Helping your elderly relatives become safe at home.

By
Home Inspector with Massachusetts Home Inspections MA. License#566 NH Lic#49

Being a full-time home inspector, I see people living with safety hazards every day of my life. I’m always concerned with these hazards and I’d like to assist in getting these corrected, especially for our most vulnerable people...our lovely Senior Citizens. Senior Citizens are injured in and around their homes continuously on a daily basis and I feel that the healthy surviving children should take time out of their busy schedules to help these fragile individuals in order to make sure they are safe from all harm. As you know, slips and falls are the most common source of injury for older individuals, but many other injuries result from hazards that are very easily overlooked and are very simple to fix. Most seniors are unable to fix these issues themselves, so it’s easier for us younger individuals to take the initiative to spot these hazards and then take some simple steps to correct them. Many injuries of our seniors can be prevented, and it takes a simple inspection of their living areas to make sure they live a safe life.

I’ve got 40 tips that should assist you all in keeping your older relatives safe from harm. Please use the following checklist to spot those possible safety issues which may be present in a seniors living area. Keep this checklist (in a file) as a reminder of safe practices that should be utilized, and use it periodically to re-check their living area.

Security and emergencies

1. Alarms - Check that smoke alarms and carbon monoxide alarms are located in each bedroom, and on each floor of multi-story homes, and in other areas where one is likely to fall asleep, such as a family room or den with a cozy recliner. Read the instructions that come with the alarms for advice on the best place to install them, but generally place them either on the ceiling or on a wall 6-12 inches below the ceiling. Also make sure to locate them away from air vents. Use the test button on the alarm to check them each month,, and replace any batteries, bulbs, or alarms that are not working properly. Many fire injuries and deaths (in the home) are caused by smoke and toxic gases rather than the fire itself. Alarms provide an early warning and can wake everyone in the event of a fire or dangerous gases. Vacuum the louvers of the alarms so that dust and dirt don’t interfere with the alarm doing its job. Replace any smoke detectors which cannot be repaired or which are older than five years. Some fire departments or local governments will provide assistance in acquiring or installing alarms. There are combination smoke/carbon monoxide alarms available, and there also are units that plug into electrical outlets.


2. Emergency exit plan - Check that they have an emergency exit plan and an alternate emergency exit plan in case of a fire. Fires can spread very rapidly, they might not have much time to get out (there might be a lot of confusion), so it is important that everyone knows what to do. Make sure your exit plan includes:

a) Shutting off the gas, water, and/or electricity whenever possible. Don’t put anyone at risk to these           tasks though. Losing property is better than losing lives.
b) Emergency phone numbers for family members, police, ambulance, and fire department, and a meeting place outside of their home so you can be sure that everyone is safe.
c) Practice this fire evacuation plan from time to time to make sure everyone is familiar with it.


3. Telephone - Make sure that they have access to a telephone if they fall or experience some other emergency which prevents them from standing and reaching a wall phone. Have at least one telephone located where it would be accessible in the event of an accident which leaves them unable to stand. Many security companies now provide health and safety monitoring services which can include bracelets, necklaces, or belts that have wireless emergency contact buttons on them. Have a telephone close to their bed, so that they are able to reach it without getting out of bed.


4. Emergency number - Check that emergency numbers are posted on or near their telephone. Write the numbers in large print and tape them to their phone or place them where they can be seen easily. Emergency numbers should include those for the police, fire department, local poison control center, family doctor, and any family members or neighbors that should be notified in the event of an emergency.

Fireplaces, chimneys, cooking, and heating.


5. Fireplace and chimney - If applicable, have their chimney cleaned and checked at least annually, more often depending on how often they use the fireplace. Burning wood can cause an accumulation of creosote inside the chimney, which can ignite and result in a chimney fire. Chimneys that are clogged from leaves, wildlife nests, or other debris can result in a poor fire, poor drafting, and smoke and poisonous gases coming back into the house. Poor drafting is often indicated by soot accumulation on the walls surrounding the fireplace. If you see such conditions, or see or hear wildlife in their fireplace or chimney, do not use the fireplace until it has been checked and cleaned by a qualified chimney sweep.


6. Cooking clothing - Make sure they are wearing  clothing with short or close-fitting sleeves when they are cooking. The CPSC estimates that 70% of all people who die from clothing fires are over 65 years of age. Long sleeves are more likely to catch fire than are short sleeves, and long sleeves are also more likely to catch on pot handles, overturning pots and pans and causing scalds. Roll back long, loose sleeves or fasten them with pins or elastic bands for their cooking convenience.


7. Electric blankets - Check that their electric blanket is not covered or tucked under the sides of the bed when in use. Use electric blankets according to the manufacturer’s instructions. Generally, tucking them in or placing additional coverings on top of them can cause excessive heat buildup which can start a fire or cause heat-related deaths in older people. Also, tell then not to allow pets to sleep on top of electric blankets. Don’t set electric blankets so high that they could burn someone who falls asleep while they are on.


8. Heating pads - Check that any heating pads are turned off before falling asleep. Even low settings can cause serious burns if left on.


9. Kitchen stove - Check that towels, curtains, and other things that might catch fire are located away from the stove. Placing or storing non-cooking equipment like potholders, dish towels, or plastic utensils on or near the range can result in fires or burns. Make sure they store flammable and combustible items in cabinets or drawers, not on countertops or on the range itself. Remove any towels hanging on oven handles and change the location of towel racks that cause towels to hang too close to a cook top burner. Shorten or remove curtains which could brush against heat sources.


10. Space heaters - Make sure they understand the installation and operating instructions for space heating equipment, such as a kerosene heater, a gas heater, or an LP gas heater. Always use the correct fuel as recommended by the manufacturer. Improper venting is the most frequent cause of carbon monoxide poisoning, and older consumers are at special risk. Vented heaters should have proper venting installed, and the venting system should be checked regularly. Un-vented heaters should be used with room doors open or windows slightly open to provide ventilation. Call the manufacturer or your local fire department if you have additional questions.


11. Stoves - Check that wood-burning equipment was installed properly. Wood-burning stoves should be installed by a qualified person according to the manufacturer’s installation instructions and local building codes. Local building code officials or fire marshals can provide requirements and recommendations for installation. Note that some insurance companies will not cover fire losses if wood stoves are not installed properly.


12. Stoves and space heaters - Check that small stoves and space heaters are placed where they cannot be knocked over and away from furnishings and flammable materials, such as curtains, rugs, and beds. Heaters can cause fires or serious burns if they cause them to trip or if they are knocked over. Many modern stoves and space heaters have audible alarms that warn of a unit that is knocked over and others will shut-off automatically.


Stairways


13. Horizontal run and vertical rise - Check that steps are even and of the same horizontal run and vertical rise. Even a small difference in rise or run can lead to falls. Mark any steps which are especially narrow or have risers that are higher or lower than the others. They should be especially careful of these steps when using the stairs.


14. Lighting - Check that stairs are lighted so that each step, particularly the step edges, can be clearly seen while going up and down stairs. Falls can occur if the edges of the steps are blurred or hard to see, or if depth perception is poor. Check that light switches are located at both the top and bottom of the stairs. Even if they are very familiar with the stairs, lighting is an important factor in preventing falls. They should be able to turn on the lights before they use the stairway from either end. If no other light is available, keep an operating flashlight in a convenient location at the top and bottom of the stairs. Install night lights if possible. If you plan to carpet their stairs, avoid deep pile carpeting or patterned or dark colored carpeting that can make it difficult to see the edges of the steps clearly. Paint edges of outdoor steps white to see them better at night.


15. Step coverings - Check that steps and step coverings allow secure footing and are not loose. Worn treads or worn or loose carpeting can lead to insecure footing, resulting in slips or falls. Warn them to avoid wearing only socks or smooth-soled shoes or slippers when using their stairs. Make certain the carpet is firmly attached to the steps all along the stairs. Refinish or replace worn treads, and replace worn carpeting. On outside steps, use a paint that has a rough texture, use abrasive strips, and use a different color or texture to help improve depth perception.


16. Storage - Check that nothing is stored in the stairway, even temporarily. They can trip over objects left on stairs, particularly in the event of an emergency or fire.



Electrical wiring, outlets, and lights


17. Fuses - If their home has fuses, check that they are the correct size for the circuit. Replacing a fuse with a larger size can create a fire hazard. If the fuse is rater higher than that intended for the circuit, excessive current will be allowed to flow and possibly overload the outlet and house wiring to the point that a fire can start. If you do not know the correct sizes, have an electrician identify and label the sizes to be used. From  my experience as a home inspector, if all (or nearly all), fuses used are 30-amp fuses, there is a chance that some of the fuses are rated too high for the circuit. Have an Electrician evaluate and correct the panel if that is the case.


18. Lighting - Check all areas for good, even lighting that doesn’t create shadows, especially in the stairways; over the stove, sink, and work areas where power tools or sharp objects are used; passageways between rooms; and hallways. Shadows and dark areas can hide tripping hazards. Low lighting and glare can contribute to burns or cuts. Improve lighting by:
¨    Opening curtains and blinds, unless it causes too much glare.
¨    Using the maximum wattage bulb allowed by the fixture. If you do not know the correct wattage for the fixture, use a bulb no larger than 60 watts. Make sure that the bulbs you use are the right type for the light fixture; don’t permanently remove the light cover or alter the light socket in order to fit a new fluorescent bulb in the lighting fixture.
¨    Reducing glare by using frosted bulbs, indirect lighting, shades or globes on light fixtures, or partially closing the blinds or curtains.
¨    Installing additional light fixtures, e.g. under cabinet or over-the-countertop lighting.
¨    Installing night lights wherever possible for safety at night. Inexpensive lights that plug into outlets are available, and you can replace standard wall switches with switches that glow or light in darkness.
¨    Installing light switches near bedroom entrances to prevent walking through a dark area.
¨    Installing lamps or light switches within reach of beds to enable people getting up at night to see where they are going.
¨    Rearranging furniture closer to switches and moving lamps closer to beds.
¨    Keeping working flashlights and backup batteries near beds, in kitchens and bathrooms, in basements and garages, and in storage areas.
19. GFCI outlets - Have ground fault circuit interrupter outlets (GFCIs) installed in kitchens, bathrooms, garages, and exterior locations. A GFCI is a shock-protection device similar to that in the picture at right which will detect electrical faults and shut off electricity before serious injury or death occurs.


20. Light bulbs - Check that light bulbs are the right size and type for the lamp or fixture. The wrong type of bulb or an oversized bulb can cause a fire because of overheating, and ceiling fixtures, recessed lights, and hooded lamps will trap heat. If you do not know the correct wattage, use a bulb no larger than 60 watts.


21. Outlet and switch cover plates - Check that all outlets and light switches have cover plates so that no wiring is exposed. Exposed wiring presents a shock hazard.


22. Overheating - Check outlets, light switches, and extension cords to see if they are unusually warm or hot to the touch, which can indicate that an unsafe wiring condition exists. Unplug cords from outlets and do not use the switches or extension cords if they are overheated. Have an electrician check the wiring.


23. Power tools - Check that power tools are equipped with a 3-prong plug or marked to show that they are double insulated. These safety features reduce the risk of an electric shock. Use a properly connected 3-prong adapter for connecting a 3-prong plug to a 2-hole receptacle. Replace old tools that do not have a 3-prong plug or are not double insulated.


24. Small appliances - Check that small electrical appliances such as hair dryers, shavers, curling irons, etc., are unplugged when not in use. Even an appliance that is not turned on can be potentially hazardous if it is left plugged in. If it falls into water in a sink or bathtub while plugged in, it could cause a lethal shock. Never reach into water to retrieve an appliance that has fallen in without being sure the appliance is unplugged. Install a ground fault circuit interrupter (GFCI) in your bathroom outlet to protect your seniors from electric shock.


25.  FillSpace heaters - Check that portable space heaters which have a 3-prong plug are being used in a 3-hole electrical outlet. The grounding feature provided by a 3-hole outlet is a safety feature designed to lessen the risk of shock. Never defeat the grounding feature by cutting off prongs or bending them out of the way. If they do not have a 3-hole outlet, use an adapter to connect the heater’s 3-prong plug but make sure the adapter has a ground wire or tab and attach it to the outlet properly.


26. Temporary wiring - Check that they are using extension cords properly:
¨    Check that it carries its proper electrical load as indicated by the labels on the cord and the appliance. Overloaded extension cords may cause fires. Standard 18 gauge extension cords can carry 1250 watts. If the rating on the cord is exceeded because of the power requirements of one or more appliances being used on the cord, change the cord to a higher rated one or unplug some appliances.
¨    Do not use cords as permanent wiring, and certainly don’t create a mess. Such conditions can cause damage to the cords and overheating, possibly resulting in a fire or personal injury. Have an electrician install new outlets for convenience and safety.


¨    Check that lamp, extension, and telephone cords are placed out of the flow of traffic. Cords stretched across walkways may cause someone to trip. Arrange furniture so that outlets are available for lamps and appliances without the use of extension cords. Place extension cords on the floor against a wall where people cannot trip over it. Move the phone so that telephone cords will not lie where people walk.
¨    Check that lamp, extension, and telephone cords are placed away from sinks. Electrical appliances and power cords can cause shock or electrocution if they come in contact with water
¨    Check that lamp, extension, and telephone cords are placed away from heat-producing appliances, such as the kitchen range and baseboard heaters. Cords can be damaged by excess heat.
¨    Check that furniture, rugs, and carpeting do not cover cords. Furniture resting on cords can damage them, creating fire and shock hazards. Electric cords which run under carpeting may cause a fire.
¨    Check that cords are not attached to walls, ceilings, or floors, with nails or staples which can damage cords, creating fire and shock hazards. Use tape, cord clips, wiring guides, or raceways to attach cords to walls or floors.
¨    Check that electrical cords in good condition and replace any damaged or worn cords. Damaged cords may cause fire and shock hazards
Bathtubs and showers
27. Grab bars - Check that bathtubs and showers have at least one (preferably two) grab bars. Grab bars can help them get into and out of their tub or shower, and can help prevent falls. Check existing bars for strength and stability, and repair if necessary. Attach grab bars, through the tile, to structural supports in the wall, or install bars specifically designed to attach to the sides of the bathtub. If you are not sure how it is done, get someone who is qualified to assist you.


28. Non-skid surfaces - Check that bathtubs and showers are equipped with non-skid mats, textured strips or appliqués, or surfaces that are not slippery. Wet, soapy tile or porcelain surfaces are especially slippery and may contribute to falls. Also place non-skid mats on the bathroom floor, especially any steps.
Miscellaneous


29. Appliances - Check that the grounding feature on appliance cords with 3-prong plugs has not been defeated by removing the grounding pin or by improperly using an adapter. Improperly grounded appliances can lead to electric shock. Check with your service person or an electrician if you are in doubt.


30. Containers—Check that containers containing flammable, poisonous, and cleaning liquids are tightly capped. If not tightly closed, vapors may escape that might be toxic when inhaled.


31. Container storage - Check that gasoline, paints, solvents, or other products that give off vapors or fumes are stored away from ignition sources such as heaters, furnaces, water heaters, ranges, and other gas appliances. Such liquids should be stored in properly labeled, non-glass safety containers, and should not be stored in living areas.

32. Exits and passageways - Check that all exits and passageways are clear of obstructions. Furniture, boxes, or other items could be an obstruction or tripping hazard, especially in the event of an emergency or fire. Rearrange furniture to open passageways and walkways, and remove boxes and clutter.


33. Fire sources - Check that ash trays, smoking materials, candles, and any other fire sources are located away from beds and bedding. Burns are a leading cause of accidental death among seniors. Burning candles and smoking in bed are major causes of fire-related deaths.


34. Kitchen ventilation - Check that kitchen ventilation systems or range exhausts are functioning properly and advise seniors to use them while they are cooking. Indoor air pollutants may accumulate to unhealthful levels in a kitchen where gas or kerosene-fire appliances are in use. Use ventilation systems or open windows to clear air of vapors and smoke.


35. Medicines - Check that medicines are stored in their original containers and that they are clearly marked with the contents, instructions, expiration date, and patient’s name, and dispose of outdated medicines properly. Unmarked medications can be easily mixed up, and taking the wrong medicine or missing a dosage can be dangerous. In homes where grandchildren or other youngsters are frequent visitors, medicines should be purchased in containers with child-resistant caps, and the caps properly closed after each use. Store medicines beyond the reach of children. Request non-child-resistant containers from your pharmacist only when you cannot use child-resistant containers.


36. Power tools - Check that power tool guards are going to be in place during use. Power tools with the guards removed pose a serious risk of injury from sharp edges or moving parts.

37. Rugs, runners, and floor mats - Check that small rugs, carpet runners, and floor mats are slip-resistant. The CPSC estimates that in 1982, over 2,500 people 65 and over were treated in hospital emergency rooms for injuries that resulted from tripping over rugs and runners. Falls are also the most common cause of fatal injury for older people. Purchase rugs with slip-resistant backing or apply double-sided adhesive carpet tape or rubber matting to the backs of rugs, runners, and mats. Over time, the adhesive on tape can wear away, and rugs with slip-resistant backing also become less effective as they are washed. Check periodically to see if the backing needs to be replaced.


38. Step ladder - Check that they have a step stool or step ladder that is stable in and good shape. Standing on chairs, boxes, or other makeshift items to reach high shelves can result in falls. If they don’t have a step stool, please purchase one. Choose one with a handrail that they can hold onto while standing on the top step. Advise them that before climbing on any step stool, that they make sure it is fully opened and stable. Tighten any loose screws or braces and discard step stools with broken parts.


39. Water temperature - Check that the water temperature is 120°F or lower. Water temperature above 120 degrees can cause scalds, especially in seniors. Lower the setting on their hot water heater to “Low” or 120°F. If you are unfamiliar with the controls of their water heater, ask a qualified person or Plumber to adjust it for you. If their hot water system is controlled by the landlord, ask the landlord to lower the setting. If the water heater does not have a temperature setting, you can use a thermometer to check the temperature of the water at the tap. Always check water temperature by hand before entering bath or shower. Taking baths, rather than showers, reduces the risk of a scald from suddenly changing water temperatures.


40. Nightwear - Older consumers should be wearing nightwear that is flame resistant, and choose garments made of tightly woven fabrics, such as 100% polyester, nylon, or wool.



                   Please remember to periodically re-check their home for safety issues so that your 
                   your loved ones can live a longer and safe life.

 

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Rainmaker
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Jack Gilleland
Home Inspection and Investor Services, Clayton - Clayton, OH

Wow, great blog David.  My Dad lives with us and some of these things escaped me. thanks.

Jan 18, 2009 12:35 PM #1
Rainmaker
30,707
David Valley
Massachusetts Home Inspections - Methuen, MA
Massachusetts Home Inspector

I'm glad I could help out.

It's simply amazing how many times I've seen safety issues in homes with senior citizens living in them.

Jan 18, 2009 12:43 PM #2
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Rainmaker
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David Valley

Massachusetts Home Inspector
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