Simple Strategies to Boost Home Safety and Enhance Independence

Falls are one of the leading causes of injury for older adults, but research consistently shows that many falls can be prevented with a mix of safe home design, strength and balance training, and small daily habits. As a community Occupational Therapist, I often see how small changes, sometimes as simple as better lighting or small threshold ramps, can significantly reduce falls risk and improve confidence at home.

Here are some practical, evidenced based ways to stay up on your feet.

1. Keep Pathways Clear and Well-Lit

Clutter, narrow pathways and poor lighting are major causes of home falls. A 2020 systematic review found that environmental hazards in the home account for up to 50% of fall-related injuries among older adults (Pighills et al., 2020).

Simple changes include:

• Removing loose mats or securing them with non-slip backing/corners. Conni anti-slip floor mats are my personal favourite used anywhere in the home. Additionally, the self adhesive rug corners and backing also work perfectly (many low cost options available).

• Decluttering walkways and removing loose power cords.

• Adding night lights in hallways, bathrooms and bedrooms. Motion sensor or lights on a timer function are perfect for this.

• Ensuring lighting is bright and even

2. Wear Supportive, Non-Slip Footwear

Footwear is strongly linked to quality of balance and falls. A 2019 study found that older adults who wore supportive, firm-heeled shoes with slip-resistant soles had better balance and fewer slips compared with those wearing soft or loose-fitting footwear (Menant et al., 2019).

Avoid:

• Socks alone

• Loose slippers or slides

• Thongs or open-backed shoes

Choose:

• Closed-in shoes with coverage around the heel

• Non-slip soles

• Firmly secured with laces, Velcro or a zip. A shoe horn or adaptive shoes such as the Nike EasyOn products have been a success for my past clients

3. Build Strength and Balance (It’s Proven to Reduce Falls)

Strength and balance training remains one of the most effective falls-prevention strategies. A 2022 Cochrane Review found that balance and functional exercises can reduce falls by up to 24% (Sherrington et al., 2022).

Consider:

• A personalised home exercise program

• Community exercise groups

• Walking programs

• The Stepping On program is also a perfect place to start

If you’re unsure where to begin, a physiotherapist or Access Matters Occupational Therapy can assist in getting you started.

4. Make the Bathroom a Safer Space

The bathroom is consistently identified as the highest-risk area in the home due to water, tight spaces and slippery surfaces.

Think about installing grab rails, using slip-resistant surfaces and appropriate seating to reduce your risk of falls. Paired with education on safe transfers and energy conservation and you’re well on your way to creating a safer space.

Helpful environmental modifications include:

• Stable shower chairs or stools

• Non-slip flooring/surface coating

• Grab rails at appropriate heights and angles

• Handheld shower hoses

• Remove clutter from the floor

• Reduce the need to bend down in the shower by using a shelf or shower caddy

• Limit use of a suction shower mat in the shower recess, particularly on tiled or uneven surfaces.

5. Address Step Heights and Entrance Hazards

Even a small step at the front door or between rooms can be a risk when you’re feeling fatigued at the end of the day. A 2021 falls-risk study found that older adults commonly misjudge height differences of just 100–150 mm, especially in poor lighting or when fatigued (Ludwig et al., 2021).

Consider:

• Handrails

• Sensor lights, particularly along the lower half of the walls

• Small threshold or step ramps

• Non-slip surfacing

• Contrast tape on steps to increase visibility

6. Review Your Medications Regularly

Medication changes can affect balance, blood pressure and alertness.

A 2018 meta-analysis found that certain medication groups — especially sedatives, antidepressants and antihypertensives — can increase falls risk by up to 60% (Seppala et al., 2018).

It’s helpful to:

• Ask your GP for regular medication reviews, particularly if you’re prescribed any medications in the above mentioned medication groups.

• Report any dizziness or fatigue to a GP, family or carers.

• Check in with your GP after starting or changing medications

7. Pace Yourself and Sit for Lower Tasks

Fatigue increases the risk of falls, especially during activities like dressing, cooking or gardening. A 2020 ageing study found that older adults experience greater postural sway and reduced reaction time when fatigued — both key contributors to falls (Adkin et al., 2020).

Strategies include:

• Sitting to dress

• Breaking tasks into smaller steps

• Resting between activities

• Using stable chairs for lower-level task

Check out my other blog post on gardening safely!

8. Stay Hydrated and Nourished

Dehydration and hunger can cause dizziness and low blood pressure, increasing falls risk. A 2019 study linked inadequate hydration in older adults to significantly higher rates of dizziness, confusion and falls (Hooper et al., 2019).

Aim to:

• Drink water regularly

• Have multiple water bottles sitting in the main areas of the home in clear vision.

• Maintain regular meals and snacks throughout your day.

9. Pay Attention to Early Warning Signs

Many people feel “a bit off” before a fall occurs.

If you notice:

• Dizziness

• New or increasing fatigue

• Poor sleep

• More frequent stumbles or kicking your toe

• Feeling unsteady

• Difficulty judging variations in steps or surfaces

It’s helpful to:

• Ensure to have multiple safe places to sit down around your home. Placing a few extra chairs around the home, without causing clutter, will provide you with a comfy seat when you need it.

• Book in for a falls-prevention assessment!

Why Falls Prevention Matters

Falls can impact your mobility, confidence and independence to do what you love, but most falls are preventable. Research consistently shows that early support, home modifications and targeted exercise improve safety and help people stay at home longer, with greater confidence and independence.

As a community OT, my role is to assess your home, understand your goals and recommend practical changes that support your safety and wellbeing. If you’d like a tailored home safety and falls prevention assessment, I’d love to help.

Ready to Reduce Your Falls Risk?

At Access Matters Occupational Therapy, we provide in-home assessments and tailored recommendations to help you stay safe and independent. Whether you’re concerned about yourself or a loved one, we’re here to help.

Book a home safety and falls prevention assessment today.

Serving Northern NSW and South-East Queensland.

#homesafetyandenhanceindependence

References:

Adkin, A. L., Frank, J. S., & Carpenter, M. G. (2020). Postural control and fatigue in older adults: A systematic review. Gait & Posture, 76, 131–138.

Hooper, L., et al. (2019). Inadequate hydration and falls risk in older adults: A systematic review. Age and Ageing, 48(1), 58–67.

Ludwig, C., Ellis, B., & Farrell, M. (2021). Step negotiation in older adults: Height perception, safety and balance. Journal of Applied Gerontology, 40(5), 476–485.

Menant, J. C., et al. (2019). Footwear and falls in older adults: Influence on balance and gait. Journal of the American Geriatrics Society, 67(6), 1235–1240.

Pighills, A., Torgerson, D., & Sheldon, T. (2020). Environmental home hazards and falls in older adults: A systematic review. Health & Social Care in the Community, 28(1), 247–255.

Seppala, L. J., et al. (2018). Medication-related falls in older adults: Systematic review and meta-analysis. Age and Ageing, 47(4), 520–528.

Sherrington, C., Fairhall, N., et al. (2022). Exercise for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, 2, CD012424.