Slips, trips or falls can happen at any time of life, however, the likelihood of having a fall and the impact that this can have on health and independence becomes more significant with age.

Falls are a major cause of hospitalization, especially amongst the elderly. For some people the consequence can be quite devastating resulting in loss of confidence, permanent injury and a restricted ability to lead an active, independent life.

Around 75% of falls occur in or around the home, but many of these can be prevented by being aware of personal risk factors, finding safer ways of performing tasks and making simple and practical adjustments to the home environment to reduce slipping and tripping hazards and improve safety.

 

Lighting

• Ensure that there is good lighting in and around the home and that switches are easy to reach. Sensor lights can be strategically placed along hallways and at entrance doors to help with night time visibility.
• Glow in the dark products can be placed next to or on door handles, light switches and other objects that may need to be located in the dark. Luminous reflective tape can be used to mark exits, stairs and other hazards.
• Allow time for eyes to adjust when moving from brightly lit areas to darker areas and vice versa. Decrease glare by adding net curtains.

Floors, Stairs and Hallways

• Check carpeting regularly for worn spots or raised patches. Avoid using throw rugs and runners but if required secure them with carpet tape to prevent slipping. Avoid polishing floors with wax or other slippery materials.
• Use contrast to highlight changes in floor surfaces and depth. Avoid heavily patterned flooring which can obscure small obstacles from vision.
• Take care when walking through doorways as sometimes the threshold makes the floor surface uneven. Small threshold ramps may help individuals to negotiate these uneven surfaces, especially for walking frame users.
• Avoid leaving clutter on the floor (books, handbags, packages, toys and so forth), as these may become a tripping hazard. Ensure any electrical cords are tucked under furniture or taped to skirting boards and do not cross walkways.
• Install stair handrails on both sides of steps and stairs.

Bathroom

• Bathroom surfaces can be very slippery when wet. Keep water spray to a limited area where possible and clean up quickly. Avoiding using talcum powder (especially on tiled surfaces) which makes floor surfaces extra slippery.
• Be extra careful when using non-slip mats. Ensure the edges are firmly stuck down and the rubber-backed mat is held in place. Consider whether these mats create another tripping hazard—applying slip‑resistant tapes or a non-slip floor treatment to the floor and shower tiles may be a safer alternative.
• Install grab rails in or adjacent to the shower, bath and toilet to provide stability and support. Replace towel rails with grab rails for extra support.
• The hot, wet shower environment can sometimes affect balance—using a shower chair, flip‑down seat or removable stool can give extra support. Ensure soap, shampoo and towels are within reach to avoid bending or reaching. Be careful of dangerous lips/edges around the shower and eliminate if possible.
• Consider whether using a bath is really necessary. A clamp on bath rail, non‑slip tape and a bath hoist may make it slightly safer to get in and out of the bath. If the shower is over the bath consider a bath board or bath seat.
• A toilet seat raiser could be appropriate if the toilet seat is too low.

Bedroom

• Ensure beds are adjusted to an appropriate height to help you get in and out. Bed blocks may be an option if the bed is too low. Always get up slowly. Sit for a short time before standing up.
• Always turn a bedside lamp on before getting out of bed during the night and have a phone next to the bed for easy access in case of an emergency.
• A commode chair, urinal or bed pan can avoid the need to get up to go to the toilet in the middle of the night.
• For walking aid users, ensure that walking frames can be accessed very close to the bed.
• Remove or tuck away any tripping hazards like overhanging bedspreads, electrical cords, clothes or other clutter.

Kitchen

• Organise storage to reduce the need for reaching high or bending low as these actions can put you off balance.
• Considering sitting down on a kitchen stool when doing the dishes or preparing a meal. Use a tray mobile or trolley to carry items around. Pick up dropped food and mop up spills as soon as they occur.

 

Outside

• Put hoses, tools, toys and other objects away after use. Remove any hanging plants that could be walked into. Keep a look out for pets before moving around the garden.
• Repair uneven or cracked paths. Ensure lawn areas are as flat as possible. Kill moss and slime on paths. Be especially careful if the ground is frosty or wet and ensure that areas that get wet have non-slip surfaces. Ensure leaves, gravel or other debris are raked up regularly and removed.
• Mark the leading edge of steps with a contrasting color and install handrails.

Clothing

• Sit down to dress. Avoid long clothing such as nighties and dressing gowns which may create a tripping hazard when standing up.
• Wear low-heeled shoes with rubber soles for good traction. Ensure shoes fit well, are in good repair and are free from grease or dirt. Avoid wearing socks or stockings without shoes when walking on tiled floors or polished floorboards.
• For those at high risk of falls, hip protectors may provide extra protection. These are plastic or foam shields worn in special underpants that protect your hips in the event of a fall.

Personal health

People often down play a slip, trip or fall, blaming clumsiness or error. It is important to take any fall or near miss seriously and take the time to work out what may have caused or contributed to the event.

• Keep up with regular health checks and keep an eye out for health problems such as poor balance, dizziness, muscles weakness, incontinence, reduced sensation in legs and feet, poor nutrition, unsteadiness or loss of confidence in walking/using steps. It is important to discuss these with a doctor to ensure any medical conditions are well managed.
• Continue regular exercise to help maintain supple joints, muscle strength, balance and walking ability.
• Be aware of vision changes and use glasses if required. If your vision is deteriorating, see a low vision advisor to recommend home modifications.
• If getting to the toilet on time is a concern talk to a doctor or continence nurse.
• Review your medications regularly. Some medicines don’t mix, may cause nasty side effects or may be affected by alcohol. A medication reminder can assist with taking medication correctly. For those who are forgetful, there are timers that can remind them when to take medications.

General

• Ensure good access to telephones to prevent rushing. Consider getting a cordless telephone or install extra telephone extensions.
• Don’t rush, concentrate on tasks and take the necessary time. If you’re feeling light headed or exhausted, sit down and rest straight away. Have a plan of how to get help if a fall does occur.
• Avoid hazardous tasks such as standing on a chair to reach something from a high cupboard. Look at rearranging the home environment so that frequently used items are at an easy to reach appropriate height. Be aware of the implications of falling from a height and consider asking someone else to assist.
• Consider the direction that bathroom and toilet room doors hang—can they be opened outwards if someone has a fall inside the bathroom or toilet room?
• Consider the use of a mobility aid such as a walking stick or walking frame. It is important to discuss this first with your doctor.
• An emergency call system may help to increase your confidence and independence by helping you contact someone if a fall does occur, particularly for if you live alone.