New Resources and Tips: Home Environmental Assessments to Reduce Falls

As you look at my picture, I am delighted to invite into my home, my kitchen. My home, like yours, welcomes family and friends of all ages. But most dearly, my home was a home for my mother who lived with my husband and I for years with progressively advancing Alzheimer’s Disease. She was also more than high fall risk – she was a repeat faller, and that included falling multiple times in my home.

We made many renovations to make our home safer for her, especially because she had severe sensory neuropathy and could not feel her feet at all. For example, we changed home entrances to eliminate steps, added bedside commodes over toilets to raise height and provide arm rests, changed out room light switches motion sensor lighting and permanent low continuous level lighting in bathrooms.

The knowledge and skills that I have as a rehabilitation nurse prepared me to create a safer home for my mother, to reduce the likelihood that she would fall inside and outside.

Recently, I have been asked by several family members caring for their parents about enhancing their home safety program, reducing risks for falls. I’ve also engaged in conversations with older adults wondering about actions they could take to make their home safer from falls. I am delighted to share with you resources that I have shared –comprehensive home safety assessment tools and brief checklists. I hope you will review these with your family and the results with your primary provider.

Cornell University-GEM Environmental Assessment. This 15-page tool, created by R. Bakker, MS, ASID, Weill Medical College of Cornell University, Gerontology Environmental Modification Project. This is a very comprehensive assessment completed of the home environment by a healthcare provider. A list of potential problems in the home environment and indications of functional or physical deterioration. Suggestions are provided to improve safety in each area assessed. Again, this tool is a very comprehensive assessment of each room in your home and hallways – such as accessibility, flooring, furniture, lighting, seating and shades. In the bedroom, much attention in paid to the bed – getting around, in and out of, even placement of a bedside commode. An “other section” guides the you through a variety of important safety steps, such as medication safety to intact rubber tips on canes. When completed, the results are to be reviewed with your family and care providers to generate an action plan.
A list of potential opportunities and problems in the home environment and indication of functional or physical deterioration are generated, followed by suggestions provided to improve safety in each area assessed. A workplan is created by you, your family and healthcare team – a strategic action plan to increase a safer home environment and prevent falls.

You can access this tool at: https://cornellaging.org/gem/enviro_assessment.pdf

Home Safety Assessment Checklist (2006). Dr. Olsen and Mr. Hutchings, both with the Health & Ageing Division Center for Architecture and Building Science Research, NJ Institute of Technology, in collaboration with the NJ Department of Health and Senior Services, Division of Aging and Community Services, developed this comprehensive home safety assessment tool.

This tool available here through the Aging and Disability Resource Connection (ADRC) in NJ, was designed to improve home safety and reduce accidents. This checklist offers you and family members the opportunity to detail opportunities to find safety needs inside and outside the home. Outside, comprehensive assessment is completed of entries to the home – lighting, driveway, walkways, steps to the doors, garage, ramps, and entry landings in the front and rear of one’s home. Even exterior doors at the front and rear of the home are evaluated, along with other outdoor concerns such as safe, accessible stairs and railings. Inside the home, the tool is designed to examine risks on multiple hallways, stairs, doors and doorways, bathrooms, and living rooms, organized by the area, such as Bath 1 / Bath 2; Toilet 1 / Toilet 2. This is very easy to use.

Unlike other home assessment tools, this home safety assessment checklist has a specific checklist for safety of Alzheimer’s Disease and Other Dementias, at risk for wandering, getting lost in the home, and/or hallucinating. Included in this section is safety assessment criteria for Dementia Patients’ safety in bathrooms, bedrooms, and general home safety. This tool is invaluable for you and family members who are taking care of loved ones with dementia in their home.

Check for Safety. A Home Fall Prevention Checklist for Older Adults Brochure. Most healthcare providers are familiar with this home safety checklist for fall prevention among older adults, developed by the CDC, so you may be familiar with this already. Ladies and gentlemen, this brochure, available since 2005, serves to educate you about facts falls, guide your assessment of fall risks in rooms within the home, and share health promotion actions to take to reduce your fall risks, improve your health, balance and strength. This brochure was designed to be an educational resources for older adults, family members caring for older adults. I made this brochure available to all my patients in my rehab and fall prevention clinics. You can access this brochure here

Fall Prevention Checklist-EASYLIVING Home Care. This checklist, created by EASYLIVING,Inc., is a 2 page handout that addresses 2 major causes of falls – health related conditions and balance problems. The checklist is organized by rooms in the home and the exterior in order to identify potential problem areas relating to falls. General safety and healthful living suggestions are provided. The main areas of assessment are the rooms and identifies some situations that predispose you to falls in the home. This basic checklist generates critical thinking about safety by combining both questions, such as “is the seating adequate and safe?” in the bathroom, to suggesting safe practices, such as “be sure there is good lighting both in the room and the work areas” in the kitchen. The checklist is completed by location and room and then follows recommended solutions to decrease your fall hazards, improving general safety within and around your home.

You can access this tool at : Easy Living Falls Prevention Checklist

Ladies and Gentlemen, I hope these resources and tips are useful to you, your family and friends to reduce our fall risks in and around your home. Your entire Harmony Team is dedicated to reducing your risks for falls. I look forward to hearing from you.

Thank you for reading this message and in advance for sharing with others. Always remember, that your Harmony Team is here for you!

Pat Quigley
02/07/22

References

Bakker, R. (2004). GEM. Gerontological Environmental Modifications. Environmental Assessment. Apartment Safety & Design. Weill Medical College of Cornell University.
Available at https://cornellaging.org/gem/enviro_assessment.pdf Accessed 020522

CDC. (2005). Check for Safety. A Home Fall Prevention Checklist for Older Adults. Available at https://www.cdc.gov/homeandrecreationalsafety/pubs/english/booklet_eng_desktop-a.pdf
Accessed 020522

EasyLiving, Inc. (n.d.). Fall Prevention Checklist. Available at https://f.hubspotusercontent40.net/hubfs/5909094/Resources/Fall-Prevention-Checklist-1.pdf
Accessed 020522

Leave a Reply