Tips for Making Your Home Safer After a Stroke or Fall
If a patient has spent time rehabilitating in hospital from a stroke or fall, it’s important that their home environment is arranged to enable their continued recovery.
After all the hard work rehabilitating in hospital, the home environment needs to facilitate ongoing recovery, rather than cause a setback that could undo this hard work and result in readmission.
People recovering from a stroke are more susceptible to falls, due to physical symptoms like balance problems, vision changes and fatigue that can all make a fall more likely if not managed in the best way.
In this guide we look at simple practical steps anyone can take in the home to reduce their risk of falling, and contribute to a strong and stable recovery.
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Before Leaving Hospital: Planning Ahead
After recovering in hospital, patients will be looking forward to being back home with friends and family, but it can also be overwhelming to return to an environment they associate with previous levels of fitness.
As they may not have returned to prior levels of fitness, it’s important to ensure the hospital team advises on post-discharge care. Part of this should include getting a home assessment from an OT or physiotherapist.
Involving an OT or physio can take a lot of stress out of this emotional hurdle, and they can talk you through the changes needed to your home environment and activities to support you in your recovery. It can also help communication with the wider family and carers, and not make the patient feel like they need to organise everything, as a lot of arrangements like seating assessments can be organised by others.
The psychological impact of a fall can cause loss of confidence when someone returns home, as they are no longer under the supervision of hospital care staff. This can prevent people from standing and moving around even when they are physically able to do so, through fear of falling again.
This is a common and completely understandable reaction, and one that an OT can help you with overcoming, with the involvement of other family members.
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Home Safety Checklist
This checklist should not be used as an exhaustive list, but rather as a helpful guide that covers some of the main aspects to attend to when returning home.
Entrance and hallways: ensure these are free from clutter, and consider securing mats and rugs to the floor so they don’t pose a trip hazard. Handrails should be mounted outside and inside the entrance to give extra stability when walking up steps or over the threshold. Ensure the area is well-lit particularly in the wintertime, and you may want to consider installing ramps or half-steps if the entrance is too steep.
Stairs: Stairs are a risk flashpoint for post-falls recovery. If stairs can still be navigated, ensure there are handrails on both sides and the area is well lit with contrasting stair edges if possible. Otherwise, consider installing a stairlift or sleeping on the ground floor until a future date.
Bathroom and toilet: There are lots of safety features for bathrooms, such as grab rails, non-slip mats, shower seats and shower chairs, raised toilets and walk-in showers. These are covered in detail by our sister company Aquadapt who can advise on how to adapt your bathroom to make it more accessible for you.
Bedroom: Bed height and bedside lighting can all make a difference. You may want to consider buying a hospital bed for home, a profiling bed available in a range of homely styles.
Kitchen: Again, height is a big factor here. Try and keep items at waist height where possible to avoid stretching or bending which can increase falls risk.
Living areas: In general keep cables away from walkways, and arrange furniture to allow plenty of room for walking aids.
Choosing the Right Seating at Home
Your OT or physio can help review your current seating and arrange a more suitable chair through social services if your current one is inadequate.
Depending on whether someone is sitting for longer periods or needs chairs to carry out daily tasks, there are different options available.
Sitting out for Longer
If someone is sitting for longer periods, a care chair or care chair hybrid is more suitable, to ensure continued postural support, comfort and pressure care.
Considering how someone transfers from bed to chair or chair to toilet is important, as this is a key falls-risk area. Chairs with removeable sides can facilitate this for level side transfers, and compatibility with standaids like the Stand Assist is important here.
For more detail on which chairs are best for different stages of stroke recovery, you can read our guide on the best care chairs for stroke patients.
Some key seating features for you to consider with your OT are lateral support and adjustable head support to prevent leaning, and tilt-in-space for repositioning and pressure relief.
All these features are available with the Lento Care Chair or Lento Mobile, depending on your level of reliance on specialist seating.
Moving Safely Around the Home
Moving around the home can not only be a challenge mobility-wise, but increase anxiety of having a fall. The VELA Activity chair is designed to overcome this obstacle with a fully mobile chair that can be wheeled around the home, with secure braking and electric height adjustment to access different height surfaces.
This is especially useful for daily activities like cooking, cleaning, washing or eating. The seat angle can be changed to suit your position, and moved up and down to access different height work surfaces such as shelves or cupboards.
Needs can change as recovery and confidence progresses, so having regular seating reviews with your OT can be useful.
We would strongly recommend having a specialist seating assessment with your OT if possible, before going ahead.
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Reducing Falls Risk Beyond Physical Layout
As well as the physical environment, there are other mitigating steps you can take to reduce the risk of falling.
One is to review any medication you might be taking with your GP, as some can cause dizziness. Having an eyesight test and reviewing your footwear are other preventative measures.
Regular, supervised movement is encouraged initially, along with any exercises and advice from your physio.
A falls alarm or pendant you can hang around your neck can be reassuring for you to get assistance in the event of a fall, particularly if you live on your own.
What to do if a Fall Happens
If a fall does occur, stay calm and don’t force yourself or the faller to get up in case of injury. If the faller is unresponsive call 999, otherwise check for injuries and help them into a lying position with a cushion behind their head.
It’s worth investing in falls recovery equipment such as a Raizer chair or lifting cushion if falls happen frequently.
Supporting the Carer
Caring for someone who has had a stroke or fall can be demanding work, and carers themselves should take regular breaks and take advantage of support services available, for example through the Stroke Association.
Conclusion
It’s important to recognise that even small changes to the home can make a big difference to confidence and independence when recovering from a stroke or fall.
The key thing is to plan ahead and not try and rush recovery, but adapt gradually to the home environment and get professional support along the way.
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