It's the last day of Falls Prevention Week. Today is about the place most falls actually happen: at home, on an ordinary day, doing something ordinary. Below is a room-by-room checklist you can work through this weekend, followed by the whole week in one place.
Why the home matters
The best evidence comes from a 2023 Cochrane review of 22 trials involving 8,463 older people living at home. When homes were checked and hazards fixed, the rate of falls dropped by 26% overall, and by 38% among people at higher risk, such as those who had already fallen or had recently been in hospital. For people who were not at particular risk, the effect was unclear.
So the checklist matters most if you, or someone you look after, has fallen before, feels unsteady, or has just come home from hospital. In the trials that worked, a trained professional visited the home and helped put the changes in place. NICE recommends a home hazard assessment for people at risk of falling, so if that's you, ask your GP or local council whether an occupational therapist can visit.
The room-by-room checklist
Everywhere
- Clear walkways of clutter, trailing cables and anything left on the floor.
- Remove loose rugs, or fix them down with non-slip underlay or tape. Watch for curled edges.
- Make sure every room has good light, with a switch you can reach from the doorway.
- Wipe up spills straight away.
- Keep the things you use every day between waist and shoulder height, so you're not reaching up or bending down.
- Never stand on a chair. If you need height, use a sturdy step with a handrail.
Stairs
- Handrails on both sides, secure, running the full length of the stairs.
- A light switch at the top and at the bottom.
- Nothing left on the steps, even "just for a minute".
- If the edges of the steps are hard to see, a contrasting strip on each edge helps.
Bathroom
- A non-slip mat in the bath or shower, and one beside it.
- Grab rails by the toilet and the bath or shower. Towel rails and sink edges aren't built to take your weight.
- A shower seat or bath board if standing to wash is tiring.
- Consider not locking the door, so someone can get to you if needed.
Bedroom
- A lamp or light you can switch on from bed.
- A plug-in night light on the route to the bathroom.
- Your phone within reach of the bed.
- When you get up, sit on the edge of the bed for a moment first. Blood pressure can dip when you stand, especially at night.
Kitchen
- Everyday items on the lower shelves and the worktop, not the top cupboards.
- Wipe spills immediately, and dry the floor after mopping before walking on it.
- Keep an instant ice pack in the first-aid box. It needs no freezer, so it's ready when a knock happens.
Outside
- A well-lit path to the front door, with an outside light.
- Clear wet leaves and moss, and grit steps and paths when it's icy.
- A rail by any outside steps.
You
- Shoes and slippers with backs and thin, firm, non-slip soles. Backless slippers slip off and catch on steps.
- A sight test every year. It's free on the NHS from 60. If you wear varifocals, ask your optician whether single-vision glasses for walking outdoors would help.
- A medicines review with your GP or pharmacist once a year, especially if you take several medicines or anything makes you dizzy or drowsy.
- Tell your GP about any fall, even one with no injury. It can be the first sign of something fixable.
- Carry a phone or wear a personal alarm, and know how to get up from the floor safely (see yesterday's post).
- Keep up strength and balance exercise, at least twice a week.
The week in summary
Monday: the numbers. One in three people over 65 falls each year, rising to one in two over 80. The best evidence we have, a Cochrane review of 108 trials, found exercise cuts the rate of falls by about 23%, and programmes that combine balance training with strength work by about a third. Read Monday's post
Tuesday: Worcestershire. Worcestershire County Council put more than 50,000 resistance bands and printed guides into residents' hands, trained 115 people from 33 organisations to lead the exercises, and an independent evaluation found improvement in every strength and balance measure tested. Read Tuesday's post
Wednesday: the 12-week programme. Eight chair-based resistance band exercises to build strength, with a free printable guide. One correction from us: seated exercise on its own does not reduce falls. The programmes that do, such as Otago and FaME, include balance exercises done standing that get gradually harder, for more time each week. Use the chair programme as a safe place to start building strength, then add standing balance work, holding a sturdy chair or worktop at first, and ask your GP or council about a local strength and balance class. Read Wednesday's post
Thursday: after a fall. Rest the injury, not the person. Cold for the first 48 hours for pain and swelling, then gentle movement, then progressive strength and balance work. Ten days in bed can cost an older adult around a kilogram of leg muscle. Read Thursday's post
Friday: the home. This checklist.
Three things to do next week
- Walk through the checklist, one room at a time. Start with the stairs and the route from the bed to the bathroom.
- Put strength and balance exercise in the diary, at least twice a week, and include standing balance work if you can do it safely.
- If you've fallen, or feel unsteady, tell your GP and ask about a falls assessment, a home safety check and a local strength and balance class.
Thank you for following Falls Prevention Week with us.
This article is general information, not medical advice. If you have fallen, feel unsteady or have a health condition, speak to your GP, physiotherapist or occupational therapist.
Sources: Clemson L et al., Environmental interventions for preventing falls in older people living in the community, Cochrane Database of Systematic Reviews 2023 (CD013258); Sherrington C et al., Exercise for preventing falls in older people living in the community, Cochrane 2019 (CD012424); NICE NG249, Falls: assessment and prevention in older people and in people 50 and over at higher risk (2025); NHS, Falls: prevention; Haran MJ et al., BMJ 2010 (single-lens glasses and outdoor falls); UK Chief Medical Officers' Physical Activity Guidelines (2019); Worcestershire County Council / University of Worcester evaluation.
