Case Study • Fall Prevention
Why She Kept Falling
A fall assessment focused on causes, not just hazards.
The Result
What Came Out of It
Three interacting causes of her falls were identified, and only one was the home itself. The family, the contractor, and her physician each received a document built for them the day after the visit, and physical therapy began shortly after.
- 3causes of her falls, only one of them environmental
- 3documents: family report, contractor packet, provider summary
- Next dayall three documents delivered
The Situation
Several Falls, One Goal: Stay Home
A woman in her 90s who lives alone had fallen several times, most recently out of bed days before the visit. She had daytime aide support, with overnight coverage pending. Her goal was clear: remain in her own home for the rest of her life.
We assessed the bathroom, bedroom, hallway, living areas, kitchen, and entrance. The key question was not only what in the home was unsafe, but why she kept falling.
What We Found
Hazards Explained Only Part of It
The Nighttime Trip
Her falls clustered on the return from the bathroom to bed, along an unlit path.
Equipment Mismatch
Her rollator’s brakes needed grip strength she no longer had, and she had fallen while using it.
An Unsafe Bathroom
Too small for her walker, so she left it at the door and pushed up from the toilet using the sink. A small shower with a step-over threshold sat beside an uncovered radiator.
Time in Bed
She spent nearly all day in bed, partly because the only television was in the bedroom.
The Plan
What to Do First, Next, and Later
- 1
0 to 30 days
Bedside commode with drop-arms, motion-activated night-path lighting, grab bars, radiator cover, rug removal, a standard rolling walker in place of the rollator and cane, physical therapy, and physician follow-up.
- 2
1 to 3 months
Adjustable bed with a half-length assist rail and fall mat, living room seating and a television to get her up during the day, and bathroom, hallway, entrance, and kitchen upgrades.
- 3
3 to 12 months
A choice of bathroom renovation paths, from a curbless shower with room for a caregiver to converting a second bathroom, plus a follow-up reassessment.
Cost and funding were part of the plan: items likely eligible for Medicare coverage with a physician’s order were separated from out-of-pocket items, and local funding programs were identified for the family to explore. If someone you love is falling at home, schedule an assessment, or call (516) 810-0330.
What Happened
Therapy Started Without Waiting for Construction
The family report, contractor specification packet, and provider summary were delivered the day after the visit. Falls without a clear cause were referred to her physician for evaluation, and physical therapy began shortly after the report, without waiting for any construction.
A reassessment is recommended at six months, or sooner if her needs change.
Why It Matters
Find the Cause, Then Fix the Home
For Families
- A clear order of action, starting with the lowest-cost, fastest-acting items.
- Guidance on what insurance may cover before paying out of pocket.
- Renovation options to weigh without pressure, built around her goal of staying home.
For Physicians, Therapists, and Contractors
- A provider summary so her physician and therapist could act on the findings.
- A contractor packet with dimensions sized to her stature, each marked code-based or evaluator-adjusted.
- No personal health details in the contractor packet.
Published with client permission. Identifying details have been removed and content condensed. Recommendations are specific to this client and home and are not a substitute for an individual assessment. Construction, permitting, and code compliance remain the responsibility of the licensed contractor and design professionals. Download the full case study (PDF)
Is Someone You Love Falling at Home?
An Assessment Finds Out Why
Families can schedule an assessment to learn why the falls are happening and what to change first. Physicians, therapists, and care managers can refer a patient with repeat falls for a home assessment that finds the cause.