Falls Prevention for Wisconsin Seniors: Home Safety Assessment and the Stepping On Program

Falls are the leading cause of injury-related death for adults over 65 in Wisconsin. One in four older adults falls each year, and a single bad fall — a broken hip, a head injury — can permanently shift a parent from independent living to facility care.

The good news: most falls are preventable. Wisconsin runs one of the strongest evidence-based falls prevention programs in the country, and your county Aging and Disability Resource Center (ADRC) can connect your family with free or low-cost home safety assessments.

The Stepping On Program

Stepping On is a seven-week community workshop developed at the University of Wisconsin and tested in randomized controlled trials. Research shows it reduces falls among participants by 31%.

The program covers:

• Balance and strength exercises designed for home practice
• Home hazard identification — participants learn to spot risks in their own living spaces
• Medication review — understanding how drug interactions and side effects increase fall risk
• Vision assessment — when to update prescriptions and how bifocals affect depth perception on stairs
• Safe footwear selection — which shoes provide traction versus which increase slip risk
• Community safety — navigating icy sidewalks, uneven surfaces, and public spaces

Stepping On workshops are offered through county ADRCs, local hospitals, and community centers across Wisconsin. Most programs are free or charge a nominal fee. Contact your ADRC to find the next session in your county.

Room-by-Room Home Safety Checklist

Walk through your parent's home with fresh eyes. What they've navigated by habit for 30 years may have become dangerous as mobility, vision, and balance change.

Bathroom (where 80% of home falls occur):

• Install grab bars next to the toilet and inside the shower/tub
• Add a non-slip mat or adhesive strips inside the tub
• Consider a shower bench or transfer seat
• Set water heater to 120°F to prevent scalding
• Ensure the bathroom door opens outward (so a fallen person doesn't block it)

Stairs and hallways:

• Install handrails on both sides of all staircases
• Add bright, consistent lighting — no dark patches between fixtures
• Remove throw rugs or secure them with double-sided carpet tape
• Keep electrical cords and clutter away from walking paths
• Apply non-slip adhesive strips to uncarpeted stairs

Kitchen:

• Move frequently used items to waist-height shelves (no reaching or stooping)
• Eliminate step stools — use a reacher/grabber tool instead
• Ensure adequate lighting over the stove and sink
• Place a non-slip mat in front of the sink

Bedroom:

• Install a nightlight along the path from bed to bathroom
• Keep a phone or medical alert device within reach of the bed
• Ensure the bed height allows feet to rest flat on the floor when sitting on the edge
• Remove wheels from desk chairs

Professional Home Safety Assessments

For a more thorough evaluation, request a professional home safety assessment through your county ADRC or through a home health agency. An occupational therapist visits the home, evaluates your parent's mobility patterns, and recommends specific modifications.

If your parent is enrolled in Wisconsin's Family Care or IRIS Medicaid waiver programs, home safety assessments and resulting modifications (grab bars, ramps, lighting improvements) can be funded through the waiver. Private-pay assessments typically cost $150 to $300.

When Falls Signal a Bigger Problem

A single fall may be an isolated incident. Multiple falls — or a fall combined with confusion, new unsteadiness, or recent medication changes — can signal a deeper issue. Talk to your parent's doctor about a comprehensive falls risk assessment that includes balance testing, medication review, and vision screening.

The Wisconsin Home Care Navigation Guide includes a printable home safety assessment worksheet, a room-by-room modification checklist, and information on accessing Stepping On workshops and ADRC-funded home evaluations in your county.

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