Under the prescription of a medical doctor, a physical or occupational therapist can make a home visit to assess for patient safety. Home safety assessments can be a helpful tool to determine if the home is accessible and the ideal set up for a patient. The following is an abbreviated check list from REHAB hospital's home assessment form.
Exterior of home:
Drive way surface: Ideally paved, smooth and level, especially if a patient uses an assistive device for walking.
Ramp Guidelines: 1' ramp to 1" of elevation with maximum length of 30'. Railing for safety. If landing needed, 5'x5' allows for wheelchair turning space.
Steps: 6-7" in height, non-skid strips can be applied for fall prevention. Sturdy railing should be available on one or ideally two sides at 32" in height and extending atleast 18" beyond top and bottom step.
Entrance to home: Ideal width of the doorway (entrance as well as doorways in the home) of about 36" can accommodate most wheelchairs and walkers. Depending on a patient's grip strength, special door handles can be used for easier access and use. Also door closing mechanism can be installed.
Living Room:
Lighting: Light switch should be close to the doorway entrance and accessible, within arms reach. Lighting should be adequate to prevent trips/falls.
Floor: Throw rugs should be removed and walkways shoulder be free of electrical/phone cords.
Furniture: Tables and chairs should be sturdy and provide support if leaned on. Unsteady chairs and furniture with wheels should be removed. Cushions on chairs and sofas should be firm. Chairs should have armrests for greater ease of sit to stand transfers. If leg weakness is an issue, chairs can be slightly elevated for greater ease of sit to stand transfer.
Telephone: Should not have long cords (trip hazard) and should be readily accessible.
TV: Remote control can be helpful.
Bed Room:
Lighting: Installation of nightlight and/or bedside lamp may be helpful if patient needs to get up to use the restroom at night. Walkway from bed to bathroom should be cleared of all obstacles and trip hazards.
Bed: Height can be raised or lowered for greater ease of sit to stand and supine to sit transfers. If patient is wheelchair bound, bed mattress of the same height of the wheelchair will allow for greater ease of wheelchair to bed transfers. Hospital bed can be purchased if needed with options of elevating head/foot rests, bed rails and entire bed lowering/elevating. Standard hospital beds require about 36" x 88" of space. Bed rails that fit above and below the matress of a standard bed can be installed for greater ease of getting into/out of bed and to prevent falls out of bed.
If needed a bell/intercom can be installed for patient to alert caregivers/family members. Telephone should be accessible.
Closet: Rod height should not exceed 54". Door should be easy to access and open.
Bathroom:
Light switches/Electrical outlets: Should be within arms reach.
Doorway and Tub/Shower entrances: Should be wide enough to accommodate assistive device or wheelchair if necessary.
Tub transfer bench, bath bench or shower chair: Equipment can be purchased if a patient has poor balance/standing endurance. Tub transfer bench sticks out of tub and into bathroom floor such that a person can sit down and pivot legs into the tub. Shower chair (with back rest) or bath bench (without back rest) can be used for high level patients that have poor standing tolerance.
Non-skid bath mat: Can be used to prevent falls when the tub/shower floor is wet/slippery.
Shower hose: For patient's who have difficulty rinsing themselves, a flexible shower hose can be installed for ease of bathing in a seated position.
Grab bars: May be installed in/around bath tub and toilet areas to assist patient with in/out tub and sit to stand transfers. Towel racks should not used for support with transfers.
Throw rugs should be removed.
Toilet: Standard toilet seat height is 19". Raised toilet seat can be installed for greater ease of sit to stand transfer. Toilet guard rails or nearby grab bars can also be installed. For patients that are unable to get to the bathroom in a timely manner, bed side commodes may be used. Bed side commode usually requires about 24"x24" of space.
Kitchen:
Floor: Throw rugs should be removed.
Table: Height should accommodate chairs with arms rests (or wheelchair if needed).
Cupboards/cabinets/kitchen appliances: Everyday utensils, dishes and appliances should be easily accessed. Installation of cabinet and drawer handles may be helpful.
