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environmental assessment for fall risk
Floor surface
1) use wall-to-wall low-pile carpeting
2) carpet edges should be tacked down
3) keep smooth floors dry & clean
4) nonskid wax should be used
5) threshholds should be beveled no higher than 1/2 inch (or removed)
6) minimize clutter or obstacles
Lighting
1) hallway & stairs should be well lit
2) reduce glare by using lamp shades & frosted light bulbs
3) light swithches should be easily accessible
Bedroom
1) mattress should be firm
2) bed height
- should allow the patient's feet to touch the floor when sitting on the edge of the bed
3) bedside table should be accessible from the bed
4) call button & light should be accessible from the bed
5) furniture
- should be arranged to provide support for the patient when walking
Bathroom
1) floors should have a nonslip surface
2) grap bars
-> should be attached to the wall next to toilet & in the bathtub or shower
3) toilet should be at a height to allow easy transferring
4) shower seat & nonslip appliques
- should be used in bathtub or shower
5) call button or cord
- should be easily reached from toilet, tub, floor
Stairs
1) sufficient lighting with light switch at top & bottom of stairs
2) securely fastened bilateral handrails
3) top & bottom steps marked with bright contrasting tape
4) stair rises of no more than 6 inches
5) steps in good repair
6) no objects stored on steps
Yard & Entrances
1) repair of cracks in pavement & holes in lawn
2) removal or rocks, tools & other tripping hazzards
3) well-lit walkways, free of ice & wet leaves
4) stairs & steps as above
Institutions:
1) all of the above
2) clean up spills on the floor promptly
3) appropriate use of walking aids & wheelchair
Footwear:
1) shoes with firm, nonskid, nonfriction soles
2) low heels (unless person is accustomed to high heels)
3) avoidance of walking in stocking feet or loose slippers
General
environmental assessment
References
- Rubenstein et al, Clinics in Geriatrics 12(4):881 19??
- Tinetti & Speechley, N Engl J Med 320:1055, 1989