Q: My wife and I are in our late seventies. She’s shown some recent changes, and last week she tripped on a rug she’s walked over for years. I’m taking her to her doctor, but it made me wonder if our home itself has become a risk. Do you have a safety checklist I should walk through?
A: You’re right to see your doctor first. But you’re also right that a change in behavior is exactly the moment to look at the house itself, not just the person in it. The CDC reports more than one in four adults over 65 falls each year, and for someone showing cognitive changes, the risk of a fall runs three to four times higher than for someone without them. A home that was perfectly safe for forty years can quietly stop being safe, because it was never actually tested against reduced judgment or a slower reaction time. It was just familiar.
Walk the house like a stranger would.
Most families miss hazards precisely because they know the house too well. A fall-prevention specialist can spot in five minutes what a spouse walks past every day without seeing: the loose mat by the bathroom door, a light switch on the far side of a dark room, a favorite chair that’s just low enough to make standing up genuinely hard. Go room to room, once during the day and once after dark, since lighting changes everything.
The general fall-proofing list:
Remove loose rugs and runners entirely, or secure them with non-slip backing. Add grab bars in the bathroom near the toilet and inside the shower. Improve lighting in hallways, stairwells, and entryways; motion-sensor lights are inexpensive and remove the need to fumble for a switch. Check every threshold and step for uneven transitions. Clear cords and clutter from walking paths.
What’s different when the change is cognitive, not just physical:
Treat this differently than standard fall-proofing. If what you’re seeing is memory or judgment related, a few additional steps matter that a general safety list won’t mention: appliances with automatic shut-off for stoves and irons, secure storage or lockable cabinets for medications and cleaning chemicals, and door locks positioned out of easy sightline if wandering becomes a concern later. None of this assumes the worst about her condition. It assumes only that judgment under stress is harder to predict than it used to be, and the house should account for that before it has to.
You don’t have to do this alone, or guess.
You can find one who will inspect your home is the resource I’ll point you to directly. You can find it through your local Area Agency on Aging. Many offer a free or income-based home safety assessment, conducted by someone trained specifically to catch what family members can’t. The Eldercare Locator, a federal directory at eldercare.acl.gov, will connect you to your local agency by zip code. That single call gets you a trained set of eyes in your home, and a specific list, rather than a general one, of what needs to change.
The rug was the warning. The house is the part you can actually fix.
