I’ve spoken with many loved ones, patients, and caregivers who worry about whether their I’ve spoken with many loved ones, patients, and caregivers who worry about whether their homes are truly safe. I often hear questions about what changes can be made and if it’s even possible to do them in time. The truth is, it’s never too early to begin making your home a safer place.
Growing older doesn’t have to mean giving up independence or moving away from the home you love. What it does mean is being realistic about new risks, such as falls, medication mix-ups, or hard-to-reach cupboards, and taking simple, practical steps to reduce them. The good news is that many of the most effective changes are affordable, easy to do, and help everyone in the home feel safer and more comfortable.
Why home safety matters
Falls are the leading cause of injury among adults 65 and older. More than one in four older adults falls each year, and a single fall significantly increases the likelihood of another. Fatal and nonfatal fall rates have been rising in recent years, especially among the oldest adults. These numbers aren’t meant to scare you; they’re meant to motivate simple, proven actions that reduce risk and preserve independence.
The simple framework: assess, remove hazards, add supports, stay strong
Rather than trying to “fix everything,” use a four-step approach:
- Assess: Look honestly at high-risk rooms and daily routines (bathroom trips at night, steps into the house, reaching for items). Use checklists, such as AARP’s HomeFit worksheets and the CDC’s STEADI “Check for Safety” checklist, to guide you.
- Remove hazards: Clear loose rugs, cluttered stairs, or poor lighting that make slips and trips more likely. Even small changes, such as removing a throw rug or relocating a lamp, can have a significant impact.
- Add supports: Install grab bars, non-slip strips in the tub, night-lights, handrails, or a raised toilet seat as needed. These make daily tasks easier and reduce the risk of injury. The AARP HomeFit Guide provides numerous examples and illustrated, step-by-step solutions.
- Stay strong and balanced: Exercise programs that focus on balance, strength, and gait reduce fall risk. Clinical guidelines recommend structured exercise for older adults at an increased risk of falls and encourage multifactorial interventions when appropriate.
Room-by-room checklist
Entryways and stairs
Why it helps: Stairs and steps are frequent sites of falls; good lighting and handrails greatly reduce risk. Use the CDC home checklist for specifics.
- Keep walkways and stairs clear of shoes, mail, and clutter.
- Add a handrail on both sides of staircases if possible; make sure existing rails are secure.
- Ensure there’s bright, easy-to-reach lighting with switches at the top and bottom of the stairs. Consider glow switches for night use.
Living areas
Why it helps: Reducing trip hazards and minimizing reaching lowers the chance of a sudden loss of balance.
- Remove throw rugs or secure with nonslip backing.
- Limit using step stools by keeping frequently used items within easy reach.
- Position seating so it’s easy to get up from (arms on chairs help).
Kitchen
Why it helps: Kitchens require frequent bends, turns, and carrying; organizing for comfort reduces moments of vulnerability.
- Store everyday dishes and food at hip-to-shoulder height. Avoid heavy lifting from low cabinets.
- Use pull-out shelves and anti-slip matting in cabinets if bending down is difficult.
- Have a sturdy step stool with a rail if you must reach higher shelves; avoid balancing on chairs.
Bathroom
Why it helps: Bathrooms are high-risk settings for slips and serious injuries. Grab bars and non-slip surfaces dramatically reduce the risk of falls. Bathroom modifications are top priorities.
- Install and use grab bars by the toilet and in the tub/shower (not towel bars, as they are not secure).
- Use a non-slip bathmat and consider a shower seat or handheld shower head.
- Ensure there’s a night light that makes nighttime trips safe.
Bedroom and nighttime safety
Why it helps: Many falls occur during nighttime bathroom trips; clear lighting and unobstructed paths reduce the risk.
- Place a lamp within reach of the bed and keep a clear path to the door and bathroom.
- Consider a bed-height that makes getting in and out easier and a phone or medical alert device at the bedside, or even better, with you at all times.
What the evidence says about home modifications and fall prevention
It has been shown that home modifications (especially when tailored to an individual’s needs and combined with other interventions) reduce the number of falls and the number of people who fall. Programs that assess a person’s individual risk (vision, mobility, and medication review) and then apply targeted changes, such as installing grab bars, improving lighting, and removing trip hazards, are more effective than one-size-fits-all fixes. That means getting a simple home-safety assessment pays off.
Beyond the house: medical and lifestyle checks that matter
Review medications with a clinician or pharmacist
Many older adults take medicines that increase dizziness or sedation. A careful medication review, including questions about whether any drugs might increase fall risk, is part of best practice. Clinical guidance recommends assessing fall history and limiting or reevaluating medications that increase the risk of falls.
Vision and hearing checks
Small changes in vision or hearing can impact balance and spatial awareness; regular vision and hearing exams can help reduce the risk of falls. If hearing or vision loss is present, treat it. Improved hearing supports spatial orientation and overall safety.
Strength and balance training
Exercise that focuses on strength, balance, and gait consistently reduces the risk of falls. Structured exercise programs (for example, group exercise classes, personal training, balance classes, or supervised physical therapy) can help older adults at increased risk of falls. Exercise can be a cornerstone of prevention.
Low-cost vs higher-cost changes
If budget is a concern, start with low-cost, high-impact steps:
- Remove loose rugs and clutter (free).
- Improve lighting and add night lights (low cost).
- Add nonslip treads in tubs and on stairs (low cost).
- Move everyday items to easy-to-reach shelves (low cost).
Next, consider moderately priced supports:
- Professionally installed grab bars and railings.
- Shower seats and handheld shower heads.
- Motion-sensor lighting for entryways.
Higher-cost renovations (if needed) may include curbless showers, stair lifts, or widening doorways to accommodate mobility devices. These are wonderful when necessary, but they often come after simpler fixes and are sometimes partially covered by local aging services programs or home modification grants. Check local Area Agency on Aging resources.
Practical tips for families and caregivers
- Approach the topic with empathy: say, “I want you to be safe so you can stay in your home longer,” rather than “You’re not safe anymore.”
- Use the AARP HomeFit checklist or the CDC STEADI checklist together; it’s a neutral, practical way to point to specific changes.
- Offer to help with easy fixes (pick up a night-light, move a rug) and plan for larger changes together (scheduling a handyperson to install a grab bar).
- If the person resists, start with changes they see immediate benefit from (a shower seat, better lighting) and revisit other items later.
Who can help
- AARP HomeFit Guide: free illustrated guide and worksheets to walk through changes room-by-room. Great starting point.
- CDC STEADI: clinical and public resources, including the “Check for Safety” checklist and materials for patients and caregivers. It is helpful for assessments and conversations with clinicians.
- Area Agencies on Aging: Local public or private nonprofit agency chosen by your state to address the needs and concerns of older individuals. They often provide home-safety assessments, information on grants, and referrals to vetted contractors. (Search your county/state aging services website)
- Physical therapists and occupational therapists: can assess mobility and recommend individualized home changes and exercises. Evidence suggests that combining home modifications with individualized interventions yields the best outcomes.
Common questions
Q: Will grab bars make my bathroom look institutional?
A: Not at all. Modern grab bars are available in a variety of attractive finishes and designs. You can choose discreet and sturdy options that blend seamlessly with your bathroom. The priority is safety; style choices are widely available.
Q: Do I need to stop living alone or move to assisted living?
A: Not necessarily. Many older adults continue to live safely at home after making targeted changes and following exercise and medication reviews. Planning and making small investments can often help maintain independence for years.
Q: Will vitamins or calcium prevent falls?
A: Routine vitamin D or calcium supplementation is not a proven strategy for preventing falls among community-dwelling older adults. The most substantial evidence supports the benefits of exercise and multifactorial risk assessment. Discuss supplements with your healthcare provider based on your individual health needs.
A gentle plan you can start today
Five minutes: Walk from bedroom to bathroom at night and imagine the path; note any rugs, cords, or low lighting. Remove one obstacle.
One afternoon: Install a night-light, move frequently used items to waist height, and pick up throw rugs.
This week: Download the AARP HomeFit checklist or CDC STEADI checklist and mark the top three items to fix. Ask a friend or family member to help.
This month: Schedule a vision and medication review with your primary care provider. Some pharmacists conduct medication reviews with extensive experience in geriatric medicine. These pharmacists often take a reasonable amount of time with each patient and tailor a plan just for you. Ask the pharmacist to collaborate with your primary care provider for the best continuity of care. A simple Google search can help you find a board-certified geriatric pharmacist (BCGP) who performs medication reviews. Join a local balance or strength class, which can help improve your overall muscle strength and balance (try to find courses led by certified trainers or healthcare professionals).
Next 3–6 months: Improve your home safety by installing grab bars in the bathroom, improving stair railings, and creating a small budget for other beneficial home supports