Trips and Slips

Electric leads, phone cables, television aerial cables etc are a trip hazard - if necessary re-route them round the edge of the room, perhaps using strong 'duct' tape every foot or so to fasten them to the skirting board (we'd suggest white or grey tape, as black may look like a hole to be investigated).

Alternatively, rearrange the items in the room so that the cables aren't somewhere they might be tripped over - see our section on the home environment to consider whether there may be other reasons to move things, although in general it's best to avoid making the room look unfamiliar unnecessarily.

We don't view cable trip guards, which simply aim to cover cables with a wider ramp, as safe. Nor should anything thicker than a telephone cable be hidden under a rug as it will still be a trip hazard (and could potentially cause an electrical cable to overheat).

Rugs can be a hazard from two points of view: tripping over the edge (especially if it's curled up or a piece of furniture on it has slid part of it along and created a wrinkle), or the whole thing slipping along a wooden floor when stood on.

For a rug that doesn't serve a real purpose and has edges to trip over it may be best to consider removing it, but there are also things can be done to make a rug safer.

There are special double-sided adhesive tapes called 'rug tape' or 'carpet tape', but check whether the one you're looking at is intended to remove cleanly from the flooring underneath or to be permanent. These tapes should be used in preference to adhesive corner pads.

To help stop a rug slipping along a smooth floor (and also to help take some of the strain off rug tape holding down the edges) there are sheets of non-slip netting mat that can be cut to size. One of those available in the UK is shown on the Complete Care Shop website, as 'Tenura netting mat'. (We don't receive any money for mentioning this shop - but we have used them and do find their range useful.) Also see the Living Made Easy website, for 'non-slip fabric' (note that the different products aren't ranked or rated, and you should check that any supplier listed is reputable).

Toilet mats are best removed, as they're a high trip and slip danger. They also tend to be unhygienic.

Trouser and long nightie hems can cause trips and slips if they're too long (and bear in mind that if the person is losing weight then trousers may ride lower than they used to).

Also look for any hems that are coming undone.

Slipper and shoe soles that are wearing smooth can be very slippery on hard floors such as in bathrooms or kitchens.

On some surfaces even a new slipper's sole may be slippery, in which case consider a slip-on shoe instead (although some rubber soles may make a squelching noise on a hard floor).

Obviously if any part of the sole is at risk of coming loose then the item must be replaced.

Look (especially from behind at the heel) at how the foot sits within the slipper or shoe - if it's to one side, with some of the weight over the edge of the sole, then this needs to be corrected.

Footwear shouldn't be too loose (or too tight), and look out for slipper heels that get flattened down rather than have the foot heel inside them - it can be very difficult to get the right fit when someone is putting the slippers on themselves.

Flip-flops are generally regarded as a hazard, and obviously high heels should be avoided.

Clutter on the floor is obviously a hazard, but note that seemingly innocuous things can become hazards. For example, pieces of post can be slippery (consider a letterbox cage), or a row of shoes in the wrong place could become a trip hazard.

Clutter in a cupboard could spill out or be pulled out while searching for something. Similarly, clutter on a table could slide or be knocked off onto the floor - for example a tall pile of books (which would be better upright in a bookshelf).

Cats and dogs can be a trip hazard, liking to be near their owner's feet, so consider a brightly coloured collar with a bell on it.

Outside paving, especially York stone but also manufactured slabs, becomes exceptionally slippery in the wet when a layer of algae has grown, even when it isn't obviously green. You're unlikely to notice this until it's wet.

A pressure washer is by far the most effective way to clean the algae off, and you'll instantly be able to test the difference (carefully!). Be careful if the surface is fragile - holding the water lance further away from the paving will reduce the pressure.

There are 'patio cleaner' chemicals available as an alternative, but they aren't nearly as effective, aren't instant, and are expensive in the long run. Keep all chemicals safely locked away.

There are many places that some form of grab rail could be useful, including in the bathroom, along stairs, on the doorstep etc. There are also products such as toilet rails that form a similar function.

We feel that it's best for an occupational therapist to advise on the rails that are most suitable for your particular needs, and to ensure that they're installed safely.

You'll see grab rails advertised that use suction pads on smooth, flat surfaces, but we don't think they're suitable for someone with dementia who won't be able to sense when they're coming loose.

Carrying trolleys can be useful if the person carries things about and risks overbalancing or tripping over something dropped. They should be height-adjustable and set to the correct height for the person, and since they're in effect a form of walking aid we'd suggest seeking the advice of an occupational therapist.

Although obviously we'd suggest staying indoors during icy weather, in case your loved one has an appointment or an emergency it's worth having a bag of salt grit for you or a carer to clear the doorstep and the way to the car.

It's also useful to have a small scoop or bucket to carry an amount of salt that isn't too heavy and to help scatter it thinly, and it's very useful to have a broom to spread out and work the salt in - you'll need much less salt and it will melt the ice much more quickly.

Don't forget a snow shovel (but be careful - a large shovelful of snow can be surprisingly heavy, and is held at a distance which is bad for your back).

Plan in advance - snow shovels in particular don't seem to be stocked by DIY stores until just before it snows, and as soon as it snows they're sold out! There are snow shovels with collapsible handles (for carrying in the car, and which are easier to post from online shops), but check the length of the handle when fully extended - if it's too short you'll be bending your back while carrying a heavy load with cold muscles - a recipe for back strain.

Avoid the inappropriate use of bed cot sides: if the person is mobile this is likely to result in the person trying to climb out over the top, resulting in a fall.

If the person is immobile, i.e. needs hoisting in and out of bed, then an occupational therapist may be able to advise on using 'bed side wedges', which are soft triangular wedges that velcro fasten onto a special bed sheet.

Similarly, soft 'crash mats' that are put alongside the bed aren't recommended for someone who's mobile, as walking on one may unbalance them or they may trip off the edge.