Falls can happen all of a sudden, putting your mobility and ability to function at risk.
Injuries related to falling happen often in people with multiple sclerosis (MS), at a rate of about 40%-50%. And people with MS have a higher risk of falling at home than people who don’t have the disease.
Given that many people generally spend a lot of time at home, especially if they also work from there, the home should be a safe space.
If you have MS, making your home as safe as possible can help lower your risk of falling. And, in case you do fall, those safety improvements might limit how badly you hurt yourself.
What Is Fall-Proofing?
Fall-proofing is a process that includes making changes to your living space and other common areas to help prevent falls and injuries. Many people think of fall-proofing as home updates made for older people, but it can also be a good way to help prevent falls for people with conditions like MS, where balance and strength usually weaken over time.
There are different types of changes you can make to fall-proof your home as much as possible, so you can decide which ones are right for you. “It's about becoming conscious about what you're doing, and taking proactive steps before there's a problem,” says occupational therapist Lindsey Biel, MA, OTR/L.
Assessing Your Home
According to Biel, the ideal way to have your environment examined for fall safety would be to have an occupational therapist visit your home. An occupational therapist can look for hazards, recommend modifications, and perhaps help put them into place to reduce falls, she says.
If your doctor prescribes occupational therapy (OT) and you have Medicare or Medicare Advantage, you might be eligible for a home safety assessment as part of the eligible OT coverage. Home safety assessments could also be covered by private insurance and long-term insurance, so it’s important to check your policy.
If an OT visit isn’t possible, you can still take a look at ways to change things around your home. A friend or family member would be best to help you because they might see something you don’t.
DIY Fall-Proofing
There are changes you can make to your home that are free or cost very little.
Throughout the house
One of the common effects of MS is the fatigue that can set in quite suddenly. Proper placement of items around your house could help prevent falls due to being overwhelmingly tired.
Chairs. One possible solution to prevent falling is to “strategically place some [sturdy] chairs around the house,” Biel says. “You don’t want them in your path, but if you can place them around the house and, let’s say, you’re on the way to the kitchen when fatigue suddenly sets in, you have a place to sit down rather than taking those extra 10 steps which might be too much.”
Threshold ramps. Another risky spot in many homes includes small thresholds at the door of each room, where the floor comes up a half inch or more. These can be tripping hazards, especially if you’re starting to shuffle your feet due to MS. But you don’t need to make a major update here.
“You can get little threshold ramps that you can add to them,” Biel said. “They’re just small things that make it so there’s no step; it’s just like a little hill.”
Someone who’s handy can build these ramps, which can also be helpful if you need to use a wheelchair at some point. They’re available online and in stores and don’t require permanent installation.
Other tips to prevent falls around the house include:
Remove scatter rugs. Accent rugs can brighten a room, but they’re also a fall and tripping risk.
Tape down larger rugs and carpets. Taping rugs down with double-sided tape can help with reduce your risk of mistepping. “Pay special attention to the corners because those tend to curl up,” Biel says. “Not just where the person walks, but a bit outside of that edge, too.”
Fix loose floorboards and tiles. Flooring around your home creates a hazard because they can lift over tiime.
Move electrical cords out of traffic areas. “I use a big, big, wide electrical tape to tape down any electrical cords because they can move into the walking path, especially if there are pets around,” Biel says.
Add or install proper lighting. A lack of proper lighting can add to fall risk, particularly along walkways, high-traffic areas, and stairs. Costs of updating lighting can range from relatively inexpensive (if you buy the simple stick-on lights to place along baseboards and stair risers) to pricier if you choose to have lights wired. Reflective tape on the edge of each step can also promote safety because you can see where the step ends.
Install handrails. Adding these rails next to stairs and steps can be especially helpful.
Bathrooms
Safety updates to make in bathrooms include adding products along the wall and in the shower/tub, like handrails and certain mats.
According to Biel, handrails with suction cups that attach to the wall aren’t ideal. “That’s not good enough, because we all know that suction cups can fail,” she says.
Towel racks aren't safe to use for fall prevention either. “Never use a towel rack to support yourself or pull yourself off the toilet,” Biel says. These racks or bars can pull right off the wall.
Using a nonskid mat in your tub or on your shower floor is also important to help you keep your balance. You might also invest in a shower seat or a transfer seat to help with getting in and out of the tub.
Bedroom
Getting up at night can be tricky. You might be groggy, which itself is a fall hazard. A good first step is to wear sturdy footwear, not floppy slippers, socks, or going barefoot, Biel says. “You want something with a tread,” she said, adding that “a good-fitting slipper is fine, but not a floppy one.”
Devices that you can keep near your bed are helpful, too.
Bed canes. A bed cane is a device that’s attached to the bed. It can give you a handle to use when getting up, and you can also attach a clip-on light, so you don’t need to reach for a bedside lamp.
Bed canes have bases that slide under the mattress. Depending on the product, it might be fastened down with straps. The arm comes up along the side of your mattress, and you hold it when you get in and out of bed. These are available online and in medical supply stores for as low as $40 and up.
Walkers. Having a walker in your bedroom — even if it’s only for use at night and you don’t need it during the day is also a good idea, Biel says. “If you get up to go to the bathroom — and we all can be a little unsteady at night — it’s an extra precaution.”
Kitchen
To try to prevent kitchen falls, make sure you can easily reach what you need while you’re preparing meals and cleaning up. You don’t want to do a lot of reaching, which will tire you. If you must reach for something on a higher shelf, use a real step stool — not a kitchen chair — with a handle or bar to hold.
Other helpful tips for kitchen safety include:
- Prepare meals sitting down at the table, or get a stool for counter-height food prep.
- Avoid cleaning products, like floor polish, that can make the floor too slippery.
Major Home Renovations
If you can afford to make more complex renovations, you can set up your home to be more functional for you as MS advances. These home modifications might include:
Widening doors. Making your door frame wider for wheelchair access is important, especially if you’re going to be using a motorized chair.
Installing handrails. Having these rails along the hallway can give you something to hold on to so you can stay steady.
Walk-in bathtubs. These tubs are becoming more popular. “Many people who own their homes have wonderful porcelain tubs that are dangerous,” Biel said. “You can get a tub seat to sit on, one that goes over the tub, and you scoot over into the tub, but that’s still dangerous.”
Shower stalls. If you prefer showers, a large roll-in shower stall, with an accessible hand shower can be ideal.
Chair lifts. If your home has a second level or your basement is part of your living space, chair lifts make these areas accessible once walking on stairs becomes difficult or impossible.
Paying for Updates
Many adaptations are costly, but even lower costs can be out of reach for some people. Installing grab bars properly usually means not only buying them, but hiring someone to install them, as does building a ramp so you can get in and out of your home.
The National MS Society. This society estimates that modification costs can range from $100-$50,000. The organization has some programs for funding assistance (grants, loans, and referrals to nonprofit partners) for accessibility modifications.
Medicaid home and community-based (HCBS) waivers. These waivers may help pay for some modifications. Each state has its own rules, so you’ll need to find out what your state offers. Government resources, such as the Administration on Aging (AoA), offer some funding. You can call 1-800-677-1116 or visit eldercare.acl.gov for more information.
Government funding. Funding for loans and grants varies from state-to-state, so if you contact your local MS Society chapter, they should be able to guide you in the right direction.
Setting up your home for fall prevention helps you now and in the future as your disease advances. Even if you don’t need the extra help yet, having it available in advance allows you the peace of mind.
