home-safety-aging

name	home-safety-aging
description	Produces a comprehensive home safety assessment checklist for aging in place, covering fall prevention, mobility accommodation, bathroom safety, lighting improvements, emergency contact setup, and room-by-room hazard identification. Generates prioritized modification plans with urgency levels and cost estimates. Use when the user asks about making a home safer for an elderly person, fall prevention, or aging-in-place modifications. Do NOT use for care facility evaluation (use care-facility-evaluation), medical assessment of fall risk (consult a physician), or full home renovation planning.
license	Apache-2.0
metadata	{"author":"foundry-skills","version":"1.0.0","tags":"elder-care checklist home-maintenance","category":"family-relationships","subcategory":"caregiving","depends":"","disclaimer":"none","difficulty":"beginner"}

Home Safety Assessment for Aging in Place

When to Use

Use this skill when:

• User asks about making a home safer for an aging parent or relative
• User wants a fall prevention checklist for a senior's home
• User asks about aging-in-place modifications or accommodations
• User wants to assess home hazards for an elderly family member
• User asks about bathroom safety, grab bars, or mobility aids for the home

Do NOT use this skill when:

• User wants to evaluate care facilities (use care-facility-evaluation)
• User needs medical assessment of fall risk or mobility (physician assessment required)
• User wants full home renovation planning (this covers safety modifications only)
• User asks about caregiver coordination (use caregiver-coordination)
• User asks about home maintenance schedules for a general household (this is specifically for aging safety)

Process

1. Assess current mobility and risk level. Gather baseline information:

   • Current mobility status: independent, uses cane, uses walker, uses wheelchair
   • Recent fall history: number of falls in the past 6 months and circumstances
   • Vision status: corrected vision, low vision, significant impairment
   • Cognitive status: fully independent, occasional confusion, needs reminders
   • Current medications (some increase fall risk -- dizziness, drowsiness side effects)

   Note: This assessment gathers information for home modification planning. It is not a medical evaluation. If the user reports frequent falls or sudden changes in mobility, recommend a physician evaluation before or alongside home modifications.

2. Conduct the room-by-room safety audit. Walk through each area systematically:

   Entryways and Exterior:

   • Porch and walkway are well-lit (minimum 50 lumens per square foot at night)
   • Steps have contrasting color strips on edges for visibility
   • Handrails present on both sides of all exterior steps
   • Doorway thresholds are flush or ramped (no trip hazards above 1/4 inch)
   • Door locks and handles are operable with one hand and minimal grip strength
   • Welcome mat is secured flat (no curled edges)
   • House numbers are visible from the street for emergency responders

   Living Areas:

   • All walkways are at least 36 inches wide for walker or wheelchair clearance
   • Area rugs are removed or secured with non-slip backing
   • Electrical cords are routed along walls, never across walkways
   • Furniture is arranged to create clear, unobstructed paths
   • Frequently used items are stored between waist and shoulder height
   • Light switches are accessible at every room entrance
   • At least one chair has armrests and a seat height of 18-20 inches for easier standing

Output Format

## Home Safety Assessment Report

### Resident Profile
- **Name:** [Name]
- **Mobility status:** [Independent / Cane / Walker / Wheelchair]
- **Recent falls:** [Number in past 6 months, circumstances]
- **Vision:** [Corrected / Low vision / Significant impairment]

### Room-by-Room Findings

#### [Room Name]
| Item | Status | Action Needed | Priority | Est. Cost |
|------|--------|---------------|----------|-----------|
| [Item] | Pass/Fail | [Action] | Immediate/Short/Medium/Long | $XX |

### Emergency Preparedness
- [ ] Emergency response device: [In place / Needed]
- [ ] Emergency contacts posted: [Yes / No]
- [ ] Smoke/CO detectors tested: [Date]

### Priority Action Plan

**Immediate (This Week):**
1. [Action] -- [Cost estimate] -- [Who will do it]

**Short-Term (Within 1 Month):**
1. [Action] -- [Cost estimate] -- [Who will do it]

**Medium-Term (Within 3 Months):**
1. [Action] -- [Cost estimate] -- [Who will do it]

**Total Estimated Cost:** $X,XXX - $X,XXX

### Follow-Up Schedule
- Next reassessment: [Date -- 6 months from now]
- Smoke detector test: [Monthly on the 1st]
- Emergency contact review: [Quarterly]

Rules

1. NEVER provide medical assessment of fall risk or mobility -- this skill assesses the home environment, not the person's medical condition
2. ALWAYS prioritize bathroom modifications first -- bathrooms account for the highest percentage of in-home falls among seniors
3. ALWAYS include cost estimates for every recommended modification
4. ALWAYS flag the hot water temperature check -- scalding injuries from water above 120 degrees F are preventable and common
5. Include the 36-inch minimum walkway width measurement for every room -- this is the ADA standard for walker or wheelchair passage
6. Flag grab bars as wall-mounted only -- suction cup grab bars are unreliable and can cause falls when they fail under load
7. Every assessment must include an emergency response system evaluation regardless of how minor the other findings are
8. Recommend professional installation for any modification that is structural (stair lifts, ramp construction, doorway widening, walk-in shower conversion)
9. ALWAYS recommend a follow-up reassessment schedule -- needs change, and a safe home today may have new hazards in 6 months
10. Present findings in a table format with pass/fail status, never as prose paragraphs

Edge Cases

• Rental property: When the senior rents rather than owns, note which modifications require landlord permission (grab bars, ramp installation, doorway widening) vs. which can be done without permission (non-slip mats, night lights, furniture rearrangement). Many landlords will approve safety modifications if asked. The Fair Housing Act may require landlords to allow reasonable modifications at the tenant's expense for disabled individuals.

• Multi-story home with stairs as primary barrier: If stairs are the primary safety concern and a stair lift is not feasible (cost or structural reasons), recommend converting a ground-floor room to a bedroom and bathroom if possible. This avoids the stair risk entirely. If no ground-floor bathroom exists, a portable commode may be a temporary solution while planning renovations.

• Cognitive impairment (dementia, Alzheimer's): Add additional checks: stove controls that can be disabled when unsupervised, door alarms on exterior doors, locked cabinets for cleaning supplies and medications, simplified remote controls and phone interfaces, and labels on drawers and cabinets. Consider a home monitoring camera system for remote family members to check in (with the resident's knowledge and consent where possible).

• Limited budget: Focus on the highest-impact, lowest-cost modifications first: removing loose rugs (free), installing night lights ($15-30), securing grab bars in the bathroom ($30-80 per bar, can be DIY if studs are available), and posting emergency contacts (free). These four modifications address the most common fall scenarios for under $150 total.

• Resistance to modifications: When the senior resists changes to their home, start with the least visible modifications (night lights, non-slip bath strips, water heater adjustment) and frame them as maintenance updates rather than safety accommodations. Grab bars can be chosen in decorative styles that look like towel bars. The goal is safety without making the home feel institutional.

Example

Input: "My dad is 82, uses a walker, and lives alone in a two-story house. He had a fall in the bathroom last month. What should we do to make his home safer?"

Output:

Home Safety Assessment Report

Resident Profile

• Name: [User's father]
• Mobility status: Walker
• Recent falls: 1 fall in the past month (bathroom)
• Vision: [Ask user to confirm]

Priority Action Plan

Immediate (This Week) -- Estimated Cost: $45-85:

1. Remove all loose area rugs throughout the house -- $0 -- Family member
2. Install 3 motion-activated night lights along path from bedroom to bathroom -- $15-30 -- Family member
3. Verify hot water heater is set to 120 degrees F or below -- $0 -- Family member
4. Post emergency contact list by phone and on refrigerator -- $0 -- Family member
5. Clear any items stored on stairway steps -- $0 -- Family member

Short-Term (Within 1 Month) -- Estimated Cost: $200-450:

1. Install 3 grab bars in bathroom: beside toilet, shower entry, shower back wall (wall-mounted, 250+ lb rated, anchored into studs) -- $90-240 installed -- Handyperson or family member with stud finder
2. Place non-slip adhesive strips inside tub or shower -- $10-25 -- Family member
3. Install raised toilet seat (adds 4 inches) -- $40-80 -- Family member
4. Set up personal emergency response device (medical alert pendant) -- $20-50/month -- Family member helps with setup
5. Install handheld showerhead for seated bathing -- $25-60 -- Family member or plumber

Medium-Term (Within 3 Months) -- Estimated Cost: $300-700:

1. Add second handrail to stairway (currently likely has one side only) -- $100-200 installed -- Handyperson
2. Replace round doorknobs with lever handles on bathroom and bedroom doors -- $60-160 (4 handles) -- Family member
3. Install under-cabinet kitchen lighting -- $40-120 -- Family member
4. Add motion-activated lights in hallways -- $40-80 -- Family member
5. Install shower chair or transfer bench -- $50-150 -- Family member

Long-Term Planning -- Estimated Cost: $3,000-10,000:

1. Evaluate stair lift installation for main stairway -- $3,000-8,000 -- Professional installation required
2. Consider converting ground-floor room to bedroom to eliminate stair use entirely -- Variable -- Contractor assessment needed
3. Evaluate walk-in shower conversion to replace tub -- $3,000-10,000 -- Professional installation required

Total Immediate + Short-Term Estimate: $245-535 Total All Modifications Estimate: $3,545-11,235

Bathroom-Specific Findings (Fall Location)

Item	Status	Action	Priority	Est. Cost
Grab bars near toilet	FAIL	Install wall-mounted bar	Short-term	$30-80
Grab bars in shower	FAIL	Install 2 bars (entry + back wall)	Short-term	$60-160
Non-slip tub surface	FAIL	Add adhesive strips	Short-term	$10-25
Raised toilet seat	FAIL	Install 4-inch riser	Short-term	$40-80
Night light	FAIL	Install sensor night light	Immediate	$5-10
Floor mat	CHECK	Verify non-slip backing, lies flat	Immediate	$0-15
Shower chair	ABSENT	Provide for seated bathing	Medium-term	$50-150

Critical Note About Stairs

Your father uses a walker on a two-story home. Stairs with a walker are a significant fall risk. The short-term plan adds a second handrail, but the long-term goal should be either a stair lift or moving his bedroom and primary bathroom to the ground floor. Discuss this with his physician and consider an occupational therapist home visit for a professional stair safety assessment.

Follow-Up Schedule

• Next full reassessment: 6 months from now or immediately after any fall
• Monthly: test smoke detectors, check night light function, check grab bar anchoring
• Quarterly: review emergency contacts, confirm emergency response device is functioning