Preventing falls in older age: a room-by-room checklist for the home

Many falls in older age happen at home, and common causes can be removed with simple measures: good lighting, clear walkways without loose rugs or cables, non-slip floors, grab rails in the bathroom and sturdy shoes. For adaptations such as grab rails, handrails or a level-access shower, German care insurance (Pflegeversicherung) pays up to €4,180 per measure from care grade 1 (Pflegegrad 1), provided you apply before work begins. Regular exercise and a home emergency call (Hausnotruf) add to this so that help arrives quickly after a fall. This guide does not replace medical advice.

Common causes of falls

Falls usually have several causes at once. Roughly, they fall into these groups:

Area	Examples
Home	Loose rugs, cables, thresholds, slippery floors, poor light, missing handrails
Body	Reduced strength and balance, sight or hearing problems, dizziness, unsteady walking
Daily habits	Getting up in a hurry at night, climbing on chairs, unsuitable footwear
Medication	Some medicines can cause tiredness or dizziness, especially in combination

If you or your relative have already fallen or feel unsteady when walking, raise it with your GP (Hausarzt). Possible causes such as eyesight, circulation or medication can be checked there. Never stop taking medication on your own.

Room-by-room checklist

Hallway and living area

• Keep walkways clear and arrange furniture so nothing is in the way.
• Remove loose rugs or secure them with a non-slip underlay.
• Run cables along the wall or in cable ducts.
• Make light switches easy to reach, ideally at the entrance to every room.
• Stable chairs with armrests make it easier to stand up.

Bedroom

• A light that can be switched on from bed, such as a bedside lamp or motion light.
• A bed height at which the feet rest flat on the floor when sitting.
• A lit route to the bathroom at night, for example with plug-in night lights.
• A phone or emergency button within reach of the bed.

Bathroom

• Non-slip mats in and in front of the shower or bath.
• Grab rails by the toilet, shower and bath, firmly fixed to the wall.
• A shower stool or fold-down seat for safe sitting.
• A level-access shower instead of a high bath edge if a conversion is possible.
• A raised toilet seat if standing up is difficult.

Kitchen

• Keep frequently used items at grip height so nobody needs to climb on a chair.
• Wipe up spills straight away.
• If needed, use a stable step ladder with a handle instead of a chair.

Stairs and entrance

• Handrails on both sides, running from the first to the last step.
• Mark step edges in a contrasting colour and light the top and bottom well.
• Clear outdoor paths in winter and use a non-slip doormat.

Clothing and shoes

• Sturdy shoes or slippers with a closed heel and non-slip sole.
• No overly long trousers or dressing gowns that can be tripped over.
• Have glasses and hearing aids checked regularly and actually wear them.

Exercise, strength and balance

Strength and balance can be trained at any age. Exercises for the legs, core and balance are considered useful for walking more safely. Which exercises and how much suit you depends on your health, so please discuss this first with your doctor or a physiotherapist. Many statutory health insurance funds (Krankenkassen) offer or subsidise prevention courses, so ask yours about options nearby. Senior exercise groups in clubs and community centres can also be a good start.

Aids and grants

Help	Who may pay?	Note
Grab rails, handrails, level-access shower, removing thresholds	Care insurance (home adaptation) from care grade 1	Up to €4,180 per measure; apply before work starts
Home emergency call (basic)	Care insurance with a care grade and if conditions are met	Basic tariff €27 net a month since 1 April 2026
Walking frame, walking stick, shower stool	Health or care insurance, depending on the aid	Check whether a prescription or application is needed
Night lights, non-slip mats	Usually paid privately	Low cost, big effect

The legal basis for the adaptation grant is § 40 SGB XI (in German). Our guide to the home adaptation grant explains how to apply and what counts as one measure. Care insurance benefits require a care grade, which you can apply for.

Getting help quickly after a fall

Not every fall can be prevented. That makes quick help all the more important, especially for someone living alone. A home emergency call with a button on the wrist or as a pendant connects to a monitoring centre at the press of a button. With a care grade and if the conditions are met, care insurance covers the basic tariff; see our guide to home emergency call costs. Additional fall sensors that raise the alarm automatically are covered in fall detectors and smart home technology.

It also helps to practise how to get up safely after a fall, or how to attract attention if that is not possible. A physiotherapist can show you how.

Step by step

1. Go through the home room by room with this checklist and fix the simple things straight away.
2. Raise fall risk and medication with your GP.
3. Plan larger adaptations, get quotes and apply for the grant before work begins.
4. Consider a home emergency call if the person lives alone.
5. Build exercise into daily life after checking with a doctor.

More articles are in our emergency call and technology section.