Ooopanaceyacare at home: there is no panacea, there is a system

An independent guide for family members caring for a relative at home. Not a medical organisation, pharmacy or care service, and not connected with the former website on this domain; it does not replace advice from a doctor. In an emergency, call your local emergency number (in Russia 103 or 112).

Prevention

Prevention

Falls are one of the most common causes of injury in older people, and many of them happen at home, on a familiar route. The good news is that the risk can be reduced noticeably without renovation: with lighting, a clear floor and support where it is needed. Below is a step-by-step walk through the home.

A home someone has lived in for thirty years feels safe precisely because everyone is used to it. Look at it through the eyes of someone whose eyesight has weakened and whose balance has slowed.

— Editor's note

Before you start

  • Half an hour of free time and a calm mood — this is not a spring clean
  • A notebook or a note on your phone to write down what needs fixing
  • A torch to check how the walkways look in the dark
  • A chance to walk the route with the person themselves and ask what they think
  • Willingness to change one thing at a time rather than everything at once

  1. Walk the usual route together

    Ask your relative to show you how they usually get from the bed to the kitchen, bathroom and toilet. Note where they hold on to furniture, slow down or step around an obstacle.

    Illustrative example: "In the hallway they hold on to a wobbly cabinet; by the kitchen they step over a cable."

  2. Add more light

    Good lighting is one of the main measures against falls. A light switch should be within reach at the entrance to each room and by the bed, and at night the way to the toilet is best lit with a night light.

    Illustrative example: "Put a night light in the hallway, move the lamp closer to the head of the bed."

  3. Clear the floor

    Remove cables, boxes, piles of newspapers and low objects that are easy to trip over from the route. The walkway should stay clear even when the person walks with a support or is being helped.

  4. Deal with rugs and thresholds

    Slippery rugs are best removed or firmly secured, and carpet edges should not curl up. High thresholds are a common trap: they can be levelled or at least marked with a contrasting strip.

    Illustrative example: "Remove the small rug by the bed, stick bright tape on the bathroom threshold."

  5. Check the bathroom and toilet

    A wet, smooth floor and nothing to hold on to make these the most dangerous rooms. Grab bars by the bath and toilet and a non-slip floor surface give support at the most unsteady moment.

  6. Look at the bedroom

    Getting up should be easy: a stable bed of a suitable height, a light that can be switched on without getting up, and something to hold on to nearby. Glasses, phone and water are best kept within arm's reach.

  7. Check the stairs and entrance

    If there are steps in the home, they need sturdy handrails and good lighting along the whole flight. Steps and the area in front of the front door should not be cluttered with shoes and bags.

  8. Tell the doctor what you've noticed

    If the person has already fallen, has become less steady or complains of dizziness, tell the doctor. There can be many causes, and a professional, not the family, should work them out.

    Illustrative example: "Lost their balance twice this month when getting out of bed."

Common mistakes

  • Changing everything in one day and throwing the person off their usual route
  • Leaving the home completely dark at night so the light "doesn't disturb"
  • Assuming that because they haven't fallen so far, they won't
  • Using wobbly furniture or a towel rail as a makeshift support
  • Deciding for your relative without asking where they themselves find things awkward
  • Not telling the doctor about a fall because "there was no injury"

If that doesn't work

  • If grab bars can't be fitted right now, at least remove slippery rugs and add light
  • If the person resists change, start with the one room where the risk is highest
  • If you live apart, ask neighbours or relatives to check the home using this list
  • If you're unsure what else can be done, ask the doctor or nurse at the next visit

Check the result

  • There is night lighting on the way from the bed to the toilet
  • Slippery rugs are removed or secured
  • Walkways are clear of cables and boxes
  • There is something to hold on to in the bathroom and toilet
  • Everyday essentials are within arm's reach
  • The doctor knows about any falls and episodes of lost balance

Room by room

WhereWhat to checkWhat you can do
HallwayLighting, cables on the floor, shoes by the doorNight light, run cables along the wall, a shoe rack
BedroomBed height, light switch, support nearbyA bedside lamp, a sturdy chair or grab rail nearby
BathroomSlippery floor, support by the bathNon-slip surface, grab bars
ToiletSomething to lean on when standing upA grab bar at the side, a light for the night
KitchenEveryday items on high shelvesMove frequently used items to hand height
  • Daily care

    Hygiene and skin, drinking and food, movement and positioning — the everyday basics of care and their limits.

  • Ask the doctor

    What to ask the doctor and nurse about monitoring at home, the medication schedule and warning signs.

  • Topics

    A map of topics: home safety, daily care, prescriptions and doctor's visits, the carer's own strength. Plus the article catalogue.

Sources

  • WHO — materials on falls prevention
  • WHO — materials on healthy ageing
  • Ministry of Health of the Russian Federation — public information leaflets
  • Guidance on caring for people with limited mobility

Information is current as of the date of preparation. Arrangements for home medical care, social services and paperwork differ between countries and can change — check the details with your local health and social services.