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Home safety assessment checklist for the elderly template

Home safety assessment checklist for the elderly template

A detailed assessment of home safety for the elderly to identify potential hazards and ensure a secure living environment.

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Home safety assessment checklist for the elderly template

A detailed assessment of home safety for the elderly to identify potential hazards and ensure a secure living environment.

Use this template with Lumiform

  • Customize this template or build your own
  • Fill out templates via mobile app
  • Get reports and analyse your data
Prices start from ░░░ per month
Book a demo
Learn more
or Download template as PDF

We created this home safety assessment checklist for the elderly template to address the critical need for standardized safety evaluations in senior living environments. This practical tool enables healthcare professionals, home care agencies, and facility managers to conduct thorough room-by-room assessments that identify potential hazards before they cause harm.

With fall death rates among older adults rising significantly over the past two decades, this template provides a systematic approach to identifying risks like inadequate lighting, tripping hazards, and bathroom safety concerns. You’ll be able to document findings, recommend specific modifications, and track implementation progress—ultimately creating safer living spaces where elderly residents can maintain independence with reduced accident risk.

Related categories

  • Risk management and compliance templates
  • Health care templates
  • Safety templates
Preview of the template
Page 1
Entryway & Hallways
Are all walkways and hallways free of clutter and tripping hazards?
Are all floors non-slip and in good condition?
Are all light switches and pull cords within easy reach?
Is there sufficient lighting in all hallways and entryways?
Are there handrails installed on both sides of all staircases?
Are stair treads in good condition and non-slip?
Living Area
Are all furniture and appliances stable and secure?
Are all electrical cords tucked away and not a tripping hazard?
Are all area rugs and carpets firmly secured to the floor?
Is the lighting sufficient for all living spaces?
Are there grab bars installed near all seating areas?
Can all light switches and remote controls be easily reached?
Bathroom
Are there grab bars installed near the toilet, shower, and tub?
Is the flooring non-slip, even when wet?
Is the shower/tub entry low for easy access?
Are all toilets, sinks, and fixtures at an appropriate height?
Is the lighting sufficient for all bathroom tasks?
Are all electrical outlets GFCI protected?
Kitchen
Are all cabinets, shelves, and countertops within easy reach?
Are all appliances, including the oven, easy to use?
Are all electrical cords tucked away and not hanging down?
Is the flooring non-slip, even when wet?
Is the lighting sufficient for all kitchen tasks?
Are there fire extinguishers easily accessible?
Bedroom
Is the bed at a comfortable height for easy access?
Are all electrical cords tucked away and not a tripping hazard?
Is the lighting sufficient for all bedroom activities?
Are there nightlights or motion sensor lights installed?
Is there a clear path from the bed to the door?
Can all light switches and remote controls be easily reached?
Safety & Emergency Preparedness
Are working smoke detectors installed in all rooms?
Are working carbon monoxide detectors installed?
Is there a first aid kit readily available?
Are emergency numbers posted in a visible location?
Is there a simple, easily accessible home escape plan?
Are all doors and windows easily opened from the inside?

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Related resources

Access a complete set of resources aimed at maximizing safety, quality, and operational excellence, including detailed guides, related templates, and real-world use cases.

Topic guides

Read in-depth guides covering key topics related to this article.

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Template collections

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Other resources

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Frequently asked questions

What areas of the home does this elderly safety assessment checklist cover?

This comprehensive checklist covers all critical areas including entrances, hallways, stairs, bathrooms, kitchen, bedroom, and living areas. Each section contains specific items to evaluate for fall risks, accessibility issues, lighting adequacy, and general safety concerns that are particularly relevant for elderly residents.

How can I prioritize safety modifications identified in the assessment?

Focus first on high-risk areas where falls commonly occur—bathrooms, stairs, and nighttime pathways. Address immediate dangers like loose rugs or poor lighting before tackling larger projects. The template includes a prioritization section to help you categorize modifications as urgent, important, or beneficial.

What should I do if the elderly person resists recommended safety modifications?

The template includes a section for noting preferences and concerns. Focus first on changes that preserve dignity and independence while addressing critical safety issues. Involve the elderly person in decisions, explain benefits clearly, and consider implementing changes gradually, starting with less intrusive modifications that show immediate benefits.


This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.
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