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Simple Home Modifications for Fall Prevention

Ten strategies preventing falls at home for older adults

When it comes to aging in place at home, a fall can mean the beginning of the end of your independence. Serious injury is one of the biggest risk factors for older adults, and falls happen much more often than they need to. Falls are the leading cause of serious injury for older adults, and this article explains home modifications that help tremendously for anyone who wants to boost the fall prevention aspect of their home.

Avoid Falls: The Biggest Risk Factor & Sources of Serious Injury

According to the Centers for Disease Control (CDC) every second, around the clock, every day of the year, an older adult falls somewhere in the US.

In the time you’ve taken to read this article so far, 20 seniors have fallen, some sustaining serious, avoidable injury. Falls lead to broken bones, and this leads to hospitalization, separation from loved ones, immobility and the development of infection and respiratory issues.

How to Prevent Falls at Home

Fall proofing your home is essentially a specialized form of home improvement, and the six strategies below are the most important ones for helping older adults from the risk of falling. Preventing this serious risk of injury is the main focus. An occupational therapist or physical therapist can advise you on choosing a mobility aid and other assistive devices.

Prevent Falls at Home Tip#1: Install Grab Bars

One of the first home features to consider is to install grab bars. This may seem obvious, but it’s surprising how often this does not happen, even when recommended by an occupational therapist. It’s also surprising how few people consider the value of floor-to-ceiling grab bars. These are especially good at preventing falls in bathrooms. Floor-to-ceiling grab bars are useful because they can be grabbed at different heights.

Solution: Install grab bars in many places, but especially floor-to-ceiling grab bars in areas with lots of activity, such as the bathroom and bedroom.


Prevent Falls at Home Tip#2: Automate the Front door

Few people realize how tricky a front door can be for older adults to open and close, especially if there are two doors involved: a screened door and a heavier inner door. The challenge is two-fold. Screen doors are typically spring loaded. The resistance to opening and the tendency to close on their own does increase the risk of falling. Wind is another issue. Screen doors can act like a sail, getting caught in the wind and opening quickly, knocking older people over.

Solution: Consider installing an automatic door opener, at least on the screen door. Many models are available, some with a wall-mounted button on the outside of your house, or even with a wireless remote control fob.


Prevent Falls at Home Tip#3: Modify Light Switches

These are typically installed too high for handy use from a wheelchair or walker, leading to unnecessary reaching and an increase in risk of falling. To reduce the fall risk, consider one of the many types of light switches made for older adults. You’ll find different models, and none require the troublesome and disruptive task of having the light switch moved lower on the wall. Options for senior-friendly light switches include models with strings that hang down for ON and OFF control; extenders that make it possible to lower light switches for easier control; and even light switches that can be controlled by voice or a phone.

Solution: Don’t live with inadequate light switches. Many models can easily can make existing switches so much easier to use.


Prevent Falls at Home Tip#4: Increase Muscle Strength

So far all the tips here have been about home modifications that help older adults avoid falls and injury, but that’s only one side of the equation. The other side is all about older adults getting stronger and less reliant on modifications. Physical activity and regular exercise is key to retaining and enhancing resistance to fall risk, and it doesn’t take much to stay physically active in a way that makes a big difference. Even a little movement each day indoors will provide balance and reduce the risk of falls. Sensible shoes, a clutter free house with a clear path to move will do wonders at preventing falls. Keep your muscles strong and it will go a long way as a fall proofing strategy.

Solution: Make regular exercise part of your life, and stick with it as a daily routine.


Prevent Falls at Home Tip#5: Install Night Lights

This sounds so simple and it is. But like many details that prevent falls at home, much of the gain comes from fairly simple things. The best night lights turn ON automatically when movement is detected, and they also have built-in battery backup so they keep working even during a power failure.

Solution: Experiment with different night lights, then settle on a style you like. Night lights are cheap so it’s not costly to try different models. No traveled area of a house should remain in complete darkness during the night.


Prevent Falls at Home Tip#6: De-Clutter Electrical Cords

This may be the simplest thing that’s possible for reducing the risk of falling, but that’s why it’s worth thinking about. Electrical cords can become a jumbled mess, but a power bar can make it possible to tame the area and help keep it clutter free. My favourite type of cable clamp, shown below, is one of the best ways to keep electrical cords tidy, preserving a clear path where people walk.

Solution: Make cord control and organization part of keeping a house clutter free. Use cord management hardware and power bars to keep all electrical cords out of the way. This is important for everyone, but especially older adults.


Prevent Falls at Home Tip#7: Fall Proofing the Bathroom

More than 80% of injuries to older adults happen because of falls, and the bathroom is the most dangerous room in the house for older people. Within the house itself, 20% of all falls happen near the toilet, but the entire bathroom is a hazardous place for seniors so the entire space should be optimized. A raised toilet seat with grab bars is easy to install, and so are horizontal grab rails near the toilet installed according to ADA guidelines. A shower chair is another feature that’s easy to install, but the best option is a barrier-free shower (with a shower chair), or a walk-in bathtub. Good lighting, the discipline to make sure wet surfaces are dried off quickly, and a commitment to keep bathrooms clutter free and dry are all ways to make fall proofing real, and to boost disease control and prevention.

Solution: Invest special care in the modification of the bathroom since this is a fall risk hotspot. Falling in the bathroom is especially hazardous because floor surfaces are usually hard and damaging, and there are many things to hit on the way down in a bathroom.


Prevent Falls at Home Tip#8: Install a Ramp or Porch Lift

Older people weren’t always older, and this means a mental transition needs to occur when it comes to fall proofing a home. And a big part of this fall proofing is some way of entering and exiting the home safely. A significant number of falls happen when a ramp or porch lift should be in place but isn’t yet there.

So, if you want just one option, how do you decide? It usually comes down to a couple of considerations. The main one being space. Wheelchair access ramps take up a fair amount of room, and the higher the overall height of the ramp, the more space is needed.

The steepest an access ramp can be according to the Americans With Disabilities Act (ADA) is 1 inch of rise for every 12 inches of horizontal run, but this is steeper than ideal in my opinion. A better option is something closer to 1 inch of rise for every 20 inches of horizontal run.

So, for instance, if you require 36 inches of vertical rise, then your ramp will need to be at least 36 feet long at the shortest and steepest, or 60 feet at the 1:20 slope. That’s a big space and not all residential properties can accommodate that. Even with switchbacks and landings it can be tricky to find room for a ramp this large. This is one reason people turn to outdoor lift systems. 

Lifts are much smaller, both physically and visually. They’re a powerful fall prevention feature, and include a kind of compartment that can accommodate someone standing or sitting in a wheelchair. You get onto the lift, close the gate or door behind you, push a button, rise to the level of a porch or verandah, then open the door and get out up top. A lift and ramp will cost similar amounts, but a lift requires some specialized installation skills. By contrast, any good carpenter can build a safe and effective access ramp from wood.

Solution: Plan early to have fall proof entry features installed. It’s important that you begin planning for a ramp or porch lift before the need arises.


Prevent Falls at Home Tip#9: Enhance Overall Lighting

The more light the better, especially as we age, and there are several simple ways to go about increasing the brightness of lighting in your home. Don’t wait until a fall happens to enhanced lighting.

LED bulbs: Today’s LED bulbs offer the option of increasing light output beyond the power of incandescent bulbs the fixtures were rated for. Here’s what I mean … Let’s say you’ve got a ceiling fixture rated for a maximum of 60 watts. This is a rating for incandescent bulbs, it’s quite common, and it has to do with heat build up. A 60 watt incandescent bulb runs cooler than a 100 watt incandescent, and quite a bit hotter than, say, a 25 watt incandescent levels. That’s why it would be unwise to put a 100 watt incandescent bulb into this socket because of the excess heat generated, but LED bulbs change all this. The LED equivalent bulb that puts out 100 watts worth of light only consumes about 15 watts, so it develops only a small amount of heat. This is why LED bulbs offer the opportunity to increase light output beyond what a fixture could normally handle. You always have the option of installing new fixtures, but this is often unnecessary.

Skylights and roof windows: Skylights open a little (or not at all) while roof windows open a lot. Either way, it goes without saying that adding some of these to your house will increase indoor lighting, but there’s more to it than this. Openable skylights and roof windows makes it much easier to maintain cooler indoor temperatures. I’ve seen this happen in my own house. After I installed four roof windows in a finished third-storey attic at my place, the entire house gets rid of hot air much faster as regular windows are opened an every floor below. The open roof windows make the house act as a chimney, allowing warm air to rise up and out much more quickly. The best skylights/roof windows I’ve seen are made by VELUX, and my favourite model of theirs is solar powered and self-closing. The sun keeps an onboard battery charged, and this allows you to open and close these skylights manually with a hand-held remote control. Automatic, programmable opening and closing can happen too, and they close quickly and automatically in case of rain. There are also remote control blinds that are available for this type of skylight. Watch the video coming up for a close look at solar skylights I’ve installed at my own place. 

Light tunnels: Similar to skylights, but light travels down a shiny tube about 18 inches in diameter that can travel through closets or upper storeys on its way to a ceiling lens. I added a sun tunnel at my own place to brighten the area above the kitchen sink and it works really well. The best models include a built-in light fixture hidden inside to deliver light from above, even at night. During the day the light coming through the ceiling lens looks as bright as an electric light but it’s not. The importance of good lighting cannot be over stressed.

Solution: Take stock of the illumination levels around the home, and make a plan to install lots of additional light sources.


Prevent Falls at Home Tip#10: Install Micro Ramps 

Many houses have small changes in floor height from one area to another that can be challenging to roll or walk over, and this is where micro ramps can help. This can be the case with any interior door and especially at the front door.

Micro ramps are small, short, movable, factory-made ramps designed to ease the transition up and down door thresholds or small changes in floor height in your home. It’s also possible to have a woodworker custom-make little ramps from wood for your situation. My preference is for custom-cut wooden ramps like these. Either way, micro ramps make it easier to roll over uneven areas, and they also make it less likely you’ll trip when you’re on foot. There are many models of threshold ramps on the market. Some are adjustable, others are meant for a specific range of heights. The largest single collection of threshold ramps I’ve seen in one place is on Amazon. Go to, then search for “threshold ramps”.

Solution: Don’t tolerance any door threshold that’s not smooth, flat and easy to roll over with a wheelchair or walker. Besides being safer, this helps make up for diminished muscle strength and poor eye sight


Prevent Falls at Home FAQs

Q: How can falls be prevented in the home?

A combination of aging in place modifications and a program of physical activity are the best ways to build fall prevention into your life. Is this a lot of trouble? Yes, but far less trouble than a hospital stay that leads to long-term decline. Taking steps to eliminate tripping hazards, creating high-friction walking surfaces, having someone eliminate icy areas outside the home, and even wearing sensible shoes indoors are changes that are within easy reach, and easy to do. Assistive devices such as a power lift chair to provide support while getting up and sitting down, nonslip mats, painting different areas of the home in a contrasting color – these all make a big difference.

Q: What are the 5 P’s of fall prevention?

A: Some people follow 4 P’s, but there’s a 5th that should be included, too:

  • Pain: Are you hurting? Seeking and accepting pain relief is important because pain can cause you to lose focus, making you more likely to fall. And if falls happen when you’re in pain, you’re more likely to be injured because your muscles will be tense.

  • Personal Needs: Many a serious injury could be prevented if assistance was available from a helper.

  • Position: A comfortable and safe position when seated or lying down is key to prevent falls and injury.

  • Placement: Can you reach things you need easily? Clearing clutter and using a grab stick to help pick up and retrieve objects such as a book, TV remote, water glass, call device and other small items will go a long way to prevent falls at home.

  • Fall Prevention By Design: This comes down to the home modifications outlined here and more specifically in my online course AGING WELL AT HOME.


    Q: What are some fall prevention strategies?

    A: The basics needed to prevent falls at home include:

  • Grab bar installation

  • Home features that open doors, climb stairs, turn light switches ON by voice or the push of a button.

  • Increasing personal strength and flexibility with exercise and the input of a physical therapist


    Q: What to do for elderly parent who keeps falling?

    A: Take note of situations that have caused falls in the past, then add physical features to compensate for this, one by one. An occupational therapist can suggest strategies for fall prevention, but more of an issue is seniors who are reluctant to have aging in place features installed in their home. Hearing recommendations from a professional can often make a big difference.


    Q: What is the best recommendation for fall prevention in the elderly?

    A: The most effective strategy for fall prevention is to begin making modifications early, before the need arises.


    Q: What is the most appropriate way to prevent falls?

    A: The first step is to recognize that changes need to happen in the home before real needs arise. In addition to the installation of grab bars, good lighting, and other assistive devices, dealing with medical issues is also part of the mix. Whenever possible, correct issues of poor eyesight, foot problems, engage in regular exercise to provide balance improvements by making muscles strong. Install nonslip mats, arrange things within easy reach, make stairs easier to use safely with high-friction surface stickers and use contrasting color of paint to make corners and other hazard areas more visible.

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