Safety in Your Home

 

1. Do you have working smoke detectors and carbon monoxide detectors? _____ Tell me more.

 

1. Do you know how to change the batteries in the detectors? _____

 

1. Do you have an emergency escape plan from your home? _____

 

1. Do you have a current list of emergency numbers you can access and use, including your doctor’s number? _____

 

1. Is the telephone accessible and can you use it easily in an emergency? _____

 

1. Are walkways within your home open and free of clutter? _____ Tell me more about Stairways & Halls.

 

1. Is the carpet on the stairs secure or is it worn or loose? _____

 

1. Are there railings on every set of stairs? _____

 

1. Are the railings secure, or are they wobbly, loose or missing? _____

 

1. Are there any area rugs that are loose on the floor, or other potential tripping hazards that should be either removed or secured? _____

 

1. Are there any loose cords or wires that could be a tripping hazard? _____

 

1. Do you have a working fire extinguisher in the kitchen? _____ In the house? _____ Tell me more.

 

1. Are there any light bulbs that need to be replaced to give you better lighting in a room or a hallway? _____ Tell me more about Lighting & Contrast.

 

1. Are any rooms or areas of your home dark, and in need of lamps or lights to help you function better? _____ Tell me more about Lighting & Contrast.

 

1. Does your bathroom need rails in the tub or near the toilet for you to use these facilities with more safety and confidence? _____

 

1. Are the rugs on the floor of the bathroom backed with a non-skid material? _____ Tell me more about Bathrooms.

 

1. Does your tub have a mat in it or gripper strips to help prevent a fall? _____ Tell me more about Bathrooms.

 

1. Are there chairs or seats in your home that you have trouble getting up and out of? _____ Tell me more about Safety in the Living Room.

 

1. Are the appliances in your home safe and easy for you to use? _____

 

1. Can you read the dials on the stove, microwave, or other appliances? _____ Tell me more about Kitchen safety.

 

1. Do you need better lighting near these appliances? _____

 

1. Do you need to mark the dials for ease of use? _____ Tell me more about Kitchen safety.

 

1. Do you need to change to a smaller or table-top type of appliance for ease of use? _____

 

1. Do you need to sit rather than stand for many of your daily tasks, cooking, washing dishes, washing clothes? _____

 

1. Do you need to use a stepladder or a step stool to reach shelves, light fixtures, or other high items? _____ Tell me more about Kitchen safety.

 

1. Is your home more than you can care for independently? _____

 

1. Can you reduce the number of rooms you and the family regularly use and need to care for? _____

 

1. If you have a multi-level home, could you live on one floor? _____

 

1. Can you make your house easy maintenance or do you need to hire help to maintain it? _____

 

Lighting and Glare

 

1. Does the lighting in each room, closet or other location help you move around safely, or are there potential accident areas? _____ Tell me more about Lighting & Contrast.

 

1. Are you taking advantage of natural lighting coming from windows, or are you using heavy curtains that block the light? _____

 

1. Do you need different lighting solutions for activities that take different amounts of time? _____

 

1. Does the lighting adequately cover potential accident areas such as stairs and landing, entrance hall, or any other level changes? _____

 

1. Do you need ‘spot’ lighting for specific tasks, for example, when you’re shaving, applying makeup, reading a book, or preparing food? _____

 

1. Do your chairs or sofa face windows where bright sunlight could cause glare? _____ Tell me more about Living Rooms.

 

1. Are there areas in your home that have glossy tiles, shiny enamel paint, or mirrors that cause glare? _____

 

1. When you view your TV or use your computer are both you and the TV/computer protected from glare? _____

 

1. Is the lighting immediately outside your door good enough for you to lock/unlock your door in a short amount of time? _____ Tell me more about Entrances.

 

Color & Contrast

 

1. Would it help to have contrasting colored plates against a tablecloth or place mat? _____ Tell me more about Dining Room safety.

 

1. Would it help to have two chopping boards: one white and another black? _____

 

1. Can you easily locate your wall sockets? _____ Tell me more about outlets, as in a bedroom or study.

 

1. Do you feel safe in your one-color tub and shower? _____ Tell me more about safety in the bathroom.

 

1. Do you sometimes have difficulties locating doorways? _____ Tell me more about Entrances.

 

1. Are your furniture and surroundings all of a similar color? _____ Tell me more about Lighting & Contrast.

 

1. Having problems with doors left open? _____

 

1. Problems locating and using household equipment controls? _____ Tell me more about Kitchens.

 

1. Difficulties with same colored pans on same colored stove? _____ Tell me more about Kitchens.

 

1. Would it help to paint the stair handrail a contrasting color to the surrounding carpet or wall? _____ Tell me more about Stairways & Halls.