Written for the adult child who has just found out their parent fell, and was not told about it until afterwards.
Most falls happen doing ordinary things in familiar places. Not on ladders or icy steps — getting out of a chair, turning around in a kitchen, walking to the bathroom at night.
That is good news, because ordinary and familiar can be changed. Here are the five things an OT recommends most often, in rough order of how much difference they make relative to cost.
The most cost-effective falls intervention there is. Ageing eyes need considerably more light to see the same detail, and adapt more slowly between bright and dark.
The specific change that matters most: a lit path from bed to toilet. Motion-sensor night lights along that route, a lamp within reach of the bed, and a light switch that does not require crossing a dark room. Then the top and bottom of any stairs, and the back door.
This costs very little and it addresses the single most common falls scenario in the home.
Watch someone rock forward three times to get out of their favourite armchair and you are watching a fall in slow motion.
A chair that is too low, too soft or too deep makes standing up a strength problem instead of a technique one. Raising the seat height, firming the base, and making sure the armrests extend far enough forward to push from usually solves it. So does moving the chair so there is something solid to reach for on the way up.
The same applies to the bed and the toilet. Height and something to push against.
Loose rugs, trailing cords, the mat at the front door, the bath mat that slides. Every OT has this conversation and it is frequently the one that meets the most resistance, because the rug was a gift or it has always been there.
The compromise that usually works: keep the rug, but fix it down properly with double-sided carpet tape or a non-slip underlay. Removing it entirely is better; fixing it is achievable.
Also worth checking: the transition strips between rooms, and whether the floor in the main walking route is cluttered with things that were put down temporarily eighteen months ago.
Bathrooms get the attention, and rightly. But the risk is not evenly spread.
The highest-risk moments are getting in and out of the shower, standing while washing, and getting up from the toilet. Grab rails address all three — but only if they are in the right places, which is not where they look tidiest. A rail needs to be where the hand naturally reaches at the moment of instability, which an OT works out by watching the actual movement.
A shower stool takes the standing out of washing and costs very little. A raised toilet seat or over-toilet frame does the same for the toilet.
Towel rails are not grab rails. They come off the wall with weight on them.
The least glamorous item on the list and one of the most effective. Backless slippers, worn socks and shoes with no support are involved in a surprising proportion of indoor falls.
What helps: an enclosed heel, a sole with grip, a firm fit. Worn indoors as well as out. This is a small change that people resist because slippers are comfortable, and it is worth persisting with.
Telling someone to be careful. Falls are rarely caused by carelessness and asking someone to concentrate harder does not change the height of their chair or the light in their hallway.
Also not on the list: doing everything for them. Reduced activity leads to reduced strength and balance, which increases falls risk. The goal is a home where the person can keep moving safely, not one where they move less.
One fall substantially raises the risk of another, and the fear that follows a fall is often as limiting as any injury. This is the point at which an OT assessment is most useful — not to take independence away, but to work out what specifically went wrong and change it.
An assessment is funded under Support at Home or the NDIS, and on the Mornington Peninsula it happens in the home. How that works under a package, or call to talk it through.
Doing ordinary things in familiar places — getting out of a chair, moving around at night, getting in and out of the shower.
Yes. Occupational therapy is a clinical support under Support at Home, which the government funds in full.
No. Towel rails are not designed to take body weight and can pull out of the wall.
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