Standard home safety advice assumes somebody can learn a new routine and remember a new instruction. When that assumption does not hold, some of it stops working and a little of it becomes unsafe.
We are not clinicians. This is what we have learned fitting equipment in these houses, and it belongs alongside advice from the people managing the care.
What changes about fall prevention
The usual list still applies: lighting, rugs, cables, footwear, clear routes. The CDC has the general picture and falls are the leading cause of injury death for adults 65 and older.
What changes is that you cannot rely on somebody remembering to be careful. The environment has to do the work rather than the person.
Contrast matters more than brightness
Perception of depth and edges changes. A white toilet against a white wall on a white floor can be genuinely hard to locate.
Contrasting colors help enormously: a colored toilet seat, a contrasting grab bar rather than a chrome one against tile, a contrasting strip on the edge of each step. This is cheap and it is the single most underused adjustment.
Conversely, avoid strong patterns on floors. A dark patterned rug can read as a hole, and somebody may try to step over it.
Mirrors and reflections
Later on, a reflection may be perceived as another person in the room, which is distressing in a bathroom. Covering or removing a mirror is a reasonable adjustment and it costs nothing.
The same goes for a dark window at night, where a blind solves it.
Equipment that stops being suitable
This is the part nobody writes about and it is the reason we are.
A stairlift needs somebody to use it correctly every time: sit properly, fasten the belt, swivel and lock at the top, and not attempt to get off mid-flight. If that cannot be relied on, a stairlift can become a hazard rather than a help.
A key switch that disables the lift, so it is only used with somebody present, is frequently the right arrangement. Ask for it, and ask at the survey rather than later.
The same logic applies to a platform lift. Constant-pressure controls help, and supervision may still be needed.
What tends to help
- Keep the layout the same. Rearranging furniture to make space can cost more than it gains.
- Label doors with words and pictures, particularly the bathroom.
- Automatic lighting on the route to the bathroom, so nobody has to find a switch.
- Remove or lock away hazards rather than relying on instruction.
- Grab bars in contrasting colors at the toilet and the shower.
- A clear, short route from bed to bathroom with nothing in it.
Bathing
Frequently the hardest part of the day for both people. A transfer bench, a handheld shower head and a grab bar at the entry reduce the physical difficulty, and the rest is approach rather than equipment.
If a caregiver will be in the room, say so at the survey. It changes the layout, because the room has to hold two people. Our bathroom guide covers the equipment.
Moving downstairs
Worth considering earlier than families expect. Reorganising to one floor removes the staircase problem entirely rather than managing it, and it beats every equipment purchase on cost. Our accessibility guide covers what that involves.
Grab bars, contrasting seats, transfer benches, night lighting and non-slip matting ship free from our online shop.
Wandering and exits
A serious risk and one that equipment addresses badly. Door alarms, chimes on exterior doors, and locks positioned outside the usual line of sight are the common approaches, and any of them has to be weighed against fire egress.
Talk to the fire service about that balance rather than guessing. A door somebody cannot open in a fire is its own hazard.
The kitchen
Appliances with automatic shut-off. A kettle rather than a stovetop. Removing or isolating a cooker that is no longer safe. These are unglamorous and they prevent the incident everybody is worried about.
Look after the caregiver too
The person doing the caring is also the person doing the transfers, several times a day, frequently at night, frequently while exhausted. A gait belt, a slide sheet and proper technique protect them, and our transfer aids guide covers what to have in the house.
If transfers now take two people, or if either person has been hurt, the equipment needs to change rather than the technique. That is not a failure and it is the point at which to ask.
Review it more often than you would otherwise
What was appropriate in spring may not be in autumn. A stairlift that was safe when somebody could reliably use it may need a key switch six months later, and the bathroom that worked may now need a second person in it.
Walk the house every few months rather than once. Our room-by-room checklist is the walk-through, adjusted by everything on this page.
Ask the people who know
An occupational therapist assessing the person, rather than the building, produces a better list than any equipment company can. Where one is involved in the care, their report is the most useful document you can hand a supplier.