Home Safety Check List

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Home Safety Checklist

This form is a complete list of all of the areas in your home that present a danger to your parent or loved one, and outlines the factors that increase risk.

Organization

Name of neighbor/friend/relative and phone number to contact in the case of an emergency and you are not able to get to your loved one’s home: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ Post your name and phone number next to every phone AND give this information to AT LEAST one neighbor/friend.

A

Name of a community member, social worker, other professional to contact in the case of an emergency and/or regular updates: ________________________________________________________________ ________________________________________________________________

IS

Location of an extra key for your loved one’s home: ________________________________________________________________

IS

Medic-Alert or LifeLine bracelet so your loved one can access help if he/she fall.

See our website under Resources for a link: ________________________________________________________________ Risk factors for falls

Over 75 years old Living alone Housebound Use of cane/walker Previous falls Acute illness, chronic conditions, tremors (neurological disorders) o Multiple medications

TH

o o o o o o

o Cognitive impairment o Vision and hearing problems o Difficulty sitting/standing from a chair/bed o Foot problems o Alcohol/drug use o Poor nutrition o Balance/equilibrium problems

Erickson Resource Group – stephanie@ericksonresource.com / www.ericksonresource.com t: 514-795-7377 EST ©2009 Erickson Resource Group - All rights reserved. No content contained within this document may be reused without prior written permission

DE M O

Bathroom

Install grab bars in the bathtub or shower and by the toilet Use rubber mats in the bathtub or shower Use a shower chair or bench Take up floor mats when the bathtub or shower is not in use Install a raised toilet seat Remove tub and install a shower with a minimal step-up. Place a chair in shower stall o Use a telephone shower head o o o o o o

Kitchen

IS

A

o Use automatic tea pot o Remove rugs without a non-stick service o Place most used pots and pans at waist level to minimize bending and stretching o Use a microwave to reduce use of oven/stove o Disconnect stove/oven fuses if there are memory impairments and it has been left turned on Outdoors

Repair cracked sidewalks Install handrails on stairs and steps or install a ramp Trim shrubbery along the pathway to the home Install adequate lighting by doorways and along walkways leading to doors All living spaces

TH

IS

o o o o

o Remove throw rugs, or tape down to secure o Secure carpet edges o Avoid visually distracting patterns on flooring/carpets; mark transitions from carpet to flooring with a different color paint/stripe o Remove low furniture and chairs that are too low to get up/down o Remove objects on the floor o Reduce clutter o Remove cords and wires on the floor

Erickson Resource Group – stephanie@ericksonresource.com / www.ericksonresource.com t: 514-795-7377 EST Š2009 Erickson Resource Group - All rights reserved. No content contained within this document may be reused without prior written permission

DE M O

o Stairs: o Install hand rails on both sides of staircases at elbow height; make sure an adult can wrap their hand completely around the handrail; attach them securely to walls or posts o Secure carpet on treads of stairs o Install light switches at the top/bottom of stairways o Do not reduce lighting in stairways o Do not place rugs at the top/bottom of stairs o Leave one hand free to hold the handrail when carrying objects o Check lighting for adequate illumination at night, especially in the pathway to the bathroom and on stairs o Avoid floor wax or use nonskid wax o Ensure that the telephone can be reached from the floor General safety

TH

IS

IS

A

o Wear shoes or slippers that fit properly and have a non-slip sole o Remove reading glasses when walking up/down stairs o Install a telephone on every level of the home, especially in the bedroom, kitchen, and bathroom o Install a bathroom on each floor o Understand side-effects of medications, such as dizziness o Avoid alcohol o Avoid carrying large or heavy objects, such as laundry baskets o Get up slowly from a sitting or laying position; sit on the side of the bed before rising o Wear clothing with an elastic waistband for easy removal

Erickson Resource Group – stephanie@ericksonresource.com / www.ericksonresource.com t: 514-795-7377 EST Š2009 Erickson Resource Group - All rights reserved. No content contained within this document may be reused without prior written permission