This is the second part of this important article. The first part was published on our blog on September 4. Subsequent parts will be published in a timely fashion.

Safety is of the upmost importance for us all, but particularly for stroke survivors, most of whom have some residual disability as a result of their stroke.

Having tools and processes in place to get help in an emergency and minimize damage from falls, accidents, or other dangers is vital. The systems and processes below can help ensure you get the help you need when you need it—with no time wasted.

Home Security System

The first emergency tool you can use is a general home security system. A special report released by the U.S. Department of Justice showed about 93% of all crime experienced by adults 65 and older was property crime, which includes general theft, burglary, and car theft.³ Using even a small system that alerts you when certain home barriers are breached or if someone is near an entryway of the home can help you be more alert and reach out for help if it’s needed.

Choosing a system with a camera and speaker system can allow you to preview people at the door from wherever you are in the home, so you can speak to them if necessary. This can help you determine whether it’s even necessary to answer the door, as well as allow you to inform visitors it will take you a few minutes to get to the door. You can take your time instead, so you don’t increase your fall risk by rushing.

Medical Alert System

Useful for getting help in an emergency, medical alert devices often include a wearable help button, which, in the event of a fall or another emergency, the wearer can push to connect with a 24/7 monitoring center. Research shows a medical alert device can help give users a stronger sense of security and independence and can bring peace of mind, even for people not at high risk of falling.⁴

Emergency Phone Tree

You’ll want to establish a process for alerting family members and caregivers if there’s an accident or if help is needed. An emergency phone tree, which specifies which caregivers and family/friends to contact in an emergency and in what order, can help alert others of an emergency and get the help you need quickly.

With some medical alert systems, you can set friends and family as emergency contacts. For example, when you push the button you can customize the alert to summon the operator as well as your first emergency contact. This can streamline your emergency phone tree and ensure your caregivers are the first people aware of an emergency.

Tip List:

• Create an emergency phone tree
• Consider purchasing a medical alert system if you or someone you care for are concerned about falls risks
• Home security systems can help prevent theft and allow you to communicate better with visitors

Interior Home Safety

When assessing the safety of the inside of the home, it might be easiest to go through each room, taking notes as you go, to spot potential hazards and make changes as needed. Be sure to use the tips below and our printable checklist.

General Considerations for Home Safety

First, we will discuss general safety considerations that should be applied throughout the home and then move through measures that are room-specific.

As a general rule, keep a list of emergency phone numbers in an accessible place, preferably near a phone or stored in your cellphone. Consider prioritizing contacts who live close to you, so if there’s an emergency, they can reach you promptly.

Lighting

Increasing the lighting in your home doesn’t need to be an expensive fix requiring an electrician or rewiring your home.

First, consider replacing current bulbs with LED lightbulbs with higher brightness in areas or rooms that need more lighting. These bulbs will also last longer, so you won’t need to change them as often. If you’re easily bothered by bright lights, you may want to install dimmer light switches, so you can adjust the brightness according to your needs. “Dimmer switches are an excellent suggestion for folks that have cataracts, too,” noted Christopher Norman, a geriatric nurse practitioner in New York State. “While fluorescent lighting is often the worst for people with cataracts, bright LED lighting can sometimes create discomfort, too.”

If you’re looking to add lighting in places not currently wired for traditional light bulbs, consider purchasing LED light strips to plug into existing outlets. They can easily illuminate walkways and give extra lighting under cabinets in the kitchen or bathroom. Our Reviews Team found LED light strips for as little as $15 from Home Depot.

You might also want to consider adding motion-detection lights. These lights are great for interior and exterior use and are perfect if you don’t want to worry about using switches or remotes to light up the room. Using motion-detection night lights in hallways can make trips to the bathroom easier at night, so you won’t stumble looking for the light switch. “Light-sensor nightlights that can plug into outlets are helpful, too—they come on automatically when light dims below a certain point, illuminating hallways better,” added Norman. We also found motion-detection lights at Home Depot starting at $14.

Removing Trip Hazards

One of the easiest ways to prevent a slip or fall is to wear nonslip footwear, like slippers, that are comfortable and easy to walk in. Look for footwear with a closed heel to prevent the shoe from coming off your foot, as well as a rubberized or textured sole to create traction when walking. Norman noted that having a hard sole is often helpful. “Slippers can still be comfy and have a hard sole. A hard sole contributes to more sensation being transmitted from the bottoms of the feet, which in turn provides a greater sense of stability and balance—thus falls prevention,” he said. This is especially important for people with diabetes, he added. “Excess sugar in the blood over a long period of time decreases nerve function and sensation. This is why some people talk about a tingly sensation in their hands and feet when diabetes is ‘uncontrolled.’”

When conducting your home assessment, pay special attention to the floor. Something as simple as a throw rug can bunch up under a walker, a cane, or your feet and easily turn into a fall hazard. Even traditional nonslip mats can become a hazard if the mat creates the slightest elevation rise between steps.

Consider removing all rugs, especially from high-traffic walkways, or at least replacing them with vinyl rugs. Vinyl rugs are low-profile, so they don’t create an elevation change, and are made of slip-resistant material that won’t bunch up under your feet or other walking aids. Any area rugs (larger rugs used in a sitting area) should be fixed to the floor to keep them from moving. “Another caveat to this is in bathrooms that have porcelain or tile floors: Having something nonskid that’s appropriately tacked down can be, not only aesthetically pleasing, but falling onto a carpet rather than directly onto a tile floor can sometimes make a difference in the extent of fall-related injuries,” added Norman.

Also, note any thresholds transitioning between flooring types and rooms. Ideally, they should be completely flat to make sure they aren’t a trip hazard. If a threshold presents a drastic change in elevation, and you can’t replace it with a flat one, you can install a small threshold ramp on either side of the threshold to make it less of a tripping hazard.

Replacing Pulls

It can be difficult to grip certain handles or turn knobs, particularly if you have reduced dexterity or arthritis, so to keep day-to-day life more comfortable, consider replacing commonly used handles, doorknobs, and other pulls with more comfortable ones. “D” handles are known for being the easiest to use because you don’t need to grip them to open them. Rather, you can simply loop your hand around the handle and pull.

If it’s not in your budget to replace all handles throughout your home, prioritize replacing the ones getting daily use, like in the primary bathroom and on kitchen cabinets.

Accessibility of Everyday Items

As you’re walking through your home, ask questions and take notes about what items are used every day and where they’re stored. This includes large and small items. For example, if you or your loved one takes daily medication, consider using an easy-to-open pill container with clear labeling. Make sure larger items are in an accessible location, as well as in a location where you won’t have to perform any overhead lifting and bending. Of course, it’s impossible to put every item in a place that’s easy to access. Ask for assistance from family and friends when needing to reach items that are not within reach.

Reducing the Risk of Burns

As we age, our skin becomes more likely to be hurt by heat because of changes in skin composition, noted Norman. If you’ll be taking hot showers or using hot water in the kitchen, consider reducing the temperature setting on your hot water heater to prevent burns. Also, be mindful when boiling water, and when possible, use an electric kettle with an easy-pour spout rather than a pan over the stove.

Living Area

The living area is a space in the home where the majority of your day is spent. Arrange the furniture to keep a clear walkway and pay close attention to coffee or other low-level tables, which can be tripping hazards. Consider removing coffee tables and replacing them with tables placed adjacent to the most frequently used couches and chairs. The most frequently used chairs should be high enough, so it’s easy to get in and out of. If you use a landline as your primary phone, consider putting it close to the sitting area to make answering calls easier. If you use a cordless phone or cellphone, make a charging station nearby to keep devices at full power.

Also, consider pets, especially cats and dogs. According to a report released by the CDC, an estimated average of 86,629 fall injuries each year were associated with cats and dogs.5 While they make great companions, our pets can also get underfoot. You can try putting a bell or other noise-making device on your pet’s collar so you’ll know where they are at all times. But you might not hear a bell if you’re experiencing hearing loss. Other ways to avoid tripping over pets include training them, knowing their habits so you’re not taken off guard, knowing your surroundings, and making sure they get enough attention and exercise.

Tip List:

• Be sure heavy furniture is safely secured to avoid tip-overs.
• Consider removing or moving low-level tables or furniture to prevent tripping
• Keep a charging station next to the sitting area for easy access to devices
• If using an area rug, make sure it’s fixed to the floor, and the edges won’t bunch up under your feet or walking aid
• Be aware of your pets

Fact Checked — Jul 10, 2024

Written by: Miranda M. Riva, Esq

Medical Reviewer: Christopher Norman, MSN, APRN, APHN-BC, GNP-BC

Reviewed by: Kathleen Cameron BSPharm, MPH, Senior Director, NCOA Center for Healthy Aging

We would be interested in any questions or comments and suggest that you email us at Bobm@StrokeRF.org.

Image from Freepik – Usage