Keeping Seniors Safe in Their Own Homes: Stairways, Hallways, & Outdoor Areas

As the home health nurse, you are continuing the walk-through of an elderly client's home. This article reviews home safety tips for stairways, hallways, and the outdoor area.

Stairways

Stair safety is important for preventing falls and serious injury or death, since one of the most accident prone areas of the house is the stairs. Falls on stairways are especially dangerous. It is common for seniors to have difficulty safely navigating the stairs, due to conditions such as arthritis or glaucoma. Steps should be in good condition and free of objects. It is imperative to have adequate lighting in stairways, hallways, and pathways, with light switches placed at each end. Light switches should be located at the top and bottom of stairs. Check periodically to make sure that lights work. Steps should have nonskid strips or carpeting on them. If carpeting is desired, then plain, light-colored low-pile carpet should be used. Avoid deep-pile carpet, as it can cause the elder to trip. Ensure the carpeting is not bunched up or uneven, worn or loose, or frayed at the edges. This can lead to insecure footing, resulting in slips and falls. Steps should be clearly visible. Patterned and dark-coloring carpeting should be avoided, as this can make it difficult to see the edges of the steps clearly. Bright tape strips (red or orange) can be added to the edge of each stair to make them more visible (but make sure the strips are securely stuck down). Install tightly fastened handrails securely on both sides of the stairs and running the entire length from top to bottom. Handrails should fit the grip of the hand fully with a diameter of about 1.5 inches and be fixed at a comfortable height of around 34 inches. Stairs should not be too steep, like an Aztec pyramid. Optimal stair dimensions are 7.2 inch riser heights with an 11 to 12 inch tread width for each step (in other words, wide enough for secure footing). The steps should be even and of the same size and height. Even a small difference in step surfaces or riser heights can lead to falls.

Hallways

The foyer should have a nonslip entrance. Ensure that hallways are well lit and free of clutter. Keep pathways clear, especially to the bathroom. If floors are uncarpeted, ensure they are not slippery. Do not polish or buff them. If carpet is used, it should be low pile and secured. If there are throw rugs or scatter rugs lying about, remove them or add a nonskid backing. Tack down all carpets and area rugs firmly to the floor. Secure rugs with nonskid tape as well as carpet edges. Have at least one phone extension in each level of the home and post emergency numbers at each phone. Keep emergency numbers in large print near each telephone. Place smoke alarms in hallways and near sleeping areas.

Outdoor Area

Door handles should be lever-action instead of round knobs. Remove high doorway thresholds, or make them low and beveled, as uneven foot spaces can cause the older person to stumble and fall. For all outdoor stairways, check lighting, handrails, and the condition of the steps and coverings. Handrails should be sturdy and securely installed on both sides of porch stoops and steps. Security lighting should be installed outside. At night, stairs should be lighted so that each step, particularly the step edges, can be clearly seen while going up and down stairs. The lighting should not produce glare or shadows along the stairway. Paint edges of outdoor steps white to see them better at night. Repair cracks or abrupt edges of sidewalks and driveways. Shrubbery should be trimmed along the pathway to the house. Keep walk areas clear of sticks, rocks, equipment, garden tools, and other clutter. Keep walk areas clear of snow and ice.

Home safety for older adults is a major concern in our aging society. The tips in this article are useful to support elderly clients in living safely and independently in the comfort of their own homes.

References

Chapter 1: Falls and stair negotiation in older people and their relationship with vision

AARP: Make Your Home Safe for Your Aging Parents

Improving Home Safety for Seniors

Fall prevention: Simple tips to prevent falls

Fall Prevention Guide for Older Adults