If you are worried about safety at home, you are not alone. In our video, Debbie from Understood Care talks about common barriers like a bathroom that is too small for a wheelchair, the absence of grab bars in the shower, and the need for safe ramped steps. She highlights that many programs can help adapt a primary bathroom and other high risk areas so the home fits your medical needs. She also notes that trained companies can perform a home safety evaluation and that advocates can help you find low or no cost options when you qualify. This is a vital part of staying independent and avoiding preventable falls and injuries.
Falls are the leading cause of injury for older adults. Many falls happen at home, and even nonfatal falls can cause fractures, head injury, or fear of falling that limits daily life. Evidence shows that practical changes in the home reduce fall risk, especially for people who have fallen before or who are at higher risk. A room by room approach works well because bathrooms, stairs, entrances, and cluttered walkways are frequent problem areas. Simple upgrades can make a major difference, and larger adaptations can make essential activities like bathing and toileting safer and easier.
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What a home safety evaluation looks for
A professional evaluation reviews your daily routines, the layout of your rooms, and the fit between your abilities and the environment. Occupational therapists and trained home safety specialists often focus on
Bathroom safety including transfer space, secure grab bars, seating for bathing, and non slip surfaces
Entrances and exits including thresholds, handrails, and ramp needs
Stairs and hallways including clear pathways and lighting
Bedroom and living areas including bed height, chair height, and space for a walker or wheelchair
Kitchen access including safe reach, stable footing, and task setup
Lighting, contrast, and visibility throughout the home
When ordered as part of skilled home health services, an occupational therapy home safety assessment may be covered by Medicare if eligibility criteria are met. Your advocate can help you understand when this applies and how to request it.
High impact changes you can make
Bathroom adaptations
The bathroom is a common site of falls because of wet surfaces and tight spaces. Helpful upgrades include
Grab bars mounted into studs or reinforced walls near the toilet and in the shower or tub
A raised toilet or a toilet safety frame for easier transfers
A walk in or roll in shower, or a secure shower chair or bench with a handheld shower
Non slip mats inside and outside the tub or shower and water cleanup habits to keep floors dry
Lever handles for faucets and doors for easier grip
Clear turning space for a wheelchair or walker where possible, supported by widely used accessibility standards that call for a sixty inch circular or T shaped turning space in many settings
Good lighting with night lights for safe bathroom trips after dark
Entrances, steps, and ramps
Safer entry often requires sturdy handrails on both sides of stairs, bright lighting, and a ramp or threshold solution that matches your mobility device. A well designed ramp improves independence for wheelchair users and anyone who uses a walker. Your evaluator can check slope, landing space, and turning needs so the ramp is safe and comfortable to use.
Floors, seating, and layout
Remove or secure throw rugs, power cords, and clutter in high traffic areas
Choose firm, supportive chairs and a bed height that lets your feet rest flat on the floor when sitting
Place commonly used items at waist to shoulder height to avoid bending or climbing
Use contrasting colors at edges of steps and thresholds to improve depth perception
Lighting and vision
Increase light at stairs, hallways, and entryways
Use night lights in bedrooms and bathrooms
Replace dim bulbs and add switches at both ends of stairs when possible
Keep glasses prescriptions current and ask about low vision strategies if you have vision loss
Mobility and assistive devices
A properly fitted cane, walker, or wheelchair improves safety when paired with a layout that allows enough space to maneuver. If your device feels hard to use at home, a fit check and small layout changes can make a big difference. Understood Care can help you review options for ramps, grab bars, and other mobility supports at https://understoodcare.com/care-types/mobility-equipment.
Grants, coverage, and ways to pay
Finding the right funding is often the hardest part. Your advocate can help you explore
Veterans benefits for home adaptations
Home Improvements and Structural Alterations, often called HISA, can fund medically necessary changes to your primary residence such as roll in showers, wider doorways, or improved plumbing and electrical for medical equipment
Specially Adapted Housing and Special Home Adaptation grants can fund larger projects, including buying, building, or remodeling a home to support independent living for qualifying service connected disabilities
Temporary Residence Adaptation can help modify a family member’s home when you live there temporarily
Your advocate can help you figure out which benefit fits your needs and assist with documentation and next steps.
Medicare and clinical services that support safety
Medicare may cover skilled services like occupational therapy in the home when you meet criteria for home health and when the services are reasonable and necessary. An occupational therapist can evaluate your home, train you and your caregiver in safe techniques, and recommend equipment or modifications. Part B may also cover outpatient therapy services that include fall risk evaluation and training. Coverage for bathroom safety items varies. Your advocate can help you decide what to request from your clinician and how to appeal if needed.
Community programs and local help
Many counties and cities partner with nonprofits and agencies that provide fall prevention classes, home safety education, and limited home modification assistance for eligible residents. Advocates can help you find these options, apply, and coordinate work with your clinician so the plan is safe and meets your needs.
Your step by step action plan
Write down what is hard at home. Note places you feel unsteady, tasks you avoid, and recent near falls or falls.
Ask your clinician for a home safety evaluation. If you receive home health services, request an occupational therapy visit focused on safety and mobility at home. If you are not in home health, ask about outpatient therapy and what to practice at home.
Make fast wins first. Clear walkways, secure or remove loose rugs, add night lights, and keep essentials within easy reach.
Plan bathroom upgrades. Prioritize secure grab bars, a safer shower setup, and a toilet height that matches your needs. These changes reduce the highest risk tasks.
Improve entries. Evaluate the safest route into the home, then plan railings, a ramp, or threshold changes with attention to fit for your device and your turning needs.
Address lighting and contrast. Replace dim bulbs, add task lighting where you read or cook, and use color contrast at edges that are hard to see.
Choose the right equipment. Get a cane or walker fitted for your height, confirm brakes and tips are in good condition, and practice safe transfers and turns.
Explore funding. If you are a veteran, review HISA, SAH, and related options. If you have Medicare, ask whether therapy or home health can support your plan. Your advocate can help with applications and appeals.
Check back and adjust. Reassess after any hospitalization, new diagnosis, or change in mobility. Home safety is ongoing and should grow with your needs.
What Debbie shared in the video and how we put it into action
Debbie emphasized three points. First, many bathrooms are not set up for safe wheelchair or walker use, which raises the risk of falls. Second, community and VA programs exist that can remodel a primary bathroom and address other essential barriers. Third, companies can perform a safety evaluation to identify what to change, and Understood Care can help you find programs that fit your needs and budget. Your advocate will start with your highest risk tasks, usually bathing, toileting, transfers, and steps in and out of the home, then help you line up the right evaluation, funding, and contractors or suppliers so the plan is safe, sequenced, and affordable.
When to call your clinician right away
Call your clinician if you hit your head, lose consciousness, have new or worsening pain, or feel unsteady after a fall. Report every fall, even if you think you were not injured. A brief check can uncover medication side effects, vision changes, or blood pressure problems that make falls more likely.
How Understood Care can help
We arrange professional safety evaluations and therapy referrals when appropriate
We help you compare modification plans and equipment choices
We coordinate with your doctors, home health, and suppliers so work happens in the right order
We help you apply for grants and benefits and gather needed medical letters
We follow up after changes to make sure the plan is working and to fix anything that is not
