Patient safety is a priority.

The key to safe and sensible home care includes:

• Safety improvements in and around the home
• Fall prevention
• Emergency planning

The Gulfside Hospice team will:

• Look for fall and safety risks at each visit
• Evaluate the need for equipment and/or assistive devices to maintain your safety
• Teach you how to prevent falls and use medical equipment safely
• Ask that you report any falls or safety concerns promptly

Adapt the Home for Safety's Sake

It is important to make appropriate changes as soon as possible after coming home from a hospitalization or nursing facility, or to adapt the home to physical changes the patient may have experienced. Hospice can supply your equipment. Ask your care team for more details.

Refer to the following sections for practical tips for improving the safety in your home. 

• Throughout the Home

  • Maintain clean, bright surroundings.
  • Make certain furniture is comfortable and sturdy.
  • Lower water heater temperature to 120 degrees to avoid burns.
  • Keep walking areas clear from clutter.
  • Make sure that cords are out of the way.
  • Remove scatter/throw rugs and secure any loose carpeting.
  • Repair any holes in carpeting and be sure to fix any flooring that’s warped or buckled.
  • Use night lights in bedrooms, bathrooms, hallways, etc.

• Kitchen

  • Set utensils, foods, and other needed items at a convenient height.
  • Install grab bars on the walls.
  • Choose a convenient height for mounting foil and paper towels.
  • Develop a safe system for storing heavy pots (for example: at waist height or close to the floor).
  • A fire extinguisher should be installed in the kitchen.

• Bathroom

  • Install grab bars on the bathroom walls (especially near the toilet and shower). REMEMBER: towel bars are NOT meant to be grab bars and are not safe to support body weight.
  • Install a toilet extension to raise the seat. A bedside commode can often be used, take the bucket out and place over the toilet.
  • Switch to a hand-held showerhead.
  • Replace bar soap with easier to hold liquid soap in plastic bottles.
  • Make sure faucets and towel bars are easy to reach.

• Stairs

  • Consider building ramps.
  • Install new railings or secure old railings.
  • Repair or replace worn or unsafe steps.

• Bedroom

  • Consider buying or renting a hospital style bed with side rails.
  • Obtain an over the bed trapeze so that the patient can lift himself or herself.
  • Have a portable toilet beside the bed.
  • Provide a bell to signal when the patient might need help.

• A Special Note Regarding Confused Patients

  If a patient has Alzheimer’s Disease or any condition that causes mental confusion:

  • Set up a daily schedule – having a routine helps limit restlessness and wandering.
  • Obtain an ID bracelet for the client in case he or she gets lost.
  • Keep medications out of reach – they can be a source of danger in the hands of confused or forgetful patients.
  • Limit access to dangerous items – Keep irons, hair dryers, power tools, scissors, pins, and any other dangerous items where patients can’t reach them.

• Fall Prevention

  Assessing loved ones for falls is a constant process for hospice patients. What are some of the things that are monitored for fall prevention?

  • Throw rugs should be held down by grippers.
  • Declutter pathways for safe ambulation. Ensure that clothing, towels, cords, etc. are out of the way, and the floors are clean and dry.  Make sure to clean up spills promptly. 
  • Recommend safety bars in the shower and toilet area.
  • Medication review will be done with the nurses at each visit. Sometimes medications can cause an increase in fall risk and should be discussed during those visits.
  • Ensure assistive devices (cane, walker, wheelchair) is within reach and is well maintained. Ensure brakes on wheelchair are locking well and able to stay in place for safe transfers.
  • Utilize gait belt as necessary for safe transfers. Talk to your nursing team for help with providing a gait belt and the training on proper use.
  • Lighting should be bright enough for patient to be able to see well to get around the home. Encourage night light at nighttime for safe ambulation to bathroom, or request bed side commode if strength and balance are worse at night.
  • Monitor for changes in mentation with new onset of confusion or worsening confusion.
  • Encourage patient to wear hearing aids and glasses appropriately.
  • Notify Gulfside Hospice of any patient fall.

• Weather Precautions

  Hurricanes, power outages, tornadoes, localized flooding, acts of terrorism and fire are all examples of possible threats to normal living.

  • Develop an action plan. Where will you go during an emergency event. If going to a shelter, have you pre-registered?
  • If you live in an evacuation zone or are electrically dependent on medical equipment (i.e., continuous oxygen, suction) plan now for where you and your family will evacuate. Your physical condition and needs should guide you in determining where you would need to go and how you would get there.
  • Options to discuss with family and your care team regarding where you will evacuate:
    • Family or friends in a non-evacuation zone
    • Host homes
    • Hotel in a non-evacuation zone
    • Public/Special Needs shelters: Please note that special needs shelters are intended to be a place of last refuge and that the conditions in a shelter may be very stressful. It is recommended that a caregiver accompany an evacuee to the special needs shelter and remain with him or her.
    • Caution: A pet-friendly shelter should be your last choice in the event of an evacuation with your pet. These are not equipped as special need shelters.
    • Other options are based on condition and needs (i.e., skilled nursing facility or hospital).
    • Remember it is important to bring your own Personal Protective Equipment (masks & gloves).
  • Have emergency numbers posted on or near all phone or doors for fire/police, relatives and out of area contacts.
  • Prepare physically. Each household should have a reserve of medicines. During hurricane season (June – November), have a 14-day supply of prescription and non-prescription medication.
  • Maintain a minimum of at least three gallons (11 L) of water per person and three days of nonperishable, ready-to-eat foods in case it is necessary to shelter in place for an extended period.

• Emergency Kit

  Prepare an Emergency Go bag or kit with following items:

  • Blankets, complete change of clothes, and sturdy shoes
  • Flashlight, radio (battery or windup), and spare batteries
  • First-aid kit and a whistle to signal for help
  • Eating utensils, can opener, pocket tool set, and waterproof matches
  • Dust masks, gloves, waterproof tape, and plastic sheeting for shelter
  • Toothbrushes, soap, towels, and toilet paper
  • Child-care supplies and special-needs items for seniors or people with disabilities
  • A waterproof container with needed medication, copies of prescriptions, and other important documents
  • List of emergency contacts and a local map
  • Credit cards and cash
  • Extra set of house keys and car keys
  • Paper, pencils, books, and games for children
  • If you own a car, try to keep the fuel tank at least half full.

• After Evacuations

  After the danger has passed and authorities have notified you that you can return to your residence or reenter an affected area. Gulfside staff will attempt to make contact with you as soon as possible. Please call us at (800) 561-4883 to update us on your condition and location.

• Fire Safety

  All family members and caregivers should be familiar with emergency 911 procedures.

  • Keep exits clear and have a plan for escape. Practice plan with family members.
  • Know your fire escape routes and plan two exits. If your exit is through the ground floor window, make sure it opens easily.
  • Alternative exits should be accessible in case of fire.
  • Install smoke alarms in hallways and near sleeping areas. Check smoke alarm batteries when you change your clocks for daylight savings time in the spring and fall.
  • If gas is used in the home, Carbon Monoxide detectors should be placed in hallways and near sleeping areas.
  • Smoke alarms/Carbon Monoxide should be placed on each floor.
  • If you live in an apartment building, know the exit and stair locations.
  • If your fire escape is cut off, remain calm; close the door and seal cracks to hold back smoke. Signal for help at the window.
  • Always keep the fire department and emergency numbers posted for easy viewing at all times.
  • Remember, life safety first, but if the fire is contained and small you may be able to use your fire extinguisher before the fire department arrives.
  • Fire extinguishers should be checked frequently for stability.
  • When using the fire extinguisher remember “PASS” -- Pull the pin, Aim hose at base, Squeeze the handle, Sweep across the base of fire.

• Oxygen Safety

  • Know the correct oxygen liter flow that your doctor ordered and do not change the setting.
  • Do not smoke or allow others to smoke within 25 feet of you when oxygen is in use.
  • NO SMOKING SIGNS should be posted in all areas of oxygen use.
  • Patients using oxygen should stay at least 25 feet away from all open flames or heat sources (e.g., space heaters, stoves, candles, fireplaces, electric razors, hair dryers, cigarettes, lighters, matches, etc.)
  • Do not use petroleum-based products or flammable products on your face or upper body. Water based products may be used such as K-Y jelly or Aloe Vera. Do not use: Vaseline, Chapstick, rubbing alcohol, bag balm, nail polish.
  • Change the nasal cannula every 14 days and as needed if soiled or damaged.
  • Oxygen concentrator should be placed in a well-ventilated area at least 2 feet from draperies, furniture, and walls.
  • The oxygen concentrator filter should be cleaned (vacuumed) every 7 days and as needed.
  • Keep oxygen tanks out of the way in well-ventilated areas, upright in a stand or on its side. Do not place anything combustible around any tank (example: stacks of paper). Ask for an extra stand to keep tanks safe and secure.

  For more information on this topic, refer to the dedicated Oxygen Safety section of this guide.