Home Safety Checklist for Older Adults in New York

For many older adults, staying at home means maintaining independence, familiar routines, and connection to the community. But as mobility, vision, balance, strength, or health needs change, a home that once felt completely comfortable may begin to present new safety risks.

The good news is that many of those risks can be reduced with relatively simple changes.

In New York, fall prevention is an important part of healthy aging. The New York State Department of Health identifies falls as a leading cause of injury deaths, hospitalizations, and emergency department visits among older adults. In 2023 alone, falls among New Yorkers age 60 and older were associated with more than 1,800 deaths, 78,000 hospitalizations, and 182,000 emergency department visits.

A home safety review does not need to involve a major renovation. It starts with looking at everyday routines, identifying areas where a person could trip, slip, lose balance, have difficulty reaching something, or struggle to get help when needed.

This home safety checklist can help older adults and families in New York identify practical ways to make the home safer.

Why Home Safety Matters for Older Adults

A person's needs can change gradually.

Someone who moved around the apartment easily a few years ago may now need more time getting out of bed. A bathroom floor may become harder to navigate. Stairs may require more concentration. Carrying groceries from the front door may become more difficult.

Several factors can increase fall risk, including:

• Lower-body weakness
• Balance problems
• Difficulty walking
• Vision changes
• Certain chronic conditions
• Some medications or combinations of medications
• Unsafe footwear
• Clutter or obstacles in walking areas
• Poor lighting

The New York State Department of Health recommends regular exercise, medication reviews with healthcare providers, annual vision checks, safer footwear, improved lighting, grab bars, non-slip surfaces, and removal of common trip hazards as ways to help reduce fall risk.

The goal is not to remove independence from an older adult. The goal is to make everyday activities easier and safer.

Home Safety Checklist: Room by Room

1. Entrances and Hallways

Start with the routes the person uses most often.

Ask:

• Is the entrance well lit?
• Is there a clear path from the door into the home?
• Are shoes, bags, boxes, packages, or other items blocking the walkway?
• Are rugs secure?
• Is there something stable to hold onto if needed?
• Can the person safely unlock and open the door?
• Is the floor slippery when wet?

In New York apartment buildings, also think about the route beyond the apartment itself.

Consider whether the person can safely navigate:

• Building hallways
• Elevators
• Lobby areas
• Steps at the building entrance
• Heavy entrance doors
• Walk-up stairs
• Uneven sidewalks
• Wet or snowy entryways

If an older adult uses a cane, walker, or other mobility device, pathways should provide enough room to use it without having to move around furniture or other obstacles.

2. Living Room and Common Areas

Living rooms often contain some of the most common household trip hazards.

Check the following:

• Remove clutter from walking paths.
• Secure electrical and charging cords away from areas where people walk.
• Remove loose throw rugs or secure them so they cannot slide.
• Make sure furniture does not create narrow or awkward pathways.
• Keep frequently used items within easy reach.
• Avoid unstable furniture that someone may instinctively grab for support.
• Make sure chairs are stable and easy to get into and out of.
• Keep pet toys, bowls, and other objects away from main walking routes.

New York State specifically recommends removing objects that can cause trips, securing or removing small rugs, and keeping frequently used items where they can be reached without climbing on a step stool.

3. Improve Lighting Throughout the Home

Lighting becomes increasingly important as vision changes with age.

Look at the home both during the day and at night.

Make sure:

• Hallways are well lit.
• Light switches are easy to reach.
• There is a light available before entering a dark room.
• The route between the bedroom and bathroom is visible at night.
• Stairways are well lit.
• Burned-out bulbs are replaced promptly.
• Lamps can be reached without walking through a dark room.
• Glare from windows or bright surfaces does not make it harder to see.

Night lights can be especially useful in bedrooms, hallways, and bathrooms.

The New York State Department of Health recommends brighter lighting as people age, as well as lighting and handrails around stairways.

4. Bathroom Safety

Bathrooms deserve particular attention because water, hard surfaces, limited space, and transfers in and out of the shower or tub can create additional risks.

Bathroom safety checklist:

• Install appropriate grab bars near the toilet.
• Install grab bars in or near the bathtub or shower.
• Use non-slip surfaces in the tub or shower.
• Keep the bathroom floor dry.
• Keep toiletries within easy reach.
• Avoid relying on towel racks for support.
• Make sure there is adequate lighting.
• Consider whether getting on and off the toilet is becoming difficult.
• Consider whether stepping into the bathtub or shower is becoming difficult.
• Make sure mobility devices can safely enter and move through the bathroom if needed.

Grab bars and non-slip bath or shower surfaces are among the specific home modifications recommended by New York State and the CDC for reducing fall hazards.

If bathing or toileting has become unsafe even with environmental changes, the person may benefit from assistance with personal care.

5. Bedroom Safety

The bedroom should allow someone to get into and out of bed without having to navigate obstacles.

Check whether:

• There is a clear path around the bed.
• The bed is at a comfortable height for getting in and out.
• A light can be turned on from the bed.
• A phone is within reach.
• Eyeglasses and mobility devices are easy to access.
• Clothing and shoes are not left on the floor.
• The path from the bedroom to the bathroom is well lit.
• Frequently used clothing is stored at an accessible height.

Think specifically about nighttime routines.

If the person frequently gets up during the night, the bedroom-to-bathroom route should be one of the first areas the family reviews for fall risks.

6. Kitchen Safety

The kitchen should be arranged so that everyday items can be used without unnecessary reaching, bending, or climbing.

Review the following:

• Keep frequently used dishes and food within easy reach.
• Avoid storing everyday items on high shelves.
• Do not use unstable chairs or furniture as step stools.
• Clean spills promptly.
• Keep the floor free of bags, boxes, and other obstacles.
• Make sure the stove and cooking area are easy to use safely.
• Keep flammable materials away from cooking surfaces.
• Make sure smoke and carbon monoxide alarms are working.

FDNY advises older New Yorkers to maintain working smoke and carbon monoxide alarms, avoid overloaded electrical outlets, and remain near the stove or pan while cooking.

If an older adult is beginning to forget food on the stove, has difficulty safely carrying hot items, or struggles to prepare meals, those changes deserve attention rather than being dismissed as minor inconveniences.

7. Stairs

For homes or apartment buildings with stairs, check both the stairs themselves and the way the person uses them.

Ask:

• Are handrails available?
• Are they secure?
• Is the entire staircase well lit?
• Are there objects stored on the stairs?
• Are stair surfaces secure and in good condition?
• Can the person clearly see the edge of each step?
• Does the person carry objects while going up or down?
• Does using the stairs cause fatigue, dizziness, or significant difficulty?

The CDC recommends railings on both sides of stairs where possible, while New York State advises installing handrails and adequate lighting throughout stairways.

In New York City, stairs may also be part of the person's daily route in a walk-up building. Families should consider not only whether the person can manage stairs inside the home, but whether entering and leaving the building remains safe.

8. Footwear and Clothing

What someone wears at home can affect safety.

Older adults should generally avoid walking in socks on slippery floors or wearing loose slippers without adequate grip.

New York State recommends shoes or slippers with rubber soles and advises against going barefoot or wearing slippers without sufficient traction.

Also check whether:

• Shoes fit properly.
• Soles provide good traction.
• Pants, robes, or other clothing are long enough to create a trip hazard.
• The person can safely put shoes on and take them off.

9. Medications, Vision, Balance, and Strength

Not every home safety risk comes from the physical environment.

Some medications can contribute to dizziness, drowsiness, or balance problems. Vision changes can make obstacles harder to detect. Reduced strength can make everyday transfers more difficult.

Families should encourage older adults to discuss fall risk with an appropriate healthcare professional rather than changing medications or treatment on their own.

New York State recommends discussing medications with a healthcare provider or pharmacist, having vision checked regularly, and considering exercises or physical therapy designed to improve strength and balance when appropriate.

A change in walking, balance, strength, or confidence can also be useful information to share with the person's healthcare team.

10. Prepare for Emergencies

A safe home should also include a plan for what happens when something goes wrong.

NYC Health recommends preparing in advance by keeping a phone accessible, maintaining emergency contacts, arranging regular check-ins for people who live alone, and considering a personal emergency response system when appropriate.

Consider whether the older adult:

• Has easy access to a phone.
• Can reach a phone from the floor if necessary.
• Has emergency contacts saved and easily accessible.
• Knows whom to call for help.
• Has a plan if they cannot reach the door.
• Has working smoke and carbon monoxide alarms.
• Has an emergency plan for fire or evacuation.
• Has essential medication and health information organized.
• Has regular contact with family, friends, neighbors, or caregivers.

FDNY also recommends that older adults maintain an emergency “go” folder with medication information and emergency contacts and have an evacuation plan.

Home Safety Checklist for an Older Adult Living Alone

Living alone does not automatically mean that someone needs home care.

However, it makes planning especially important.

If an older adult lives alone in New York, families may want to review:

• How reliably the person uses the phone
• Whether someone checks in regularly
• How groceries and household essentials are obtained
• Whether medications are being managed appropriately
• Whether meals are being prepared regularly
• Whether the person can bathe and dress safely
• Whether there have been recent falls or near-falls
• Whether the person can leave the home safely
• Whether they can manage stairs or the building entrance
• Whether there is a backup plan if they become ill or need assistance
• Whether changes in mobility or memory are affecting daily routines

A regular check-in with family, neighbors, or friends can be useful. For some people, additional in-home support may also help make daily routines more manageable.

Signs That Home Safety May Need to Be Reassessed

Home safety should not be treated as a one-time project.

Consider reviewing the home again after:

• A fall or near-fall
• A hospitalization
• A new diagnosis
• A significant medication change
• A change in mobility
• Beginning to use a walker or cane
• Changes in vision
• Increased weakness or fatigue
• Increasing difficulty with bathing or dressing
• Changes in memory or behavior
• A move to a new apartment or home
• A change in the person's caregiving situation

A home that was safe six months ago may no longer match the person's current needs.

When Home Care Can Help

Home modifications can reduce hazards, but sometimes the main safety concern is that everyday activities have become difficult to perform independently.

An older adult may begin needing help with:

• Bathing and dressing
• Mobility and transfers
• Meal preparation
• Daily routines
• Personal care
• Supervision
• Getting safely around the home
• Maintaining an appropriate care schedule

In these situations, professional home care may provide another layer of support.

The purpose of home care is not simply to “watch” someone. Depending on the person's needs and authorized plan of care, an HHA or PCA may assist with everyday activities that help the person remain safely and comfortably at home.

Home Care Support From S&A Unified Home Care

S&A Unified Home Care works with older adults and families across New York to help coordinate appropriate care at home.

Our HHA and PCA services can support eligible individuals who need assistance with everyday activities such as personal care, mobility, meal preparation, and daily routines.

Care should reflect the individual rather than follow the same checklist for every person. The appropriate services, schedule, and level of support depend on the person's needs, eligibility, coverage, location, and care plan.

If you are noticing that an older parent or family member is having more difficulty managing safely at home, you do not need to determine the entire care plan on your own.

Our intake team can learn more about the situation, explain the home care process, discuss available services and coverage, and help you understand the next steps.

Start care with S&A Unified Home Care.