Falls prevention at home involves looking at the person's health, daily activities, environment and support. A checklist can help you notice concerns and organise a conversation, but it does not replace an individual assessment or guarantee that falls will not occur.
An OT can explore how someone uses the home and whether changes to a task, equipment or environment may help. Medical, medication, vision or balance concerns may also need input from the relevant treating professionals. A useful plan can involve more than one type of support.
Start with the person's experience
Ask when the person feels least steady or confident. The answer may involve a particular activity, time of day or route through the home. Notice tasks they have stopped doing because they feel uncomfortable.
A recent fall, a near miss or a change in function is useful information to discuss. Record what was happening and what assistance was available. Avoid assuming that one obvious home hazard explains the whole situation.
A practical home checklist
Use these questions to prepare for a discussion:
- Can the person see clearly along the routes they use, including at night?
- Are frequently used walkways clear of objects and loose cords?
- Are there changes in floor level or surfaces that cause difficulty?
- Can the person access the bathroom with their usual equipment and assistance?
- Are commonly used items easy to reach without an awkward manoeuvre?
- Does the person have suitable help for tasks they cannot manage safely?
Do not turn the checklist into a request to test a risky activity alone. If something is concerning, describe it to the appropriate professional and discuss the assessment needed.
Bathroom and personal care
An OT may ask about entry into the bathroom, the shower routine and assistance with transfers. Equipment needs to suit the person and the space. The position of a rail or chair matters, so purchasing one without assessment may not solve the difficulty.
Explain what is already used and whether the arrangement has changed. A person may now need a different level of assistance, or an item may no longer fit the task. Recommendations should address the whole activity rather than simply adding a product.
Essential routes through the home
Consider the routes used most often, such as between the bedroom and bathroom or from the kitchen to a dining area. The therapist can discuss what makes those routes difficult and how the person normally moves through them.
Small changes may be worth considering, but the person needs to be involved. Moving familiar furniture or frequently used items without discussion can create new difficulties. Agree on changes and review how they work in the actual routine.
Support outside the OT appointment
Ask the treating team about concerns beyond the environment. Changes in dizziness, vision, medication effects or mobility should be directed to the appropriate professional. New or sudden symptoms may need timely medical assessment rather than waiting for a routine OT visit.
If someone has fallen and may be injured, seek appropriate medical assistance. A future home assessment is not a substitute for addressing the immediate situation.
Making a plan that gets used
Choose priorities and identify who will follow them up. If equipment is recommended, someone may need to arrange a trial, purchase or installation. If the plan involves a change to assistance, discuss whether the required support is actually available.
Review the outcome with the person. A change that looks sensible on paper may create a different problem in daily use. Tell the therapist what happened so the recommendation can be adjusted.
Common questions
Does removing clutter prevent every fall?
No. The environment is only one part of falls risk. An assessment may need to consider health, the task, equipment and assistance as well.
Should we buy a shower rail straight away?
Discuss the task and suitable assessment first. Rail position, installation and the person's needs matter. A general online example is not an individual prescription.
Can a family member use this checklist?
Yes, as a way to notice concerns and prepare questions. Involve the person and avoid asking them to demonstrate a task that feels unsafe.
Can an OT help after a fall?
An OT may assess practical needs at home once immediate medical concerns have been addressed. Tell the provider about the fall, current assistance and the tasks causing difficulty.
Make a referral to discuss a home assessment and practical falls-related concerns with Ergo Therapy Group.