Tips on... Home Safety and Modifications

by Rich O’Boyle, Publisher
More About Rich…

As an individual ages, her ability to live independently is severely restricted. And once an aging individual shows signs that they are in danger of falling, or that they can’t navigate their home any longer, that a nursing home is the safest option. Or at least that is the common perception.

With careful consideration and some creative thinking, families can make some modest changes to a home that will make it safer and easier for their loved one to stay there longer. In many cases, minimal changes to the home environment can have a significant impact on independence.

Most injuries occur in one of three primary places within the home: the bedroom, the bathroom, or in the hallway. So it’s important to look at these areas and reduce or eliminate the aspects that can contribute to falls, reduce mobility, or limited access to features (such as showers and toilets).


  - The leading cause of falls is due to clutter on the floor of a room, especially the bedroom. Make sure that floors are kept free of cords, piles of papers and magazines, and discarded clothing. At a minimum, keep clutter away from high traffic areas.
  - If your loved one shuffles or uses a walker, it will help to remove door sills/saddles in between rooms to improve mobility and reduce the likelihood of tripping.
  - Minimize the number of types of flooring that are used throughout the house. Since we walk differently on various surface types (plush carpet, polished floors, flat carpet, tile, etc.), it can be problematic for someone who does not clearly see the floor when the surface changes.
  - Use low beveled strips over carpet edges to prevent tripping and keep a neat appearance.
  - If floors are polished or slick, avoid the use of socks. Wear skid resistant slippers or carpet the floors.
  - Remove all throw rugs.


  - Many older adults keep lights turned off (to conserve electricity) and shades drawn (for privacy), even in the daytime. Sheer drapes allow more light to come in and still provide privacy. Compact fluorescent bulbs are extremely cost-effective.
  - Low light levels can increase depression as well as contribute to falls.
  - Night lights should be installed I=on door jambs. Use an extension cord from the baseboard if necessary.
  - Additional night lighting should be installed on the path from the bedroom to the bathroom.

Bathroom Safety

  - Use heavy-duty screws to install grab bars in the shower and toilet area. Grab bars are used for stabilization as well as supporting a person’s full body weight if they lose their balance. Mount grab bars onto internal beams, not just into the tile facing.
  - Install bars with a textured grip (rather than smooth stainless steel).
  - Install a variety of vertical and horizontal bars around the shower. Consider your loved one’s height and the actual motions on stepping into and out of a shower/tub.
  - Make sure bars that straddle a bathtub rim are securely attached, especially after removal and cleaning.
  - Transfer benches can be used in old narrow bathtubs so that the individual can slide over the rim using the bench.
  - Hand-held shower heads should have an 84” hose attachment and an on-off switch on the nozzle. Install adjustable mounts at your loved one’s head level and hand level, not at the top of the shower.
  - Install commode rails onto a toilet as well as grab bars near the toilet.

These suggestions are not an exhaustive list of modifications. Individuals should consider financial constraints as well as the preferences of the aging individual. Individuals affected by Alzheimer’s Disease have special needs for safety and comfort that can be addressed by reviewing the series of articles by Mark Warner on ElderCare Online’s Alzheimer’s & Dementia Care Channel.

Related Articles
  - Comprehensive Home Safety Checklist
  - Safety vs. Independence: A Case Study
  - Preventing Falls
  - Caregiver’s Guide to Home Modification
  - Consumer Protection: Signing Contracts

Recommended Reading
  - The Complete Guide to Alzheimer’s-Proofing Your Home by Mark Warner
  - The Complete Eldercare Planner by Joy Loverde

Online Resources
  - Gerontological Environmental Modifications at New York Presbyterian Hospital-Weill Medical College of Cornell University
  - Abledata Product Locator
  - Ageless Design
  - National Resource Center on Supportive Housing & Home Modification
  - Centers for Disease Control
  - The Lighthouse (low vision)

This article is based on a presentation given by Rosemary Bakker, MS, ASID, Director, Project GEM,
Gerontological Environmental Modifications Project at New York Presbyterian Hospital-Weill Medical College of Cornell University on January 23, 2002 to the Greater New York Chapter of the National Association of Professional Geriatric Care Managers.

Available from ElderCare Online™                2002 Prism Innovations, Inc.