Is Your Home A Safe Haven? - making homes safe for disabled persons

Accent on Living, Summer, 2001 by Julie Silver, Laura A. Ryan, Maria H. Cole, Dorothy D. Aiello

We think of our homes as havens--places where we are safe and secure from the unpredictable, mercurial and sometimes downright hazardous "real world." More often than not, however, this security is unfounded. In fact, most of us live in homes that are fraught with hidden dangers that could potentially cause us serious injury. Indeed, studies show that accidents are the sixth leading cause of death in persons over sixty-five years of age and falls account for 2/3 of these deaths. Moreover, at least 1/3 of falls result in someone getting hurt occur in the home or in other familiar surroundings. The good news is that research also shows that modifications to make your home safer can dramatically decrease your risk of falling.

How to Make You Safe

In order to minimize the chances of falls and subsequent injuries you must first rule out any health issues that may contribute to your risk of falling. In the medical literature, these factors are often called intrinsic factors.

Intrinsic factors are those things that affect how your body works. Examples of intrinsic factors include, but are not limited to, blood pressure abnormalities, poor vision and/or hearing, the effects of medication and overall weakness and/or inflexibility. In order to optimize your safety you should ideally have an annual physical examination by your doctor that includes an assessment of your vision, hearing, balance and strength. It is also important to have your doctor review your medications. Simple changes in medications, eyeglasses or even a little physical or occupational therapy to improve balance and strength can have an enormous impact on your personal safety both at home and in the community.

How to Make Your Home Safe

The medical literature also focuses on extrinsic risk factors for falls. These are things that may affect your ability to move about safely, but don't have anything to do with your personal health. For example, the presence of throw rugs or slippery bath mats, clutter in your home, poor lighting and the lack of grab bars in the bathroom are all considered extrinsic risk factors that contribute to people falling. Because these risk factors have to do with the environment, they are nearly always correctable.

The Game Plan

Since most of us have difficulty viewing our homes objectively, it may be worthwhile to have a physical or occupational therapist come to your home and make specific recommendations about how to make your home safer. This is generally covered by medical insurance if your doctor recommends a "home visit." However, regardless of whether a therapist is available to come to your home, there are some basic guidelines for home safety that you can use to improve access and safety in your home:

Stairs/Entrance

Stairs and entrances are notoriously dangerous areas in home. It is critical to keep entrances free of clutter and to eliminate doorway thresholds and scatter rugs as much as possible. Outdoor walkways and stairs should also be clear of clutter and need to be shoveled and sanded when inclement weather occurs. A railing on both sides of indoor and outdoor stairs greatly improves safety. Nonskid tape on top and colored tape on the edge of the stair (a good visual clue -- especially if you have poor vision) are also helpful. If you have difficulty going up and down stairs, consider installing a stairlift indoors and a ramp outside.

Kitchen

Ideally, a gas stove is safer than electric because you can see when it is off and it cools quickly after being turned off. However, an open gas flame can be a real hazard, too. It is important to avoid cooking when wearing clothes that are loose or may get in the way of your heat source. When cooking, keep commonly used items within easy reach. Items that you use daily (e.g., pots and dishes) can be placed on the counter. For those things that are stored in cabinets it is best to keep them at waist height and toward the front of the cabinet in order to avoid stooping or reaching. There are many commercially available compartment accessories that you can use on your counters or in your cabinets to both improve how the space is organized and how attractive it looks.

Bathroom

Bathrooms can also be high-risk areas because of the slippery surfaces and often small rooms. Many people fall when holding onto a towel bar or pushing on the sink in order to stand from the toilet. This obviously is not safe to do. Instead, professionally installed grab bars, particularly next to the toilet and in the bath or shower, will make negotiating your bathroom much easier and safer. Generally a short bar (12") vertical on the wall as you enter the tub and, ideally, a right angle grab bar on the far wall is recommended. Another simple and inexpensive option is to use a tub rail that clamps to the side of the tub -- these can usually be installed without professional assistance. Moreover, this rail can be re-positioned and provides a grip for both entrance and exit to the tub.

Shower chair recommendations will depend on how much you weigh and how you move about. The features of the chair (e.g., armrests, surface type) should be considered as well as width, depth and height of the chair. A hand-held shower offers more control over directing the flow of water and adjusting the water temperature. This also allows you to get into the tub without having to step directly into the stream of water thereby reducing your chances of slipping. To improve safety when exiting the shower, a nonskid bathmat cut to a narrow width can be utilized.