In the U.S., many older adults are injured in or near their home every year. It is estimated by the U.S. Consumer Product Safety Commission (CPSC) that on average 1.4 million adults aged 65 or older are treated in emergency rooms each year for injuries associated with consumer products. The rate of injury is highest for adults 75 or older. One of the major causes of injuries to older adults is falls in or around their home. Older adults are also at a greater risk of mortality due to house fires. Many injuries result from hazards which are easily overlooked, but easy to fix.
The U.S. Consumer Product Safety Commission created a home safety checklist for older consumers to help prepare for emergencies and identify possible safety hazards in the home in order to prevent injuries to consumers or visitors to their home. Their top 10 safety checklist for older consumers includes7:
- Installing smoke and carbon monoxide detectors throughout the home
- Having an emergency escape plan with arrangements in place for assistance with escaping if needed
- Keeping a fire extinguisher in the kitchen in case of fire
- Ensuring there is proper lighting both in the home and outside of the home to prevent falls
- Making sure that walking surfaces are even, slip-resistant, free of clutter, and in good condition in order to decrease the risk of falls
- Keeping any smoking materials, candles, etc. away from any combustible items such as curtains or furniture and never leave fires unattended
- Having any appliance which runs on fuel inspected by a professional every year to ensure they are working correctly and not leaking carbon monoxide
- Installing ground fault circuit interrupters in potentially damp areas such as the kitchen or bathroom in order to protect against electrocution
- Ensuring that all medications, matches and lighters are stored out of reach of children
- Setting the hot water heater to no more than 120° F to prevent burns
Smoke alarms and carbon monoxide alarms should be installed on every level of the home, including outside of sleeping areas. The alarms should be checked on a regular basis to ensure they are still working properly. Approximately 2/3 of home fire deaths occur in houses without working smoke alarms. For patients who are hearing impaired, alarms with strobe lights should be installed to notify of smoke or carbon monoxide during the day and an assistive device which vibrates the bed and pillow should be used at nighttime.
An emergency escape plan can help to reduce the time required for a patient and their family to exit the home safely and can improve chances of survival. When possible, two exits should be identified from every room, and patients should avoid escape routes which require the use of a ladder, which could increase risk of falls. It is important to ensure that the patient or their family member can unlock and open all windows involved in the escape plan. The emergency escape plan should be practiced on a regular basis. Emergency phone numbers, including police, fire department, local poison control center, doctor, and a trusted neighbor or family member, should be posted on or near all telephones. A telephone should be present in the bedroom in the event that the patient is trapped in their bedroom by a fire. For patients with impaired vision, a telephone with large, lighted number keys should be used. It is also helpful to keep telephones at a low height so that the patient can reach the phone if they have a fall or accident which results in them being unable to stand. Another option would be to use a wearable medical alert device which includes a button which can be pushed to call for assistance.7
It is important to ensure that all walking surfaces are free of electrical cords, boxes, furniture, appliances, and any other objects which could be a tripping hazard, especially in the event of an evacuation due to an emergency or fire. All flooring should be in good condition, flat and uniform, and slip-resistant or covered with slip-resistant carpeting, rugs, mats, or similar materials. Slip-resistant surfaces are especially important in potentially wet locations such as bathrooms, kitchens, and entryways. Any carpet in place should be low pile and in good condition. Any steps should have flat, even surfaces and be free of objects that could pose a tripping hazard. All stair treads should be in good condition and have slip-resistant surfaces, such as slip-resistant strips which are securely attached to the steps. All stairs should have sturdy, easy to grip handrails that run continuously along the full length of the stairs on both sides. Light switches should be located at both the top and bottom of stairs.
Good lighting is an essential factor in preventing falls as poorly lit or shadowed areas can possibly hide slipping or tripping hazards. Indirect lighting or frosted bulbs can be utilized to decrease glare. All light bulbs should be the appropriate wattage and type for the lamp or light in which they are installed. If a light fixture does not identify the correct wattage, bulbs should not exceed 60 watts or 25 watts for bulbs with a miniature base, such as a candelabra. Compact fluorescent or other energy-efficient bulbs produce more light than incandescent bulbs.7
All electrical outlets located in potentially damp locations, such as the kitchen, bathroom, garage, near the utility tub or sink, and on the exterior of the house, should have ground-fault circuit interrupters (GFCIs) installed to protect against electrical shock. GFCI receptacles can provide power even when they no longer provide shock protection. The GFCI receptacle should be tested monthly by plugging a night-light or lamp into the receptacle and turning it on. When the TEST button is pressed on the GFCI receptacle, the RESET button should pop forward, and the light should go out. Pressing the RESET button should restore power to the outlet. Electrical outlets or switches should never be unusually warm or hot to the touch as that may indicate unsafe wiring condition. These electrical outlets should stop being used immediately and be checked by an electrician as soon as possible. All electrical outlets and switches should have cover plates installed so that no wiring is exposed. Any unused receptacles should have safety covers installed to prevent access by young children. All cords such as electrical or extension cords or telephone cords should be out of the walkway as they pose a tripping hazard. Cords should not be placed underneath furniture, rugs, or carpet or be pressed against the wall by furniture. Electrical cords should be in good working condition and free from any damage. The total wattage of all appliances plugged into an extension cord should not exceed the rated capacity of the extension cord. If the extension cord rating is exceeded, a higher-rated cord can be used or some appliances should be unplugged. Standard 16-gauge extension cords can carry 1625 watts.7
A fire extinguisher should be located in the kitchen in case of fire. To operate a fire extinguisher, the National Fire Protection Association (NFPA) recommends that everyone remembers the acronym PASS. This stands for Pull the pin - hold the extinguisher with the nozzle pointing away from you and release the locking mechanism. Aim low - point the extinguisher at the base of the fire. Squeeze slowly and evenly. Sweep the nozzle from side to side. Fire extinguishers should be less than 10 years old. The extinguisher itself and the area around it should be free from dust, grease, and clutter which could potentially catch fire. It is recommended to avoid wearing loose-fitting clothes with flowing or oversized sleeves while cooking.
It is also important that kitchen ventilation systems or range exhausts are functioning properly. Indoor air pollutants and carbon monoxide can accumulate to unhealthy levels in a kitchen where gas or kerosene-fired appliances are used. Ventilation systems or open windows should be used to clear the air of vapors and smoke. The range or stove should never be used to heat the home. It is important to always stay within view of any food cooking on the stovetop. Cooking is the number one cause of home fires and home injuries, especially unattended cooking. Electrical appliances and extension cords should be kept away from the sink and other water sources, as well as away from hot surfaces such as the range. Electrical receptacles that supply countertop appliances, such as coffeemakers and toasters, should be protected by ground-fault circuit interrupters. A steady step stool with a handrail should be easily accessible for reaching high items as standing on chairs, boxes, or other unsteady objects could result in falls.7
All chimneys should be professionally inspected and cleaned every year. Chimney openings should be clear of leaves and other debris that could clog them as a clogged chimney can cause poisonous carbon monoxide to enter the home. Burning wood in a fireplace can cause creosote, a highly flammable substance, to build-up inside the chimney. This material can ignite and result in a severe chimney fire. All portable space heaters and wood-burning heating equipment should be at least 3 feet from walls, furniture, curtains, rugs, and other flammable or combustible materials. All portable space heaters should be stable and located out of walkways. The surface of each fireplace should be fireproof. All wood-burning heating equipment should be installed on fireproof flooring or on an approved non-combustible floor protector. Burning material can be ejected from an open fireplace. Fire-resistant hearthrugs, made of wool, fiberglass, or other synthetics, should be used to protect the area in front of a fireplace. Ashtrays, smoking materials, candles, hot plates and other potential fire sources should be kept away from curtains, furniture, blankets and other combustible items and should never be left unattended.7
All bathtubs and showers should be equipped with non-skid mats, abrasive strips, or surfaces that are not slippery and have at least one secure and easy to grip grab bar. The bathroom floor should be slip-resistant or covered with secure slip-resistant materials. Personal care items such as hair dryers, razors, curling irons, and other small electrical appliances should be unplugged when not in use and should be away from sinks, bathtubs, and other sources of water. In the bedroom, a flashlight should be within reach of the bed in case there is a power outage, as well as a telephone within reach of the bed in case of an emergency. Patients should make sure that their mattress meets the new federal flammability standard. Newer mattresses are more resistant to fires from open flames such as candles, lighters, and matches, and will have tags to indicate that they meet the federal standard. Electrically-heated blankets should not be folded, covered by other objects, or tucked into the bed when in use. The power cord should not be pinched or crushed by the bed, between the bed and a wall or the floor. Any object that covers the blanket’s heating elements or controls can cause overheating. The patient should not allow anything, including other blankets, comforters, and pets, on top of an electric blanket while it is in use. The heating pad should always be turned off before the patient goes to sleep as it can cause serious burns, even at relatively low settings.7