A room-by-room home safety checklist for aging parents

A useful home safety checklist for an elderly parent follows the route they walk every day and looks for what causes falls: stairs with a rail on only one side or none, dark halls, a slippery tub, loose rugs, and icy front steps. Most of the fixes are small. Walk the house with your parent at the times of day they're actually up and moving, and write down every spot where they put a hand on a wall or a chair back to steady themselves.

How to walk the house

Go in the evening as well as during the day. Dim light changes everything. Ask your parent to show you how they get from bed to the bathroom at night, how they get into the shower, and how they carry the laundry. Then watch instead of asking. People rarely bring up the things they've quietly stopped doing, like using the upstairs tub or going down cellar.

If you can, ask their doctor for an occupational therapist's home safety evaluation. An OT looks at how your parent moves, not only at the house, and recommends specific equipment and changes. For families in Saratoga County, going through this list first makes that visit, and any talk with a contractor, go a lot further.

The way in

Start outside, at the door they use most. That's often the side or back door off the driveway, not the front.

• Rails on both sides of the entry steps, solid and easy to get a hand around
• Even steps, with no heaved or cracked treads. Freeze-thaw moves steps around every winter here; see concrete and wood step repair
• A light over the door on a switch or a motion sensor, and a path light from the driveway
• A shelf or bench to set the groceries on while they find their keys
• A plan for who shovels and puts down salt or sand, and how soon after a storm
• No tall threshold at the door for a toe to catch on

If the steps themselves are the problem, our post on wheelchair ramp vs steps lays out the options.

Stairs

Stairs are where we'd look hardest. Code calls for a handrail on stairs with four or more risers, 34 to 38 inches above the nosings. One rail meets the code. Two rails, one for each hand, are far safer, and on the way down a person's stronger hand is often on the side with no rail.

• A handrail on both sides, running the full length of the stair
• Every rail solid when you pull on it hard. A wobbly rail is worse than no rail, because people trust it
• A light switch at the top and at the bottom
• Tread edges you can see. Contrasting tape or a painted stripe on each nosing helps older eyes
• Carpet tight, with no loose runner and no worn nosings
• Nothing stored on the steps

Give the basement stair the same look, especially if the washer and dryer are down there. Cellar stairs in older houses tend to be steep and dim, with a rail on one side if you're lucky. More in when stairs need a handrail.

Bathroom

• Grab bars at the toilet and in the tub or shower, anchored into blocking or studs. A towel bar won't hold a person
• A non-slip mat or a slip-resistant floor
• A handheld shower head and a shower seat
• A toilet high enough to stand up from easily. Comfort-height toilets run 17 to 19 inches to the seat
• The water heater set low enough to prevent scalding. About 120 degrees F is common guidance
• A night light on the route from the bedroom
• A door that swings out or slides, so someone who falls against it can still be reached

Watch your parent get in and out of the tub. If stepping over the side is a struggle, a walk-in shower may be the long-term answer; see tub to walk-in shower conversion.

Bedroom

Check that the bed is a height that makes sitting down and getting up easy, and that there's a lamp or a switch they can reach without getting up. The path to the door and to the bathroom should be clear of cords and rugs. Keep a phone or a medical alert button within reach of the bed, and clothes stored between hip and shoulder height so nobody's climbing or bending to the floor to get dressed.

Kitchen and living room

Everyday dishes and food should be reachable without a step stool. Lever faucet handles are easier on stiff hands than knobs. Take up throw rugs, or at least put non-slip backing under them. Move furniture so there are wide, clear paths through the room, and make sure there's a chair with arms to push up from. Test the smoke and carbon monoxide alarms on every floor.

Light everywhere

Lighting is one of the cheapest fixes and one of the most effective. Older eyes need more light, and they adjust slowly going from a bright room into a dark hall. Brighter bulbs, switches at both ends of halls and stairs, lighted switches, and plug-in motion night lights all help. If a lighting change needs new wiring, have a licensed electrician do it.

What to do this week, this season, and later

This week, pick up loose rugs, clear the stairs and walkways, add night lights and brighter bulbs, test the alarms, and move everyday things within reach. None of that needs a contractor.

This season, add a second stair rail, put in grab bars and a handheld shower, fix uneven entry steps, and add outside lighting.

Further out, plan the bigger changes: a walk-in shower, wider doorways, a safer entry, or a bedroom and bath on the first floor. Our aging in place guide for Saratoga County covers what order to do them in.

Frequently asked questions

What causes most falls at home?

Stairs and bathrooms account for a lot of them, along with trip hazards like rugs and clutter, and poor lighting. That's why this list puts rails, grab bars and lights first.

How do I bring this up with a parent who doesn't want changes?

Talk about what they want to keep doing, like staying in the house or cooking for the family. Start with changes nobody notices, such as better lighting, and grab bars that look like ordinary towel bars and fixtures.

Who can do a professional home safety evaluation?

An occupational therapist, usually through a doctor's referral. They look at the person and the house together and make specific recommendations.

Safe at Home is the service we're preparing for Saratoga County families: home safety assessments, stair rails, grab bars and accessible bathrooms. It's not open yet. You can join the waiting list on the Safe at Home page.