- Nearly 87% of adults age 65 and over prefer to stay in their current home and community as they get older(1).
- Unfortunately, millions of the elderly live in homes that do not have the important accessibility features to help them live safely and independently(2).
- This article will cover the common danger points in homes, including the steps to make seniors’ homes safer and the specific reasons why.
- With senior homes set up for living success, older people can stay confident in being self-reliant and live an easier life without limiting their independence.
Health Report Live provides solutions to seniors with back pain and looking to take control of their lives.
For example, detailed instructions are given to help seniors set up their bedroom and choose a sleeping position for a good night’s sleep.
Proper sleeping positions can help those living with chronic back pain keep their body aligned to reduce pain.
What the Statistics Say
Seniors age 65 and over have increased in population. From 37.2 million in 2006, the number grew to more than 49 million in 2016(3).
The older population is expected to continue to grow significantly in the future, says the United States Census Bureau.
The AARP (American Association of Retired Persons) Public Policy Institute says that nearly 87% of adults age 65 and over prefer to stay in their current home and community as they get older(4).
The AARP is the United States’ largest nonprofit, nonpartisan organization, with 38 million members in every state(5).
The organization empowers people to choose how they live as they age. It works to strengthen communities and advocate for what matters most to seniors, focusing on health security, personal fulfillment, and financial stability.
Safety Tips for Seniors Living in Their Own Home
The CDC (Centers for Disease Control and Prevention) describes “aging in place” as the ability to live in one’s own home and community comfortably, independently, and safely(6).
Unfortunately, millions of the elderly live in homes that do not have the important accessibility features to help them live safely and independently(7).
One in every three seniors has trouble using some home features, says the Census Bureau(8).
Potential hazards and at-home risks could be putting the elderly’s safety, and even their lives, in harm’s way. They may also blame themselves needlessly when things go wrong.
The following tips are for older people aging in place, particularly those dealing with chronic pain and illnesses.
These safety measures can help them live safer and more comfortable lives in their home.
Keeping Emergency Numbers Close
Basic cell phone models with large keypad numbers and display windows are ideal for the elderly.
Seniors often find the excessive options in newer cell phones confusing, costly, and completely unnecessary.
However, smartphones can also be handy for seniors.
Smartphones allow users to create a medical ID or “in case of emergency” (ICE) contact with their health information and emergency contacts.
Seniors can make an ICE number accessible by making it their lock screen background.
Elderly persons and their family members and caregivers can print a list of important numbers and make them visible by the seniors’ home phones.
The list will be useful to the elderly who have trouble remembering things, particularly those dealing with Alzheimer’s disease and dementia.
The numbers should be posted in large fonts and placed near every phone in every room in the house and on the back of older people’s cell phones.
Having an extra copy in the senior’s car is also helpful.
The list should include these important emergency numbers:
It is wise to dial 911 during life-threatening situations, such as crimes in progress, accidents, fire, and smoke detectors or carbon monoxide alarms sounding.
Immediate Family Members and Friends
One great tip is to use a contact name with “my husband,” “my son,” or “granddaughter.” This way, if the senior is in an emergency and some folks find their phone, they know who they are calling.
Next-Door Neighbors and Friends
Knowing that the seniors have neighbors who can give them immediate support is reassuring for family members living or working far away.
Older adults and their families can meet the neighbors and exchange numbers to contact each other when an emergency happens.
Professional Caregiving Service or Primary Hospital
It would help to note a few other hospitals near the seniors’ residence. It is practical to list these options according to their distance from the house.
The American Association of Poison Control Centers’ helpline can be reached at 1-800-222-1222(9).
To add poison control as a contact in the senior’s phone, they can text POISON to 7979797.
Seniors who have pets at home should also include ASPCA (American Society for the Prevention of Cruelty to Animals)’s number.
One can contact the ASPCA Animal Poison Control Center at (888) 426-4435 for emergencies involving pets(10).
Bedroom Safety Tips
To make the bedroom safe for seniors, they or family members living with them can do the following:
- Ensure a light switch is within easy arm’s reach of the bed. Use nightlights to light up the way from the bed to the bathroom.
- Provide bright light to avoid stumbling over objects on the floor.
- Avoid rearranging bedroom furniture, so those with limited vision do not hurt themselves when they bump into them at night.
- Rearrange extension cords and electronics so the wires do not cross pathways.
- Remove any clutter, so paths are wide, straight, and clear. Avoid using throw rugs to avoid slips and falls.
- Position closet shelves so that they are only between waist and shoulder high to avoid excessive bending and reaching.
- Ensure proper bed height. When sitting on the bed’s edge, the elder’s knees should make a 90° angle, with both feet flat on the floor.
- Use enabling side rail or attach poles at the side of the bed to facilitate in-bed movement and safe bed ingress and egress.
- Provide stable and sturdy chairs with armrests to help those with weak arms stand up safely.
- Replace a round bedroom doorknob with a single-lever type. Seniors can easily push down lever handles to open the door.
- Replace a sagging, soft mattress with a firm one that can provide more comfort and support.
To those worried about what they need for their specific situation, a consultation with their doctor is recommended before shopping for a new mattress.
- Use pillows to put the body in the correct sleeping position and avoid pain and discomfort.
Pillows are not only for the head and neck. Depending on one’s sleeping position, additional pillows can help keep the spine in the proper position(11).
Sleeping positions that align and support the body can help the elderly sleep more comfortably through the night.
Good sleep can significantly reduce the number of times they (and their caregivers) wake up at night.
Listed below are invaluable tips on sleeping positions that can help reduce back pain, including helpful suggestions on how to use pillows for better body support and alignment.
For side sleepers
To relieve back pain, seniors can sleep on their side and do any of the following:
- Add a pillow under the head to keep it in a neutral (middle) position, keeping the spine aligned from the neck to the body.
- Put a pillow under the torso, leaving space for the arm, to reduce pressure on the lower shoulder.
- Add a pillow between the lower legs or knees to keep the hips, pelvis, and spine aligned. Draw both legs up slightly toward the chest.
- Use a pillow under the arm to reduce pressure on the upper shoulder.
For back sleepers
To relieve back pain, seniors can sleep on their back and do any of the following:
- Put a pillow or a leg wedge (like a rolled towel) under the knees to help maintain the normal curve of the lower back while providing additional support(12).
- Avoid using many pillows under the head. If the head is too elevated, the neck is forced to bend forward.
For stomach sleepers (and those with degenerative disc disease)
Sleeping on the stomach is not generally advised because this position is hard on the back.
However, stomach sleeping may be practical for seniors with degenerative disc disease, as this position can help keep the spine in a neutral position(13).
To sleep on their stomach comfortably, seniors can:
- Use a thin pillow (or none at all) under the head.
- Place a medium or thin pillow under the pelvis or stomach.
- Bring one leg to the side and slightly bend it, and then put a pillow under this knee.
For those with a herniated disc
The fetal position is a helpful sleeping position for back pain caused by a herniated disc(14).
Sleeping curled up minimizes the bending of the spine and opens up the joints simultaneously.
Using a reclining chair (and for those with isthmic spondylolisthesis)
Sleeping in a reclined position can help seniors with a spinal condition called isthmic spondylolisthesis, where a vertebra slips over the one below it.
Reclining may be beneficial for a senior’s back because it creates an angle between the thighs and trunk(15). This angle helps to reduce the pressure on the spine.
A bed wedge mimics a recliner chair’s shape. A more expensive alternative is to buy an adjustable bed.
All these tips are starting points only. The overall goal is to keep an older adult’s body in an aligned, neutral position as much as possible while they sleep.
One should try to keep their ears, shoulders, and hips aligned, regardless of their preferred sleeping position(16).
A little experimentation and adjustment are needed until seniors find a position that works for them.
For example, seniors with kyphosis (rounded back) may find it uncomfortable to lie flat on their back.
Sleeping on their side with their spine supported (because it is curved) may bring comfort.
It is always best to check with a doctor before trying something new to avoid any chance of injury.
Bathroom Safety Tips
A study was conducted by the CDC (Centers for Disease Control and Prevention) using national data collected from 2008(17).
Surveys revealed that more than 230,000 non-fatal, unintentional bathroom injuries were treated in US hospital emergency departments.
Data showed that bathrooms’ injury rates increased with age and were the highest for individuals older than 85 years(18).
Seniors can keep their bathroom safe by:
Making Items Accessible
Having towels, bathing essentials, and clothing ready make it easy for seniors to reach for them without having to stretch or bend, preventing slips or falls.
Keeping the bathroom floor clean and clutter-free
There should not be any objects lying around on the floor. Only nonskid bath mats should be used in the bathroom.
Installing Grab Bars or Handrails
Grab bars in and out of the tub or shower and next to toilets can help older adults steady themselves as they move in and out of the tub or on or off the toilet.
The bars should be placed at a height that allows an older adult to hold onto them without having to reach too far up or down.
Installing a raised toilet seat or frame
It is a good idea to invest in a raised toilet seat with handlebars. Toilets should be between 17 and 19 inches in height, making it easy for seniors to sit and stand on their own.
Using a Transfer Bench
Getting in and out of the tub can be a challenge to the elderly, who may not be able to lift their leg high enough to make it over the top of the tub.
A transfer bench eliminates the problem of stepping in and out of the tub. Older people can safely enter and exit the tub while remaining seated.
Using a Shower Chair
Seniors who have difficulty balancing or standing for long periods can benefit from a shower chair, which can provide stability, especially to seniors bathing on their own.
A shower chair with a handheld shower-head is a good investment to help make bathing safe and convenient for older adults.
Using Non-slip Mats
One can prevent slips on wet surfaces by placing non-slip mats on the floor of the shower or tub.
Also, using a non-slip mat on the floor when stepping outside of the tub or shower can help.
Testing Water Temperature
Checking the water temperature before bathing or taking a shower is a must. This can be done using a bath thermometer or feeling the temperature with an elbow.
Keeping Electrical Devices and Outlets Away From Water
Electrical equipment and appliances, like water heaters, must be kept in top working condition.
Damaged power cords and outlets should be replaced immediately.
Kitchen Safety Tips
Automatic shut-off alert devices and timers are great tools to help those that have memory issues but still enjoy cooking.
Kitchen towels, potholders, and loose clothing can catch fire if too close to the stove. These items must not fall against an open flame or oven coil.
A report from the Federal Emergency Management Agency (FEMA) noted that people over the age of 65 have a 2.7 times greater risk of dying in a kitchen fire than the general population(19).
Seniors are advised to store an easy-to-operate fire extinguisher in their kitchen.
Senior-Friendly Kitchen Appliances
Appliances equipped with safety monitors and alarms are a good investment.
The elderly or their family members should schedule a qualified electrician to check all wiring and outlets to ensure safety compliance.
Dirty kitchen ventilation systems, a common source of kitchen fires, should also be cleaned regularly.
A smoke detector that sounds an alert for both flames and smoke is ideal.
Kitchen Modifications for Safety and Ease of Mobility
Rearranging drawers, cabinets, pantries, and refrigerators can make it easier for seniors to reach for things they need.
The ideal position of a cabinet or shelf is between the elder’s waist and shoulder.
Storing frequently-used items on high shelves or in high cabinets should be avoided. Using a Lazy Susan is ideal if cabinet or shelf space is limited.
Kitchen chairs with arms allow older adults with back pain to sit or stand up more comfortably. Wheeled chairs should never be used in the kitchen.
Whenever possible, elders should ask for help retrieving things from high shelves instead of relying on step stools.
Seniors should use only water-absorbent, nonskid mats. Spills should be wiped clean right away to avoid slipping.
Fall Prevention Tips
Research says about 34% of adults age 65 and over fall at least once a year, with almost 50% of them experiencing multiple falls(20).
To avoid tripping hazards, all rooms in the house should be clutter-free and brightly lit.
Seniors are also encouraged to always wear their glasses (or keep them handy) and wear shoes with nonskid soles.
The elderly can avoid slips and falls with these tips.
- Stairways should be at least 32” across to allow for easy access.
A more open environment makes it easy to access entryways and hallways, especially for seniors using the wheelchair or walker.
- Loose handrails must be fixed or replaced with new ones. The CDC suggests putting handrails on both sides of the stairs and making them as long as the stairs(21).
- Throw rugs and mats that do not have rubberized backing should be removed as they do not grip the floor.
- Having electrical cords that stretch across the floor must be avoided.
- All tile gaps and uneven floor planks should be fixed right away. One should make sure that no nails are protruding.
- Any clutter on the floor should be cleaned or put away immediately. There should always be a designated place for everything.
Functional limitations that restrict one’s mobility and ability to engage in everyday activities can increase fall risks.
Best practices for fall risk assessment include(22):
- The Hendrich II Fall Risk Model(23), which includes the Get Up and Go test
- The Katz Index of Independence in Activities of Daily Living(24), also called the Katz ADL
- The Housing Enabler(25), used in the assessment of housing accessibility
Patient-specific interventions should be done after completing a home safety evaluation to help older adults stay safe and address risk factors.
A medical alert system that notifies caregivers or family members of a fall can also be helpful.
Most devices on the market automatically alert medical responders if a person falls, even if the alert button is not pushed.
Falling incidences among older people have been linked to problems with step or stair negotiation(26).
Locating the first step edge position can be challenging for older adults when lighting levels are particularly low(27).
Lighting that uses dimmer light switches allows senior residents to have the proper lighting for all situations.
For example, nightlights that regulate the level of lighting can reduce eye strain and ensure a good night’s sleep in the bedroom.
A combination of decorative and recessed lights can fully light up the front entrance or front door and deter unwanted visitors.
Preventing Poisoning (Medicine, Food, and Accidental Poisoning)
To avoid poisoning risks, seniors or their family members should:
- Keep food and medicines in their original containers as much as possible to avoid mix-ups and contamination.
Seniors should take their medications in a well-lit room where they can read the labels and ensure that medications are taken as directed.
- Set the refrigerator to 40° F or below(28). This setting keeps perishables, like meats and dairy, from going bad.
- Use a permanent marker to write the purchase date on food items that do not have an expiration date on the label.
- Never heat the home with a stove, oven, or grill because these can give off carbon monoxide. Install carbon monoxide detectors in the house.
- Avoid mixing cleaning products, like bleach or ammonia. They can create deadly gases when mixed.
Financial Safety: Protection Against Abuse, Scams or Crime
The Consumer Law Center, Inc. (CLC) says Americans lose approximately $40 billion per year to the fraudulent sale of goods and services over the telephone(29).
The elderly are frequent targets of telemarketing frauds and sweepstakes scams(30).
To keep themselves safe, seniors are advised to:
- Avoid sharing personal information, such as Social Security number, credit card details, bank information, or account passwords, with strangers.
- Ask loved ones for help in verifying offers and prizes, and do not respond until all information has been reviewed thoroughly.
- Refrain from signing contracts, making donations, or buying expensive items without first discussing the details with a family member or trusted friend.
- Shred all receipts or documents containing personal and financial information. Never throw them in the trash.
- Avoid keeping large amounts of valuables or cash at home. They can get destroyed, misplaced, or stolen.
To keep seniors safe when driving or inside a vehicle, loved ones should remind them to:
- Ensure that doors are locked and windows rolled up while driving and when leaving the vehicle.
- Never leave car keys inside the vehicle. Avoid having a spare key in the car.
- Park as close as possible to where they are going. When returning to the car, they should look around while approaching the vehicle.
Aging in place gives senior citizens and elderly homeowners the freedom that is quite different from what they may experience in a senior facility.
Home care for seniors living with family members or caregivers or being visited regularly by professional home care service providers beats any accommodation in nursing homes.
Family members living with their aging parents can use the lists and safety tips discussed in this article when making a home safety assessment.
These home safety tips can help seniors, particularly those with chronic pain, lead dignified and independent lives within the familiarity of their home.
More importantly, the best safety tip for seniors aging in place is to encourage family members and loved ones to check in with them frequently.
Neighbors and professional caregivers can also help to make sure they are always safe.
- U.S. Department of Health and Human Services, Administration for Community Living. (2020, Sept 21). Promoting Aging In Place by Enhancing Access to Home Modifications. Retrieved from https://acl.gov/grants/promoting-aging-place-enhancing-access-home-modifications#:~:text=According%20to%20the%20AARP%20Public,remain%20in%20their%20homes%20permanently.
- U.S. Department of Health and Human Services, Administration for Community Living. (2020, Sept 21). Promoting Aging In Place by Enhancing Access to Home Modifications. Retrieved from https://acl.gov/grants/promoting-aging-place-enhancing-access-home-modifications#:~:text=According%20to%20the%20AARP%20Public,remain%20in%20their%20homes%20permanently; United States Census Bureau. Older Population and Aging. Retrieved from https://www.census.gov/topics/population/older-aging.html
- U.S. Department of Health and Human Services, Administration for Community Living. Op. cit.
- AARP. About AARP. Retrieved from https://www.aarp.org/membership/
- U.S. Department of Health and Human Services, Administration for Community Living. Op. cit.
- National Capital Poison Center. Retrieved from https://www.poison.org/contact-us.
- American Society for the Prevention of Cruelty to Animals. Animal Poison Control. Retrieved from https://www.aspca.org/pet-care/animal-poison-control.
- University of Rochester Medical Center Rochester. Good Sleeping Posture Helps Your Back. Retrieved from https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=1&ContentID=4460.
- Mayo Foundation for Medical Education and Research (MFMER). (2020, April 22). Slide show: Sleeping positions that reduce back pain. Retrieved from https://www.mayoclinic.org/diseases-conditions/back-pain/multimedia/sleeping-positions/sls-20076452?s=2.
- Atlanta Spine Institute. How Should You Sleep If You Have Lower Back Pain? Retrieved from https://atlantaspineinstitute.com/how-should-you-sleep-if-you-have-lower-back-pain/#.
- The Orthopaedic Institute. (2020, Dec 28). Retrieved from https://www.orthopaedicinstitute.com/new/5-ways-to-reduce-back-pain-while-sleeping.
- University of Rochester Medical Center Rochester. Op. cit.
- CDC. (2011, June 10). Nonfatal Bathroom Injuries Among Persons Aged ≥15 Years — United States, 2008. Retrieved from https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6022a1.htm.
- U.S. Fire Administration/National Fire Data Center. (2006, January). Fire and the Older Adult. Retrieved from https://www.usfa.fema.gov/downloads/pdf/statistics/fa-300.pdf.
- Blake AJ, Morgan K, Bendall MJ, Dallosso H, Ebrahim SB, Arie TH, et al. Falls by elderly people at home: prevalence and associated factors. Age Ageing 1998;17:365–72. 10.1093/ageing/17.6.365.
- CDC. Check for Safety: A Home Fall Prevention Checklist for Older Adults. Retrieved from https://www.cdc.gov/homeandrecreationalsafety/pubs/english/booklet_eng_desktop-a.pdf.
- Hendrich A. How to try this: predicting patient falls. Using the Hendrich II Fall Risk Model in clinical practice. Am J Nurs. 2007;107(11):50–58; Gray-Micelli D. Nursing standard of practice protocol: fall prevention. Hartford Institute for Geriatric Nursing. 2008. http://consultgerirn.org/topics/falls/want_to_know_more.
- Hendrich, Ann. (Revised 2013). Fall Risk Assessment for Older Adults: The Hendrich II Fall Risk ModelT. Retrieved from http://www.wsha.org/wp-content/uploads/Hendrich-II-Fall-Risk.pdf.
- Wallace, Meredith. Katz Index of Independence in Activities of Daily Living (ADL). Retrieved from https://www.alz.org/careplanning/downloads/katz-adl.pdf.
- Iwarsson S. The Housing Enabler: An Objective Tool for Assessing Accessibility. British Journal of Occupational Therapy. 1999;62(11):491-497. doi:10.1177/030802269906201104.
- Startzell JK, Owens DA, Mulfinger LM, Cavanagh PR. Stair negotiation in older people: a review. J Am Geriatr Soc 2000;48:567–80. 10.1111/j.1532-5415.2000.tb05006.x; Roys M. Steps and Stairs. In Haslam R, Stubbs D, editors. Understanding and Preventing Falls. London: CRC Press; 2005. pp. 52–68. 10.1201/9780203647233.ch3; Templer JA. The Staircase: Studies of Hazards, Falls and Safer Design. Cambridge, MA: MIT Press; 1992.
- Elliott DB, Foster RJ, Whitaker D, et al. Analysis of lower limb movement to determine the effect of manipulating the appearance of stairs to improve safety: a linked series of laboratory-based, repeated measures studies. Southampton (UK): NIHR Journals Library; 2015 Jul. (Public Health Research, No. 3.8.) Chapter 1, Falls and stair negotiation in older people and their relationship with vision. Available from: https://www.ncbi.nlm.nih.gov/books/NBK305246/.
- US FDA. Refrigerator Thermometers – Cold Facts about Food Safety. (2017, Oct 30). Retrieved from https://www.fda.gov/food/buy-store-serve-safe-food/refrigerator-thermometers-cold-facts-about-food-safety.
- National Crime Prevention Council. Crimes Against Seniors. Retrieved from http://archive.ncpc.org/topics/crime-against-seniors.html.