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WARNING SIGNS 5 min read
Mom Says She's Fine. Here Are 5 Signs to Look For on Your Next Visit.
By Robyn Mellang, OT, Mindful Living
You call on Sunday. She says she's doing great. She asks about the kids and changes the subject.
Then you visit and something feels off. The house smells different. She takes longer to get out of her chair. You can't name it, but you notice it.
Trust that feeling. Older adults often keep problems to themselves. Some don't want to worry you. Some worry that saying "I fell" will lead to a talk about moving out. So the clues show up in the house before they show up in conversation.
About 1 in 4 adults age 65 and older falls each year, and many never tell anyone. The good news: most of the warning signs are easy to see once you know where to look. Here are five to check on your next visit.
1. The fridge tells the real story
Open the refrigerator. Look for food past its date, leftovers that have gone bad, or almost nothing at all.
A stocked fridge takes a lot of steps. Mom has to drive or arrange a ride, carry bags, stand at the counter, and remember what she bought. Trouble with any of those shows up here first.
What to check
Expired milk or moldy food
The same unopened items from your last visit
Lots of snacks and frozen meals, with no fresh food
Burn marks on pots or the stove
A thin or spoiled fridge can mean low energy, trouble standing to cook, or memory changes. Poor nutrition also weakens muscles, which raises fall risk.
2. Bruises she can't explain
Look at her arms, hands, shins and face. Ask about any bruise or scrape in a calm, curious way. "Oh, what happened there?" works better than "Did you fall?"
Vague answers like "I bumped into something" or "I don't know" are worth noting. So is a sore wrist or a new limp. Many falls happen when no one is home, and a parent who got up on her own may decide it "didn't count."
Also look around the house for clues. A dented lampshade, a cracked picture frame near the floor, or a chair moved out of place can point to a fall.
3. A pile of unopened mail
Mail on the table seems small. It often isn't.
Look for unopened bills, late notices, or repeated charity requests. Paying bills takes focus, sorting and memory. When a parent who always kept tidy records starts falling behind, it can signal changes in thinking, vision or energy.
It can also put her at risk for scams. People who send repeated mail requests often target older adults who have answered before.
4. She holds onto the furniture
Watch how Mom moves through the house. Does she touch the counter, the back of the couch, then the doorframe as she walks? OTs call this "furniture walking."
It means she doesn't feel steady on her own. She has built a path of handholds without saying a word.
Other movement clues
Smudges or worn spots on walls at hand height
She pushes up hard with her arms to get out of a chair
She has stopped going upstairs or sleeps in her recliner
She shuffles or takes short, careful steps
Each of these points to weaker legs or poorer balance. Both are risk factors for a fall. Both can also improve with the right exercises and home changes.
5. Changes in how she takes care of herself
Notice her clothes, hair and nails. Is she wearing the same outfit two visits in a row? Has she stopped getting her hair done?
Then check the bathroom. A dry shower, a tub full of stored items, or towels that haven't moved can mean bathing has become hard or scary. The bathroom is one of the riskiest rooms in the house. Stepping over a tub wall on a wet floor takes strength and balance. Many older adults quietly stop showering rather than admit that.
Quick visit checklist
Open the fridge and check dates
Look for bruises and ask calmly
Glance at the mail pile
Watch her walk from room to room
Peek in the shower or tub
What to do next
Write it down
Note what you saw and the date. One sign may mean nothing. Two or three signs that keep showing up mean it's time to act. Notes also help when you talk to siblings or her doctor.
Start with a question
Skip the lecture. Try: "I noticed the stairs seem harder lately. What would make them easier?" Mom is far more likely to accept help she helped choose.
Pick one fix
Choose the change that lowers risk the most. A grab bar in the shower or a night light on the way to the bathroom is a good first step. Small wins make the next talk easier.
Get a professional eye
An occupational therapist can assess the home and how your parent moves through it. Research shows home safety visits led by an OT can lower falls, with the biggest benefit for people at higher risk.
You don't need to fix everything this visit. You just need to notice, and start.
Sources: CDC, Older Adult Fall Prevention. Gillespie et al., Cochrane Database of Systematic Reviews, 2012.
READ NEXT The Floor Test: Can Your Parent Get Up Without Using Their Hands?
STRENGTH AND BALANCE 4 min read
The Floor Test: Can Your Parent Get Up Without Using Their Hands?
By Robyn Mellang, OT, Mindful Living
Most families worry about a fall. Fewer think about the minutes and hours after it.
When an older adult falls and can't get up, they may stay on the floor until someone finds them. Doctors call this a "long lie." Lying on the floor for an hour or more is linked to dehydration, pressure sores, pneumonia and a harder recovery. It also makes people afraid to move, which leads to weaker muscles and more falls.
In one well known study, about half of older adults who fell without serious injury still could not get up on their own.
So one of the best questions you can ask is simple: if Mom ended up on the floor today, could she get herself back up?
The floor test gives you an answer before a fall does.
Is this test right for your parent?
Safety comes first. Do this test only if your parent can stand and walk on their own today.
Skip the test and ask their doctor or therapist first if your parent:
Had recent surgery, especially hip, knee or back
Has hip replacement precautions
Gets dizzy when standing or changing position
Has severe joint pain or fragile bones their doctor has warned about
Uses a walker or cane to get around the house
How to set it up
Pick a carpeted spot or lay a thick blanket or yoga mat down
Place a sturdy chair with no wheels against a wall nearby
Clear the area of tables, cords and pets
Have a second adult present, with you standing close by
Agree that your parent can stop at any time
How to do the test
Getting down
Have your parent hold the chair and lower down slowly. One knee to the floor, then the other, then sit to the side. Using the chair to get down is fine. We are testing the way up.
Getting up
Ask them to get up the way that feels natural. Don't coach yet. Just watch, and stay ready to steady them.
What to watch for
Hands: Did they push off the floor, their knee, or the chair?Time: Did it take a few seconds or more than a minute?Effort: Did they need to rest, hold their breath, or wince?Help: Could they do it alone, or did you have to lift?
What the results mean
Up with no hands, or one light touch
Great sign. Your parent has solid leg strength and balance. Keep them active and retest every few months.
Up using the chair or both hands
This is very common, and it's workable. Your parent can get up, but with little reserve. Illness, a bad night's sleep, or a minor injury could tip it the other way. Start strength practice now.
Could not get up without your help
This is your top priority. It doesn't mean your parent can't stay at home. It means you need a plan before a fall happens.
What to do with what you learned
Teach a safer way up
Most people try to stand straight up from the floor. That's the hardest way. An easier method:
Roll onto your side
Push up onto hands and knees
Crawl to a sturdy chair
Place hands on the seat and bring one foot forward
Push up with the front leg, turn, and sit down
Practice this on a good day, with help close by, so it feels familiar on a bad one.
Build leg strength
The sit-to-stand is one of the best exercises for this. Have your parent stand up from a sturdy chair and sit back down slowly, 5 to 10 times, once or twice a day. As it gets easier, try it without using their hands.
Plan for a fall when no one is home
A medical alert button worn at all times, including in the shower
A cell phone carried in a pocket or pouch, not left on the table
A throw blanket and pillow kept low in main rooms, for warmth while waiting for help
A daily check-in call at a set time
The floor test takes five minutes. What you learn from it can shape a much safer plan for staying at home.
If the test raised concerns, an occupational or physical therapist can work on strength, teach floor recovery, and adjust the home so getting up is easier.
Sources: Tinetti, Liu and Claus, JAMA, 1993. CDC, Older Adult Fall Prevention.
READ NEXT Living Far From Mom? A Room-by-Room Safety Check You Can Do on a Video Call
LONG DISTANCE 6 min read
Living Far From Mom? A Room-by-Room Safety Check You Can Do on a Video Call
By Robyn Mellang, OT, Mindful Living
You live three states away. You visit twice a year. Each time, you notice something new: a loose rug, a burned-out bulb, a step she now avoids.
Then you fly home and wonder what you missed.
Here's the good news. You can spot most home risks from your couch. A 20 minute video call, done with a plan, shows you more than you'd expect. This guide walks you through the rooms where falls happen most, with exactly what to look at in each one.
Before the call
Pick the right time
Schedule it during daylight so rooms are easy to see. Choose a time when Mom isn't rushed or tired. Mid morning often works well.
Frame it as a favor
"Can you give me a tour? I want to picture where you are when we talk" feels very different from "I need to check your house for hazards." Keep it warm and curious.
Get the camera right
If a neighbor or friend can hold the phone, even better. Ask them to flip to the back camera so you see the room, not a face. Ask for slow movement and a pause in each room.
Take screenshots
Screenshots let you look closer later and share with siblings or a therapist.
The front entry and stairs
Falls on steps tend to cause the most serious injuries. Start here.
Is there a sturdy handrail? Ideally on both sides, running the full length of the stairs
Can you see the edge of each step? Dark or patterned carpet can hide the edge
Is there a light switch at both the top and bottom?
Are shoes, bags or boxes sitting on the steps?
Is the outdoor entry lit, with no cracks or loose boards?
Ask: "Can you walk up a few steps for me?" Watch whether she grips the rail with both hands or takes one step at a time.
The living room
This is where Mom spends most of her day, so small risks add up.
Area rugs, especially ones with curled corners or no grip pad
Cords running across walkways
A clear path at least as wide as a walker between furniture
A favorite chair that is too low or too soft to get out of easily
Lamps she can reach without getting up
Ask: "Show me how you get up from your chair." If she rocks several times or pushes hard with her arms, the chair may be too low. A firm cushion or furniture risers can help.
The kitchen
Are the items she uses every day stored between her waist and shoulders?
Is there a step stool or chair she climbs on to reach things?
Is the floor slippery, or is there a throw rug by the sink?
Is there good light over the counters and stove?
Ask: "Where do you keep your favorite mug?" If the answer is the top shelf, move it down together on the call.
The bathroom
This is the most important room on the tour. Wet floors, hard surfaces and tight spaces make it a common place for falls.
Are there real grab bars by the toilet and in the shower? Towel bars are not built to hold body weight
Is there a non-slip mat or strips inside the tub?
How high is the tub wall she steps over?
Is the toilet low? A raised seat or safety frame can make a big difference
Is there a night light?
Ask: "Show me how you get in the shower." She doesn't need to step in. Just pointing to where she holds on tells you a lot. If she says "the towel bar" or "the soap dish," that's a priority fix.
The bedroom
Many falls happen at night, on the way to the bathroom.
Is the bed a comfortable height, with feet flat on the floor when seated?
Can she turn on a lamp before she gets up?
Is the path from the bed to the bathroom clear and lit?
Is her phone within reach of the bed?
Ask: "Turn off the lights and walk me to the bathroom." Plug-in motion night lights are one of the cheapest and most useful fixes in the house.
Easy fixes you can order from home
Motion sensor night lights for the hallway and bathroom
Non-slip rug pads or double-sided rug tape
A raised toilet seat or toilet safety frame
Non-slip tub strips
A cordless phone or phone holder for the bedside
Grab bars and stair rails need to be installed into wall studs. Use a trusted handyman or contractor for those.
Watch Mom, too
The house is only half the picture. While she gives you the tour, pay attention to how she moves.
Does she reach for walls or furniture as she walks?
Does she stop to catch her breath between rooms?
Does she turn slowly or take several small steps to change direction?
Does she hold the phone and the rail at the same time on the stairs?
That last one matters. A phone in one hand means only one hand for the rail. Suggest she set the phone down or let a helper hold it for any part of the tour that involves steps.
Listen to what she says, too. Comments like "I don't go down there much anymore" or "I just sit on the edge of the tub and wash up" tell you which tasks have become hard. Ask a gentle follow-up: "What makes that tricky?" Her answer often points straight to the fix.
After the call
Sort what you found
Make two lists. Quick fixes you can ship or a neighbor can do this week. Bigger fixes that need a contractor or a professional opinion.
Start with the bathroom and the night path
If you're unsure where to begin, start there. These two areas cover a large share of home falls.
Line up local help
A trusted neighbor, church friend or local handyman can be your hands. Send them your screenshots with clear notes.
Repeat it
Do a short tour every few months, or after any hospital stay or illness. Homes change, and so do the people living in them.
You can't be there every day. But you can see far more than you think, and a few small fixes can make home safer for a long time.
Want a professional set of eyes? An occupational therapist can do a full home safety assessment and give you a clear list of what to change first.
Source: CDC, Check for Safety: A Home Fall Prevention Checklist for Older Adults.
READ NEXT Mom Says She's Fine. Here Are 5 Signs to Look For on Your Next Visit.
