Elderly Fall Prevention Checklist

• Elderly Home

• Address
  Address

• Aged-care Worker

• Conducted on

  Date

Room

• Are throw rugs/carpets secured to the floor?

  Yes

  No

  N/A

• Remove throw rugs or use double-sided tape or a rug pad to secure the rug to the floor. For small tears, a little glue or carpet staples can fix the problem.

• Is the room decluttered from clothing, magazines, newspaper, or other items?

  Yes

  No

  N/A

• It might be a good time to work with the older adult and clean out closets and drawers of items he or she no longer wears or uses.

• Does the older adult have easy access to a telephone or cellphone, especially at night?

  Yes

  No

  N/A

• Consider a cordless phone. If the older adult is not agreeable to having a phone in the room, or he or she doesn’t own a cell phone, suggest an emergency alert system.

• Is there adequate lighting?

  Yes

  No

  N/A

• Nightlights are a good option for dark rooms at night. If the older adult likes to read in the room at night or turns on the light in the middle of the night to go to the bathroom, make sure the bulb wattage is high enough (within allowable limits) to properly illuminate the room. Rope lighting is another good option for hallways that connect the bathroom and bedroom.

• Are electrical cords neatly fixed to keep pathways clear?

  Yes

  No

  N/A

• Use extension cords to run electrical cords behind furnishings. Rearrange furniture that must be plugged into areas near an outlet. Consider a power strip where several cords can be plugged into one long power source.

• Does the furniture provide proper support?

  Yes

  No

  N/A

• Make sure bedroom chairs are the proper height, so the older adult's feet touch the floor. Chairs should have sturdy legs and arms.

• Is the bed too high or low?

  High

  Low

  N/A

• The bed is too high when the legs do not touch the floor when sitting on the edge of the bed. Remove the bed frame or use a lower profile mattress or box springs.

• The bed is too low if the older adult's knees are above the hips when sitting on the bed. Bed risers under bed legs can raise the height.

Shower/Bathroom

• Are grab bars available near the tub, shower, and toilet?

  Yes

  No

  N/A

• Loose towel and curtain rods could be a sign that an older adult is grabbing on to these for support. Adding grab bars near shower/tub units and the toilet can help prevent falls and other accidents.

• Are there enough bath mats to keep the floor dry?

  Yes

  No

  N/A

• Add a rubber mat or adhesive non-stick decals to the bottom of a tub.

• Is the bathtub the correct height?

  Yes

  No

  N/A

• If the bathtub is too high, such as a claw foot tub or antique tub, add a tub transfer bench.

• Is the toilet the correct height?

  Yes

  No

  N/A

• Add a raised toilet seat for stools that are too low. Contact a plumber about installing a lower profile stool if your older adult’s toilet is too high.

• Are medications stored properly (not too high or too low for the older adult to reach)?

  Yes

  No

  N/A

• Make sure medications are stored in cabinets that are easy to reach. If the cabinet is too high, an older adult might have problems reaching into it. If it is too low, the older adult could have trouble bending down to find the medication. Consider a medication organizer for pills that can be set on a countertop or shelf.

• Can the bath water be too hot or cold?

  Yes

  No

  N/A

• Set the water thermostat to 120 degrees F so the water in the shower and sink faucet does not exceed dangerous or uncomfortable levels. Another good idea is to make sure the hot- and cold-water faucets are clearly labeled. Painting parts of them red or blue will help distinguish them.

Common Area

• Is there enough space to move around the furniture and no clutter around?

  Yes

  No

  N/A

• Organization is the key to preventing too much clutter. It might be a good time to work with your older adult to downsize and eliminate bigger pieces of furniture. Add shelving.

• Is furniture stable?

  Yes

  No

  N/A

• Sit in chairs to see if arms or legs are wobbly. Try gluing legs or armrests. Or, if more extensive repairs are needed, locate a furniture repair service representative. If the chair is too low, add a cushion or pillow on the seat to raise the height.

• Can the older adult reach the light switch to turn it off or on?

  Yes

  No

  N/A

• Add a “clapper” light switch to control lamps or check out other remote control switching options. Sometimes, rearranging furniture can allow quick access to a wall switch or lamps.

• Is there adequate lighting?

  Yes

  No

  N/A

• Increase wattage to allowable limits in lamps and lights. Add additional lamps, or contact an electrician about installing overhead lights.

• Are throw rugs and electrical cords neatly secured?

  Yes

  No

  N/A

• Remove throw rugs. If carpet is necessary, installing low-pile rug can be better than shag. Having carpet stretched or removed can eliminate bumps.

• Is the floor even?

  Yes

  No

  N/A

• For uneven floors, consult a contractor or your local home improvement store.

• Can the room temperature be too hot or cold?

  Yes

  No

  N/A

• Install lock-in switches on thermostats to control the temperature and help prevent furnace fires.

  Yes

  No

  N/A

Hallways & Stairs

• Is there a working smoke alarm and carbon monoxide detector in place?

  Yes

  No

  N/A

• Install new smoke detector batteries once a year. Pick a date and make sure all of the smoke detector batteries in the home
  are replaced. The National Fire Protection Association recommends replacing carbon monoxide batteries and alarms according to the manufacturer’s recommendations.

• Is there adequate light at night?

  Yes

  No

  N/A

• Night lights are an ideal solution for dark hallways. Search online to find a variety of lights, including LED options that are just right for an older adult. Rope lighting is another good option for hallways that connect the bathroom and bedroom.

• Are handrails sturdy and functional?

  Yes

  No

  N/A

• Consider installing circular rails because they are easier to grip completely compared to other rails.

  Yes

  No

  N/A

• Are the stairs evenly built/dimensionally uniform?

  Yes

  No

  N/A

• Consider talking to a construction contractor for possible renovation options.

  Yes

  No

  N/A

Completion

• Additional Observations

• Aged-care Worker Name & Signature

  Sign