Fall Hazards
About This Health Driver
Fall hazards are environmental conditions that increase fall risk for occupants with reduced balance, coordination, mobility, or sensory processing. In residential settings, fall hazards include level changes (thresholds, steps, sunken rooms), slippery surfaces (wet tile, polished floors), inadequate lighting (particularly at transitions and in nighttime circulation paths), loose or unsecured floor coverings, clutter in circulation paths, and absence of support surfaces (grab bars, handrails) at points where balance is challenged.
How It Affects Bodies
A fall produces immediate injury risk (fracture, head trauma, soft tissue damage) and longer-term consequences including fear of falling, activity restriction, social isolation, and accelerated functional decline. In individuals with neurological conditions, falls compound existing disability: a hip fracture in an ambulatory MS client may permanently shift them to wheelchair dependence. Fear of falling restricts movement patterns, accelerates deconditioning, and reduces quality of life.
Where It Comes From
- Level changes and thresholds - transitions between rooms, step-downs, raised thresholds, and uneven surfaces
- Slippery flooring - wet tile, polished hardwood, high-gloss surfaces, and loose rugs
- Inadequate lighting - dark corridors, unlit stairways, absence of night lighting, shadows at grade changes
- Clutter and obstacles - cords, furniture in circulation paths, items stored on stairs, pet toys
- Absence of support surfaces - no grab bars at toilets and showers, no handrails in corridors
- Bathroom wet surfaces - shower and tub floors without slip resistance, water on bathroom flooring
- Outdoor surfaces - uneven walkways, cracked pavement, wet decking, leaf accumulation
How to Address It
- Non-slip flooring throughout - matte-finish hardwood, textured tile, or slip-resistant vinyl; avoid high-gloss surfacesInteriors
- Threshold elimination - flush transitions between all rooms; beveled thresholds where elimination is not possible (maximum 1/2 inch)Carpentry
- Curbless shower with linear drain - eliminates the highest in-home fall sitePlumbing
- Grab bars and blocking - install at all wet areas; blocking in all bathroom and corridor walls for future installationCarpentry
- Continuous handrails - both sides of stairs; one side of all corridors longer than eight feetCarpentry
- Motion-activated night lighting - bedroom-to-bathroom path, hallways, stairwaysElectrical
- LED edge lighting at grade changes - stair nosings, ramps, sunken roomsElectrical
- Illuminated light switches - all rooms, accessible at entry pointsElectrical
- Secured floor coverings - remove area rugs or secure with non-slip backing; no runners on stairsInteriors
- Clear circulation paths - maintain 36-inch minimum width; cord management systemsOperations