Did you know that falls are the second leading cause of injury in the state of North Carolina? The tough irony is that most of these accidents are preventable, especially when families and caregivers know what to look for.
Preventing these falls goes beyond simple knowledge. Instead, a safe and supportive environment starts with action. With a structured fall risk assessment for seniors, you can reduce hazards, protect independence, and bring peace of mind to everyone involved.
In this guide, we’ll walk through a room-by-room checklist designed to help with fall risk factors here in Wilmington, across the Cape Fear region, and throughout North Carolina.
Why Fall Prevention Matters
According to the North Carolina governor’s office, approximately 17.6% of North Carolinians are 65 or older, and it’s estimated that one in four older adults experiences a fall each year. Even more concerning: those who fall once are two to three times more likely to fall again.
Fall-related injuries can be serious, including hip fractures, broken bones, or head trauma. However, the emotional impact can be just as lasting. Many seniors experience a loss of confidence or independence after a fall, which can lead to isolation and reduced mobility over time.
Common fall risks include poor lighting, slippery floors, unsteady furniture, and cluttered pathways. Health factors like weaker muscles, limited vision, and balance issues make those hazards even more dangerous.
This is where home caregivers make a difference. Learning what to watch for and using a structured fall risk assessment for seniors creates a safer home environment and stay ahead of potential dangers as your loved one’s needs evolve. Think of this checklist as your own personal fall risk assessment tool.
Fall Risk Assessment Checks: Preparing for a Home Assessment
Every home is different, but the risks are often the same. Rugs that slip, cords that catch, poor lighting, or furniture that’s hard to get around can all contribute to falls. A room-by-room fall risk assessment helps you break the task into manageable steps and catch issues that might otherwise go unnoticed.
This guide is designed for caregivers, adult children, and family members who want to make the home safer for an aging loved one. Whether your loved one is recovering from a recent fall or simply planning to age in place, this checklist offers a proactive approach to fall risk screening.
Use the sections below to walk through each area of the home. Look for hazards, note what needs adjusting, and involve your loved one in the process when possible. Small changes can make a big difference.
1. Gather Basic Tools
Before you begin your fall risk assessment, take a few minutes to prepare and examine modifiable risk factors. A few simple tools can go a long way in identifying safety concerns:
- A flashlight for checking dim or shadowy corners
- Non-slip tape or pads for rugs and mats
- A notebook or printed checklist to stay organized
- A tape measure to check furniture heights and clearance in walkways
- Analyze any previous falls to prevent falls
Free printable checklists are available through the CDC’s STEADI (Stopping Elderly Accidents, Deaths & Injuries) initiative and the North Carolina Division of Aging and Adult Services. These can provide helpful structure as you move from room to room.
2. Make It a Collaborative Process
If possible, include your loved one in the assessment. Ask them where they feel most confident, and where they feel unsure or unsteady. Be specific and timely. Ask about any of these variables over the past year. Do a medication review.
These valuable insights make the process feel supportive to avoid serious injury rather than disruptive and significantly reduce a patient’s fall risk.
Even small changes might feel like a loss of control to someone who values their independence. Involving them in conversations about safety, you’re more likely to get cooperation to avoid injurious falls (and even appreciation) in the long run.
3. Focus on Safety with Dignity
This isn’t about taking things away. The goal is to build a home that works better for everyone.
A thoughtful, caregiver-led fall prevention checklist respects your loved one’s preferences while reducing risk. It’s one of the most effective ways to support senior independence while keeping them safe and avoiding any medical treatment.
Entryways and Hallways Safety
These are some of the most frequently used areas in any home and some of the most overlooked when it comes to fall prevention. Narrow spaces, poor lighting, and everyday clutter can all increase risk.
Here’s what to check:
1. Lighting
Good lighting is one of the simplest and most effective ways to foster low-risk environments. Seniors with impaired vision are especially vulnerable in dimly lit spaces.
Start by addressing any shadows or dark corners.
- Make sure all entryways and hallways have bright, even lighting
- Replace burned-out bulbs promptly
- Add nightlights or motion-sensor lights, especially near bedrooms and bathrooms
2. Clutter
Tripping hazards often come from everyday items, not just the obvious obstacles. The more consistently clear your walkways are, the safer your loved one will feel moving around, and the more you reduce falls.
- Remove items that tend to pile up: shoes, coats, mail, or bags
- Use hooks, bins, or shelves to keep walkways clear
- Maintain at least three feet of clearance for walking paths
3. Rugs and Cords
Loose rugs and cords are common culprits in hallway falls. They’re easy to miss but just as easy to fix with the right tools when predicting falls.
- Use non-slip pads or double-sided tape under area rugs
- Eliminate or relocate loose extension cords
- Secure cords along walls and out of foot traffic zones
Even small adjustments in these high-traffic areas can make a significant difference, especially for seniors with balance concerns or vision loss.
Living Room Checklist
The living room should be a place to relax and not a space full of hidden hazards. For seniors who use walkers or need stable seating, even a cozy setup can become risky without small adjustments.
1. Furniture Arrangement
Rearranging furniture can dramatically improve safety while stopping elderly accidents. Focus on creating wide, open walkways with no sharp turns or narrow passages.
- Keep at least three feet of clearance for walking paths
- Remove or reposition low tables, decorative stands, and unstable chairs
- Avoid furniture with sharp corners or slippery finishes
2. Floor Safety
Many falls in living spaces happen due to shifting rugs or loose items underfoot. When evaluating patients’ homes, a few preventive steps can make the floor much safer.
- Use non-slip pads under rugs or remove them entirely
- Keep electrical cords, magazines, or pet toys out of walking areas
- Vacuum regularly to avoid debris buildup that could catch a foot or cane
3. Safe Seating
Getting in and out of a chair should feel steady and controlled, not like a balancing act. Simple decisions can avoid a visit to health care providers.
- Choose sturdy chairs with armrests for leverage
- Avoid soft or low-slung seating that’s difficult to stand from
- Position chairs near good lighting and within easy reach of remotes or phones
Bedroom Checklist
Nighttime disorientation, low lighting, and awkward furniture can all raise the risk of falls in the bedroom. Create a calm, functional layout for safer nighttimes and easier mornings.
1. Bed Height and Accessibility
A bed that’s too high or too low can lead to awkward movements, especially during nighttime trips to the bathroom. That could even result in head injury.
- Adjust the mattress so the top is at knee height (around 20–23 inches)
- Add a bed rail for stability if needed
- Make sure there’s clear space on both sides of the bed
2. Lighting and Emergency Access
Falls often happen when seniors wake up in the dark and try to move quickly. Prioritize visibility and quick access to help.
- Place lamps or switches within reach of the bed
- Add motion-sensor night lights along the path to the bathroom
- Keep a phone, emergency alert device, or bell close at hand
3. Clutter-Free Floors
The floor around the bed should stay clean and organized. Even slippers or a tangle of cords may cause a fall.
- Store slippers or walking aids within arm’s reach of the bed
- Keep clothes, cords, and clutter off the floor
- Secure or remove bedside rugs
Kitchen Checklist
Kitchens may feel familiar, but they’re full of fall risks, from slick floors to reaching for items on high shelves. Paying attention to layout and accessibility can reduce the risk of sudden slips or awkward movements.
1. Non-Slip Mats and Grab Bars
Moisture and smooth flooring are a dangerous mix. Focus on traction and safe movement around sinks and stoves.
- Place non-slip mats near the sink, stove, and prep areas
- Clean up spills immediately; no exceptions
- Avoid towel bars for balance; use secure grab bars if needed near kitchen entry points
2. Safe Storage and Countertops
Minimize bending, stretching, and the need for unstable step stools. Make everyday tasks as easy to reach as possible.
- Store frequently used items at waist-to-shoulder height
- Use pull-out racks or baskets to reduce reaching into deep cabinets
- Keep counters clear to avoid knocking items to the floor
3. Appliance and Water Safety
Even small appliances can present hazards. Heat, steam, and cords all play a role in preventing (or causing) accidents.
- Use electric kettles instead of stovetop kettles for better control
- Replace worn appliance cords and avoid overloaded outlets
- Set water heater temperature to no higher than 120°F to prevent burns
Bathroom Checklist
Bathrooms are one of the highest-risk areas for falls. Water, hard surfaces, and tight spaces all contribute. A few smart upgrades can make this room much safer.
1. Grab Bars and Support Equipment
Don’t rely on balance alone in the bathroom. Every major movement (sitting, standing, or stepping) should have some kind of support.
- Install grab bars next to the toilet and inside the shower or tub
- Use a raised toilet seat if sitting and standing is difficult
- Add a shower chair for seated bathing
2. Non-Slip Surfaces
Falls often happen when stepping in or out of the tub. Focus on surfaces that offer grip.
- Place non-slip mats both inside and outside the tub or shower
- Avoid smooth bath rugs that slide or bunch
- Wipe up water immediately, especially near sinks
3. Water Temperature and Lighting
Quick movements to avoid scalding can lead to stumbles. Poor lighting only adds to the danger.
- Install anti-scald devices on faucets and showerheads
- Make sure lighting is bright and even, especially near mirrors and entry points
- Add a nightlight for early morning or late-night trips
Outdoor Areas Checklist
Stairs, porches, and driveways are easy to overlook but weather, uneven ground, and poor lighting make these areas hazardous year-round.
Handrails and Step Visibility
Getting in and out of the home should feel stable, not risky. Make steps as visible and secure as possible.
- Add handrails on both sides of the stairs and ramps
- Apply contrasting tape or paint to step edges for better visibility
- Check that each step is even, secure, and slip-resistant
Outdoor Pathways and Lighting
Seasonal changes, especially in coastal areas, create new risks. Keep these spaces tidy and well-lit.
- Sweep away leaves, snow, or debris regularly
- Trim overgrown bushes or tree branches that block paths
- Install motion-sensing or solar lights near entryways and walkways
General Outdoor Safety
Even durable surfaces wear down over time. Prioritize proactive maintenance to avoid surprise hazards.
- Repair loose boards, cracked steps, or broken pavers
- Keep assistive ramps stable, level, and weather-protected
- Avoid placing planters or furniture in narrow walking areas
Creating a Personalized Fall Prevention Plan
A checklist is a great place to start, but it’s only the beginning.
Each home, and each individual, is different. Customize a fall prevention strategy to your loved one’s routines, habits, and health needs to make safety feel more natural and sustainable.
Monitor and Update Regularly
Fall risks change quickly. What felt safe a few months ago may not work after a health change or seasonal shift. Make home assessments part of your regular caregiving rhythm.
- Review the home every 6 months, or sooner if your loved one’s condition changes
- Check new furniture, recent repairs, or seasonal clutter that could introduce hazards
- Keep a record of changes to track progress and spot patterns over time
Keep Communication Open
Your loved one’s perspective is extremely valuable. If they feel overwhelmed or resistant to changes, a calm, honest conversation can make all the difference.
- Ask regularly what feels safe, difficult, or stressful about their space
- Involve them in decisions, especially about mobility aids or layout changes
- Explain how fall prevention steps support independence, rather than take it away
Use Local Resources
You don’t have to do this alone. North Carolina offers a wide range of support services to help families stay ahead of fall risks.
- Contact the North Carolina Falls Prevention Coalition for tools and checklists
- Reach out to local senior centers or caregiver groups for advice and support
- Schedule a home safety evaluation through local agencies or healthcare providers
Taking the time to create a personalized plan shows care, respect, and foresight. It turns prevention into something that’s empowering and not limiting.
Build a Safer Home with Intention Over Fear
When a serious fall happens, you face a disruption to routine, confidence, and sometimes independence.
Fortunately, when we treat safety as an act of care more so than caution, the home becomes a place of empowerment. Every thoughtful adjustment is a quiet way of saying: “I want you to keep living fully, on your terms.”
If you’re ready to take the next step, we’re here to help. At New Estuary Home Care, our trained caregivers offer in-home safety consultations, mobility support, and personalized fall prevention plans tailored to your loved one’s space and lifestyle.
Reach out to schedule a fall risk assessment and start building a safer, more supportive environment, one room at a time. Contact us today!
