Begin by talking to your parents about the strong association between falls and nursing home admission. Schedule some time with your parents and ask them to show you how they do things around the house. Get your pencil ready and take notes!
Entrances/Exits
Which entrance does your parent use the most? Which entrance is the most covered? Observe your parents exiting and entering the house. What do they hold onto? The door frame? Is there a hand railing? Is it secure? Is their performance safe? How do they get the mail? Have them walk to and from the mailbox. Can your parent safely take out the trash? Ask your mom or dad to show you how they transport the trash can to the curb. Is the driveway sloped? Is the sidewalk cracked? How would they take out the trash if they had to use a walker? Is their performance safe?
Is there a hand railing along the steps to enter the house? If your parent uses a walker, what does he do with it on the steps? Does he leave the walker behind and use a cane instead? Do they have a storm door? Does it close in on your mom when she tries to get the walker through the doorway? How does she bring in the groceries from the car? Ask her to carry a bag of groceries from the car into the kitchen. Is her performance safe?
Take notes on what areas appear to be potential safety hazards that may place your parent at risk for falling.
Kitchen
Do your parents still cook or mostly microwave their meals? Do they wash dishes? Empty the dishwasher? Use the microwave? Make sandwiches/cereal/coffee? Do they use the stove? Ask them if they have ever left the stove on? Ask them to show you how they transport a cup of coffee from the counter to a chair. If your mom uses a walker, how does she transport items around the kitchen? Ask her to show you how she carries a cup from the sink to the table. Is her performance safe? If your dad uses a walker, what does he do with it when he approaches a chair? Can your parent move from the kitchen door to the sink, counter tops, and table without risk of tripping over something? If they needed a walker in the future, could they travel these paths without bumping into the edges of the door? Examine the thresholds. Is there a change in the level of the floor surfaces? If your dad has visual deficits, is there a contrasting color between the floor surfaces? Does your Mom have to pick up the walk up to get over the threshold? Does she do this safely? Is there a rug beneath the sink – is it nonskid?
Are you taking notes of safety hazards and potential problems that could cause a fall?
Bathroom
Seniors rate bathing as the #1 most difficult activity. This is a critical area in the house for safety! A fall in the bathroom has a high likelihood of resulting in a serious injury. Ask your parents how often they are taking a shower. Is your dad in the habit of going to the basement to shower? Falling on the stairs has a high chance of resulting in an injury. Ask them if they have ever fallen or almost fallen getting in or out of the shower. Does your mom like to take a bath instead? Ask her to show you how she gets in and out of the tub. Does she struggle to get up? Does your dad try to help? Is the performance safe? Does your dad use a towel rack to hold onto as he steps over the tub? Is there a nonskid surface on the floor of the shower? Is the bathroom cluttered with items such as a hamper, decorative baskets on the floor? Is there a waste basket obstructing the pathway in/out of the tub/shower? If your parent uses a walker, does he have to leave it outside of the bathroom because the door is too narrow? Can your mom turn the faucet handles easily? What is the water temperature set at? Could your parent get into the bathroom using a wheelchair?
Take notes of anything that concerns you.
Stairs
Many falls occur on the last 2-3 steps. Analyze the staircases at your parents home. Does the hand railing stop short of the last step? Is there a light switch at the top and bottom? Is the light adequate? Is there a throw rug below the last step? Does it slip around? Is the carpeting on the stairs frayed in any areas? Are they using a plastic runner to protect the stairs? Do your parents have to manage stairs to access a bedroom or full bathroom? Could a main floor bathroom be enlarged to include a shower? Could a bedroom be created on the main floor? If they only have to manage steps to access the basement, could the activities they do in the basement be brought to the main level? Could the washer/dryer be moved to the main floor? Could a handyman check the furnace/water heater? Ask your mom and dad to show you how they negotiate the stairs. Is their performance safe?
Gather your notes, thank your parents, and call me.
Who am I? I am an Occupational Therapist specially certified by the American Occupational Therapy Association in Environmental Modifications. An occupational therapist has a medical background with knowledge about the progression of health conditions. A home assessment by an occupational therapist trained in home modifications has been shown to prevent falls. A fall is a major threat to your parents’ independence and ability to remain living at home.
I offer a $97 one-hour home assessment that will save your parents money because I focus on no cost and low cost home modifications and simple essential safety solutions.
Nancy Dillinger, MOT, OTR, SCEM, ATP
liveLife@Home, LLC