults over 60 suffer the greatest number of fatal falls, and that most deaths from falls happen in low- and middle-income countries. Many falls have more than one cause: weaker muscles, poor eyesight, side effects of medicines, and something in the home such as a loose rug or a dark step.

You can't remove every risk, and a home should still feel like home, not a hospital. The aim is to find the changes that make the biggest difference for this particular person. Use the questions below on your next visit, or ask someone in Ghana to go through them with you over a video call.

Getting about the house

• Are walkways clear of clutter, shoes, loose wires and low furniture?
• Are rugs and mats fixed down, or could they slide or curl at the edges?
• Are there steps between rooms, or into the compound, without a rail to hold?
• Is the floor slippery when wet, for example near the kitchen, the shower or the outside tap?
• Can the person get up from their usual chair without pushing on unstable furniture?
• If they use a walking stick or frame, is it the right height and in good condition, and do they actually use it indoors?

Light, day and night

• Is there a light switch they can reach at the entrance to each room, without walking in the dark?
• Is the route from the bed to the toilet lit at night?
• What happens during a power cut? Is there a torch or rechargeable lamp within reach of the bed?
• Are stairs and outside steps well lit after dark?

The bathroom and toilet

The bathroom combines water, hard surfaces and movements that need balance.

• Is there a non-slip mat in the shower or bath area?
• Is there something firm to hold when getting up from the toilet or stepping in and out of the shower? Grab rails, fitted securely, are safer than towel rails or basins.
• Could the person sit to wash, on a sturdy shower chair or stool?
• Is the water heater, if there is one, set so the water can't scald?
• Can the bathroom door be opened from outside in an emergency?

The kitchen

• Are everyday items kept between waist and shoulder height, so there's no climbing or bending low?
• Is the gas cooker or coal pot used safely, and is the gas cylinder stored and checked properly?
• Are there signs of pans left on, or food left out too long?
• Is drinking water easy to reach and pour?

Heat and hydration

Older people are less able to regulate their body temperature in hot weather, and they are more likely to become dehydrated, which can cause dizziness and falls.

• Is there a cool place to rest during the hottest part of the day, with a fan or good airflow?
• Are curtains or shutters closed against the sun in the afternoon and opened in the cooler evening?
• Are drinks always within reach, including at night?
• Does someone check on the person during very hot spells?

Health, eyes and medicines

Some of the most important questions aren't about the house at all.

• Has the person had their eyes tested recently, and do they wear their glasses?
• Has anything changed with their hearing? Ear problems can affect balance.
• Are they taking any medicines that make them dizzy or drowsy? Ask their doctor or pharmacist to review them, especially if there have been falls. Don't stop or change medicines yourself.
• Do they wear shoes or slippers that fit well and have a good grip, rather than loose sandals?
• Are they staying active? Gentle activity and strength and balance exercises, where their doctor agrees, help keep people steady.

If a fall happens

• Can the person call for help? Is a phone within reach, and do they know who to call?
• Does someone check on them every day if they live alone?
• Does everyone in the household know not to lift someone who may be hurt, but to make them comfortable and call for help?

If someone has fallen and may be injured, or hit their head, or can't get up, call 112 or take them to the nearest emergency department. Tell their doctor about any fall, even one without injury.

Making changes that last

1. Start with the person. Ask what they find difficult or worry about. They'll know where they nearly slip.
2. Pick the top three changes, such as a night light, a grab rail and fixing a rug, rather than trying to change everything at once.
3. Agree who will do each one, and by when.
4. Check again after a few months, or after any fall, illness or hospital stay. Our guide to getting the home ready after hospital covers what to check before a discharge.

A home safety and falls-risk check can go through the home with you and write up suggestions. It's a practical check, not a building or electrical inspection, and changes to the home are always the family's decision. If the person needs a hand day to day, help with moving about safely can be part of a care plan.

Sources

1. Falls (fact sheet), World Health Organization (checked Invalid Date).
2. Falls: prevention, NHS (UK) (checked Invalid Date).
3. Heatwave: how to cope in hot weather, NHS (UK) (checked Invalid Date).

This guide is general information, not medical advice for a particular person. Talk to the person's doctor about their health, treatment and medicines.