Elderly Home Safety Checklist

Elderly Home Safety Checklist

Use this checklist to determine whether or not a senior citizen is safe living home alone given the current state of the home. Any NO response indicates an area of concern. NO responses do not necessarily mean that the person can no longer remain home, but indicates areas in which the home may require modifications, or assistance may need to be brought in to ensure safety.

If the senior is unable to perform the task independently mark NO; if a caregiver is available to assist with the task mark CAREGIVER. This will help determine whether the care recipient is safe without a caregiver present.

Home Interior Yes No
Stairs inside home are safe
End of stairs is clearly marked (top and bottom)
Handrails on both sides of stairs
Hallways and doorways wide and obstruction free
Fire extinguisher available
Smoke detectors present
Adequate lighting
Throw rugs absent
Area rugs secure and safe
Adequate heat
Adequate cooling
Space heaters safe
Hazardous materials stored safely
Adequate plumbing
Absence of rodents/insects
Adequate trash pickup
Space free of clutter/debris
Electrical cords safe
Safe use of electrical circuits/extension cords
Furniture arranged to facilitate mobility
Furniture appears sturdy and in good repair
Non-carpeted floors are not slippery
Door thresholds safe
Safe water temperature
Safe Storage of Chemicals Yes No Caregiver
Able to distinguish between products
Chemicals stored away from food
Outdated products safely disposed
Flammables kept away from heat
Exterior Yes No Caregiver
Able to get in/out of front door safely
Able to get in/out rear door
Able to retrieve mail/newspapers
Ramp available, if needed
Stairs safe and in good repair
Railing on stairs
Proper lighting
Snow/ice removal, when needed
Bathroom Yes No Caregiver
Able to get into bathroom
Able to turn on light
Able to get on/off commode
Able to safely transfer in/out of tub or shower
Able to use faucets
Soap available
Safe use of transfer bench
Night light, if needed
Grab bars available and secure
Raised toilet seat, if needed
Non-slip mat or strips in tub or shower
Proper disposal of soiled incontinence pads
Adequate cleaning/sanitizing
Kitchen Yes No Caregiver
Adequate food storage
Able to recognize if stove/oven is on
Able to feel heat
Fire extinguisher available
Smoke detectors present
Able to prepare meal
Able to operate microwave
Able to get groceries
Frequently used items within reach
Pet Care Yes No Caregiver
Pets safe underfoot
Able to feed pets
Able to let pet outside
Able to change litter box
Able to provide pet adequate exercise
Bedroom Yes No Caregiver
Able to get in and out of bed
Room for hospital bed, if needed
Light accessible
Phone accessible from bed
Emergency alert system accessible from bed
Adequate heat
Bedside commode
Flashlight available
Night light, if needed
Mobility Yes No Caregiver
Absence of falls
Balance stable
Able to maneuver assistive device
Activity tolerance
Shoes are safe and comfortable
Communication Yes No Caregiver
Able to utilize telephone
Emergency response system available
Able to use system
Can call for help in emergency
Able to exit in emergency
Able to clearly communicate needs
Able to hear alarms
Personal Safety Yes No Caregiver
Safe clothing for ambulation and circulation
Wears shoes or non-skid socks inside
Able to self-manage medications
Safe storage of medications
Able to manage thermostat
Able to verbalize and enact emergency plan
Oxygen Care Yes No Caregiver
No smoking around oxygen
Able to safely change/refill tanks, as needed
Tubing does not obstruct safe ambulation
 Reprinted from A Place for Mom