September is more than a seasonal reminder to talk about falls. For occupational therapists specializing in home modifications, aging in place, and home safety, it is an opportunity to educate the public, strengthen referral relationships, and clarify the clinical value we bring when fall risk intersects with daily life at home.
Every September, fall prevention becomes more visible. Community organizations share safety messages. Primary-care practices may encourage fall-risk screening. Caregivers are reminded to watch for warning signs. Older adults may encounter checklists, balance-program advertisements, and advice about rugs, grab bars, footwear, or exercise.
All of that awareness is valuable. But awareness alone does not make a home safer.
For occupational therapists who work in home modification, Fall Prevention Month offers a chance to communicate something more specific: a fall-risk screen is often the beginning of the conversation—not the intervention. Our contribution is helping people understand how personal factors, meaningful occupations, daily routines, caregivers, and environmental demands come together in one particular home.
Falls remain a major public-health concern for adults age 65 and older. CDC data indicate that more than one in four older adults falls each year, with millions of fall-related emergency department visits and more than one million related hospitalizations annually. Yet the real impact of a fall—or fear of falling—often shows up first in ordinary occupations: getting to the bathroom at night, entering the home in wet weather, showering, carrying laundry, preparing meals, navigating stairs, or simply moving confidently from room to room.
For home-modification OTs, that is where our work begins.
A September opportunity
Fall Prevention Awareness Week is observed nationally in September, providing organizations and clinicians with a timely platform for education and outreach. The National Council on Aging’s campaign materials are designed to support community awareness, including customizable social-media content, flyers, handouts, presentations, videos, and other public-facing resources.
This is useful for therapists because you do not need to create every educational tool from scratch. National resources can help open the door to conversation with older adults, caregivers, referral sources, and community partners. Your role is to help move that conversation from broad awareness to meaningful action.
Consider the difference between these two messages:
“Falls are common. Remove loose rugs and use grab bars.”
And:
“If a client reports a fall, begins holding furniture while walking, avoids the shower, rushes to the bathroom at night, or worries about stairs, those changes may be telling us something important about the fit between the person, the task, and the home.”
The first message is a generic safety reminder. The second communicates the value of occupational therapy clinical reasoning.
Fall Prevention Month gives us permission to say, clearly and consistently, that the home environment is not simply a backdrop for daily life. It can support participation—or quietly increase the effort, risk, and caregiver burden involved in ordinary routines.
From screening to intervention
CDC’s STEADI initiative—Stopping Elderly Accidents, Deaths & Injuries—offers a practical framework for healthcare teams: Screen, Assess, and Intervene. It includes clinical tools, patient resources, provider training, coordinated-care planning materials, and implementation guidance for practices and health systems.
The initial screen can be remarkably brief. CDC encourages providers to ask older adults:
- Have you fallen in the past year?
- Do you feel unsteady when standing or walking?
- Do you worry about falling?
A “yes” to any of these questions identifies a person as being at increased fall risk and signals the need for further assessment.
For the home-modification OT, that positive response is not a cue to move immediately to a list of products. It is a cue to become curious.
A client may say they fell “in the hallway.” But what does that actually mean?
Perhaps they got out of bed at 2:00 a.m. because of urinary urgency. The lighting switch was not accessible from the bed. The hallway was dim. A floor transition was difficult to see. The client had recently started a medication that increased dizziness. They reached for a piece of furniture that was never intended to provide stable support.
That is not simply a hallway problem.
It is a person–occupation–environment problem. It may involve health changes, visual demands, nighttime routines, urgency, furniture placement, lighting, flooring transitions, medication effects, confidence, and a home environment that no longer matches the client’s current abilities.
A useful Fall Prevention Month message for therapists and referral partners is this:
Screening identifies who may need a closer look. Occupational therapy helps determine what needs to change—and how to make those changes realistic in the person’s actual life.
Why home modification matters
Environmental interventions are not an afterthought in fall prevention. A 2023 Cochrane review found that home fall-hazard interventions probably reduce the rate of falls among community-dwelling older adults by 26%. The review found particularly strong evidence when interventions were targeted to people at higher fall risk, including people who had fallen in the past year, had recently been hospitalized, or needed assistance with daily activities.
Earlier Cochrane evidence also found that home-safety assessment and modification interventions reduced both the rate of falls and the likelihood of falling, with benefits appearing greater when the intervention was delivered by an occupational therapist.
Those findings matter—but they should not lead us to oversimplify the work.
A home assessment is not a scavenger hunt for hazards. It is not just a checklist of loose rugs, clutter, and grab bars. Those issues may be relevant, of course. But the clinical value comes from analyzing the fit between a specific person and the demands of specific occupations in a specific environment.
For example, a bathroom recommendation should not begin with, “Install grab bars.” It should begin with questions such as:
- How does the client enter and exit the shower or tub?
- What transfer pattern do they use now?
- When does fatigue, pain, dizziness, or urgency affect performance?
- Can the client reach and use a support surface safely?
- Does the bathroom layout allow a caregiver to assist without unsafe body mechanics?
- Is lighting adequate at the time the bathroom is most often used?
- What sensory, cognitive, visual, or mobility changes influence performance?
- What matters most to the client: privacy, efficiency, bathing independently, conserving energy, reducing caregiver assistance, or remaining at home?
The same reasoning applies to entryways, stairs, kitchens, bedrooms, laundry areas, pathways, and outdoor access.
AOTA’s Aging in Place: Safe at Home checklist illustrates the range of issues that may be relevant in a home-safety and accessibility review: entry lighting, exterior walking surfaces, railings, thresholds, stair visibility, bathroom supports, floor surfaces, and clear circulation routes.³ But the checklist is only a starting point. The therapist’s expertise lies in determining which issues matter most, what to address first, and how to align recommendations with the client’s goals, resources, routines, and living situation.
Use national tools strategically
CDC STEADI and NCOA resources can help therapists reach several audiences during Fall Prevention Month. The key is not to send the same message to everyone. Each group needs a clear and appropriate next step.
| Audience | Useful resource or approach | Your practice-building message |
|---|---|---|
| Older adults | CDC Stay Independent questionnaire; NCOA Falls Free CheckUp; home-safety education | “A fall is not an inevitable part of aging. If daily activities are becoming less safe or more difficult, a home evaluation can identify practical solutions.” |
| Family caregivers | CDC caregiver materials; NCOA caregiver conversation guide | “Furniture-walking, avoiding the shower, struggling with stairs, or needing more help with transfers may be important functional changes—not simply normal aging.” |
| Physicians and primary-care teams | STEADI three-question screen, algorithm, and coordinated-care materials | “When an older adult screens positive, consider referral for an OT home-safety evaluation focused on function, environmental demands, and feasible home modifications.” |
| Case managers and discharge planners | Referral-red-flag sheet and brief home-safety education | “Refer when a successful discharge home depends on safe transfers, stairs, bathing, access, caregiver capacity, or a home setup that has not been evaluated.” |
| Community partners | NCOA awareness-week toolkit, public presentation, or screening event | “Home modification OT is part of a broader fall-prevention team: we help make the home support daily participation, confidence, and safety.” |
The CDC Stay Independent brochure is particularly useful for public outreach because it translates fall-risk factors into plain-language self-reflection. It asks about falls, mobility-device use, unsteadiness, furniture-walking, fear of falling, difficulty rising from a chair, difficulty stepping up onto a curb, urgency getting to the toilet, reduced sensation in the feet, medication effects, and depression. A score of four or more suggests elevated fall risk.
For the therapist, this is not a diagnostic instrument or a substitute for clinical evaluation. It is an accessible conversation starter.
A caregiver who notices that an older adult is holding furniture may not think, “This person needs a comprehensive occupational therapy home assessment.” But they may recognize that statement on a screening tool. A primary-care provider may not have time to examine a nighttime pathway, shower-transfer technique, storage routine, or the demands placed on a spouse who assists with mobility. But they can identify risk, refer appropriately, and collaborate with the OT.
This is how a public resource becomes a practice-building tool: it makes a concern visible and creates a logical path to the services you provide.
Focus on the referral bridge
During September, consider selecting one referral audience and making it easy for that audience to understand when to refer.
For primary-care teams, your message may be:
When an older adult reports a fall, unsteadiness, or concern about falling, consider whether the home environment and daily routines have been evaluated. Home-based OT can assess transfers, access, lighting, pathways, equipment use, task demands, caregiver capacity, and home-modification options.
For case managers and discharge planners, your message may be:
A client may be medically ready to leave the hospital but not functionally ready to navigate the home. Consider referral when safety depends on stairs, bathroom access, bed or toilet transfers, mobility-device use, caregiver assistance, or environmental modifications.
For caregivers, your message may be:
You do not have to wait for a serious fall to ask for help. Changes in routines—avoiding certain rooms, holding furniture, declining to bathe, struggling with seasonal entryways, or limiting community participation—may be early signs that the home needs to work differently.
For older adults, the message should remain strengths-based:
The goal is not to make your home look institutional. The goal is to make the things you want and need to do easier, safer, and more sustainable.
This approach also helps avoid a common pitfall in fall-prevention marketing: leading with fear. Fear may capture attention, but it does not always support engagement. A person may reject recommendations if they feel that “safety” means losing independence, giving up a familiar home, or being told what they can no longer do.
Home-modification OTs can reframe the conversation around participation:
- What does the client want to keep doing?
- Which routines have become harder, slower, or less confident?
- What demands in the home are no longer a good fit?
- What changes would make meaningful occupations more possible?
That is a more accurate reflection of occupational therapy—and a more compelling reason for clients and referral sources to seek our help.
A practical September plan
You do not need an elaborate campaign to participate meaningfully in Fall Prevention Month. Choose one simple action and do it well.
Option 1: Create a referral-partner handout
Develop a one-page resource for physicians, case managers, discharge planners, home-health agencies, and community partners.
Include:
- The three CDC STEADI screening questions.
- A brief list of referral red flags.
- Two or three examples of what a home-modification OT evaluates.
- A straightforward referral pathway.
- Your contact information and service area.
Keep it focused on the question referral partners are already asking: When should I call you?
Option 2: Offer a caregiver education session
Partner with a caregiver-support group, senior center, library, or community organization. Use CDC and NCOA materials as trusted public education resources, then teach the occupation-based lens that caregivers may not encounter elsewhere.
A useful session title might be:
When the Home No Longer Fits: Early Signs It May Be Time for a Home-Safety Evaluation
Emphasize that caregivers should not be expected to solve every problem by themselves—and that caregiver safety belongs in the plan as well.
Option 3: Publish a clinician-facing post
Use your newsletter, blog, LinkedIn page, or professional network to explain the difference between screening and intervention.
A short post could read:
A positive fall-risk screen is not a prescription for a generic checklist. It is an invitation to ask better questions: What happened? What has changed? What does the task require? What does the home demand? What does the client need to keep doing?
For home-modification OTs, fall prevention begins with function—and ends with a plan that fits real life.
Option 4: Make one community connection
Reach out to one organization already serving older adults: a senior center, primary-care practice, Area Agency on Aging partner, home-health agency, housing organization, caregiver organization, faith community, or rehabilitation provider.
Offer one useful resource and one specific service. Do not ask them to understand every aspect of home modification in one conversation. Make the next step easy.
The message to carry forward
Fall Prevention Month can bring attention to a serious issue. But home-modification OTs have an opportunity to bring depth to that attention.
We can remind referral partners that a positive screen needs a thoughtful next step. We can help caregivers notice functional changes before a crisis. We can give older adults practical, respectful options that support their independence. We can demonstrate that home safety is not merely about hazard removal—it is about helping a person continue to live the life they value in an environment that supports, rather than undermines, daily participation.
This September, consider choosing one audience, one evidence-informed resource, and one clear referral message.
Start the conversation. Make the next step visible. And help ensure that fall prevention includes what matters most: the person, the occupations they value, and the home in which daily life unfolds.
References
Clemson, L., Stark, S., Pighills, A. C., Fairhall, N. J., Lamb, S. E., Ali, J., & Sherrington, C. (2023). Environmental interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, 2023(3), CD013258. https://doi.org/10.1002/14651858.CD013258.pub2
Centers for Disease Control and Prevention. (2021). Coordinated care plan to prevent older adult falls. https://www.cdc.gov/steadi/pdf/Steadi-Coordinated-Care-Plan.pdf
Centers for Disease Control and Prevention. (2026). Older adult fall prevention: Facts about falls. https://www.cdc.gov/falls/data-research/facts-stats/index.html
Centers for Disease Control and Prevention. (n.d.). STEADI: Stopping Elderly Accidents, Deaths & Injuries. https://www.cdc.gov/steadi/
Centers for Disease Control and Prevention. (2023). Stay independent: Check your risk for falling. https://www.cdc.gov/steadi/pdf/steadi-brochure-stayindependent-508.pdf
Gillespie, L. D., Robertson, M. C., Gillespie, W. J., Sherrington, C., Gates, S., Clemson, L. M., & Lamb, S. E. (2012). Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, 2012(9), CD007146. https://doi.org/10.1002/14651858.CD007146.pub3
Montero-Odasso, M., van der Velde, N., Martin, F. C., Petrovic, M., Tan, M. P., Ryg, J., Aguilar-Navarro, S., Alexander, N. B., Becker, C., Blain, H., Bourke, R., Cameron, I. D., Camicioli, R., Clemson, L., Close, J., Delbaere, K., Duan, L., Duque, G., Dyer, S. M., … Task Force on Global Guidelines for Falls in Older Adults. (2022). World guidelines for falls prevention and management for older adults: A global initiative. Age and Ageing, 51(9), afac205. https://doi.org/10.1093/ageing/afac205
National Council on Aging. (n.d.). Falls Prevention Awareness Week. https://www.ncoa.org/professionals/health/center-for-healthy-aging/national-falls-prevention-resource-center/falls-prevention-awareness-week/
National Council on Aging. (n.d.). Falls prevention for older adults. https://www.ncoa.org/older-adults/health/prevention/falls-prevention/
American Occupational Therapy Association. (n.d.). Aging in place: Safe at home checklist. https://www.aota.org/~/media/Corporate/Files/Practice/Aging/rebuilding-together/RT-Aging-in-Place-Safe-at-Home-Checklist.pdf
The sources and approaches above reflect current CDC fall-prevention resources, NCOA’s awareness-campaign materials, AOTA’s home-safety checklist, and systematic-review evidence supporting targeted home fall-hazard interventions—particularly for older adults at higher risk and when interventions are delivered by occupational therapists.
Author Disclosure
This article was developed by Sue Doyle, PhD MSc (PP) BOccThy OTR/L, with limited assistance from generative artificial intelligence for research organization and editorial drafting. The author selected and reviewed the cited literature, independently evaluated the accuracy and applicability of the content, provided the professional and clinical interpretation, and completed all substantive revisions. Sue Doyle, OTR/L, is the responsible author and accepts full responsibility for the article’s accuracy, integrity, originality, and final published form.
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