Stay at Home Safely: Preventing Falls & Improving Independence
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If you or a loved one is having a hard time getting around the house, you may be looking for ways to stay at home longer, while keeping safety and independence at the forefront. Depending on the situation, some people turn to in-home care or aids to help with things around the house, or even self care tasks like dressing and bathing.


However, wading through the options —and weighing the costs— often poses a challenge to people and their families as they try to stay at home independently. Now, a lot of research has been done over the past several years, focusing on the role of home accessibility & safety for what has now been termed “aging in place”.


The Importance of Home Safety


As the population continues to age, with increasing life expectancy and an increase in the desire of people to “age in place”, the home environment should be addressed to ensure safety and improve healthcare outcomes [1]. In fact, many adults rate remaining at home or “aging in place” as a high priority. However, environmental barriers and accessibility concerns often threaten their ability to safely remain at home [2].

Environmental barriers & fall or safety concerns have typically been addressed by in-home care like home health aids and the like [3]. This can be costly and, in some ways, reduces overall community involvement and independence. Assessing and addressing safety and independence in the home can increase independence, decrease the risk of falls and even reduce the level of care required for patients to age in place and remain in their home [1][2][3]. Simply put: addressing home accessibility & safety can reduce the risk of falls and increase independence with normal, everyday activities. 


Recommendations from Research


Without just rambling off a bunch of statistics and data from research studies, let’s take a look at the research around home safety and accessibility. I’ll try to break it down into simple and understandable terms (no need to break out the scientific calculator!). We’ll look at what are likely the two biggest questions around home safety, gaining in place, and the caregiving needs.


What role can PT/OT services play in improving independence and safety for the long-term?


Besides offering therapeutic programs and exercises to improve strength endurance, and safety with activities of daily living, PT & OT may also complete home assessments and recommend modifications and/or equipment that can help reduce the risk of falls in the home [1]. Programs like aquatic therapy, vestibular & balance programs, and even musculoskeletal rehab programs can help decrease the risk of falls and increase independence with activities of daily living. 

In fact, evidence suggests that home assessments and modifications can improve outcomes in areas related to injury and falls prevention; self-care or independence; physical health and well-being; caregiving; economic effectiveness; aging process; and social participation.[1]. That means addressing home accessibility can help improve long-term safety and independence, allowing people to safely stay at home. 


What about the impact on caregiving needs?


One study published in 2019 showed that home assessment and modifications could hours of care needed by 42% per week [3]. Reducing the care need by even half of that could save someone thousands of dollars every year! Sometimes, these home modifications don’t need to require construction and knocking down walls, either. Equipment like shower chairs, hand rails, or toilet seats can greatly improve safety and independence without a large out-of-pocket cost. 

Another study showed that patient self-reported perceptions of their daily activity performance significantly improved after home modifications. This change was maintained at a 2-year following, pointing to the long-term affects of home accessibility assessment & modifications [2]. Basically, the study showed that home accessibility assessments and/or recommendations can improve how people feel about their ability to complete their daily tasks. 




Wading through the information and resources for home accessibility, home care, and aging in place can be difficult. There’s no shortage of vendors, contractors, and marketers trying to sell people equipment and projects that may —or may not— help depending on the person’s unique circumstances. Is best to speak with your physician and/or therapist about how a home accessibility and safety assessment can help you or your loved one stay at home safely.


Now, this all starts with an initial meeting to see if this is even a good option for you. Give us a call to schedule a home accessibility & safety consultation. Medicare and many other insurance companies do cover these evaluations and services if they are medically necessary.



[1] Carnemolla P, Bridge C. A scoping review of home modification interventions – Mapping the evidence base. Indoor and Built Environment. 2020;29(3):299-310. doi:10.1177/1420326X18761112

[2] Stark S, Landsbaum A, Palmer JL, Somerville EK, Morris JC. Client-centred home modifications improve daily activity performance of older adults. Can J Occup Ther. 2009;76 Spec No(Spec No):235-245. doi:10.1177/000841740907600s09

[3] Carnemolla P, Bridge C. Housing Design and Community Care: How Home Modifications Reduce Care Needs of Older People and People with Disability. Int J Environ Res Public Health. 2019;16(11):1951. Published 2019 Jun 1. doi:10.3390/ijerph16111951


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Rafi Salazar OT

Rafael E. Salazar II, MHS, OTR/L (Rafi) is the CEO & President of Proactive Rehabilitation & Wellness, as well as the Principal Owner of Rehab U Practice Solutions and the host of The Better Outcomes Show. He has experience in a variety of rehab settings, working with patients recovering from a variety of injuries and surgeries. He worked as the lead clinician in an outpatient specialty clinic at his local VA Medical center, where he worked on projects to improve patient & employee engagement and experience throughout the organization. He also has experience as a faculty member at Augusta University’s Occupational Therapy Program, as a Licensed Board Member on the GA State OT Board, has served on several committees for the national OT Board (NBCOT), and as a consultant working for the State of Georgia’s DBHDD. He is also on the Board of Directors for NBCOT.