The three most hazardous places in a home for falls are the bathroom, the stairs and the bedroom. Here are some tips for navigating and managing stairs at home and away.

Please share this information with your patients!

Cheryl Hall, OT
Author and Illustrator, Occupational Therapy Toolkit

Lighting

• Stairs inside and out should be well lit at the top and bottom.
• Consider motion-activated lights.
• Place automatic, solar powered lights on outdoor stairs.
• Try battery-powered, LED lighting that turns on with a motion sensor or remote.
• Hang a small flashlight at the top and bottom of the stairs.

Treads

• Make sure treads are secure and stable.
• Remove or repair loose or torn carpeting.
• If the tread surface is slippery, modify the surface.
• Use reflective paint to mark the edge of each trend.

Railings

• Always use the railing.
• Railings should be easy to grip and less than 6.25 in/13 cm in diameter.
• The railing should be free of splinters and other hazards.
• Railings should be securely fastened to the wall and run along both sides of the staircase.
• Railings should extend all the way from the first step to the last.

Assistive Devices

• Know the proper way to navigate stairs and curbs with a cane or a walker.
• Use the phrase “up with the good and down with the bad” to remember which leg to start with when using an assistive device to go up or down a step.

What Not to Do

• Never use the stairs to store items.
• Never carry anything up or down stairs that requires the use of both hands.
• Never wear loose clothing that can catch on the end of the rail.
• Never wear long clothing that you can trip over.
• Never wear shoes that do not fit well or that have slippery soles.
• Never just wear socks which can be slippery.
• Never keep loose throw rugs at the top or bottom of the stairs.

Away from Home

• If you encounter stairs outside the home, survey the stairs, test the handrail, ask for assistance if needed and use with caution.
• Carry a small flashlight or use the flashlight function on your phone in case stairs are poorly lit.
• Beware that steps may be uneven.
• Outside steps may be slippery with dirt, moss, rain, snow or ice.

My book, The Occupational Therapy Toolkit, is full of information for OTs and their patients including:

• 10 fully illustrated patient handouts for navigating stairs and curbs with a cane or walker
• “Don’t Let a Fall Get You Down” – Patient Booklet
• “Don’t Let a Fall Get You Down” – Post Fall Survey for patients
• “Fall Triggers and Tips to Prevent Fall” – Occupational Therapist Resource
• “Home Safety and Performance Assessment” – Occupational Therapist Resource