What Is a Home Fall Risk Assessment?

According to the Centers for Disease Control and Prevention (CDC), 36 million Americans age 65 and older experience a fall each year. And many of those falls can have serious long-term effects. Of those who fall, 1 in 5 experience broken bones or head injuries that can land them in the hospital.

To avoid pain, suffering, and hospital bills down the line, it’s wise to take precautions now. Home fixes that lessen your chance of falling make your home a safer place to age. Even if you’re steady on your feet, making your space as safe as possible is key to staying healthy and independent.

Below, we’ll describe how a home risk assessment can help you prepare to age in place.

In what cases is a home risk assessment necessary?

Friends and family may be urging you to have a home risk assessment because they’ve seen the statistics on falling. Or maybe your doctor wants you to have one because of particular concerns about your health.

Each year, 1 in 4 older adults will experience a fall. Half of these falls take place at home.

The CDC says such mishaps can result from:

• Physical changes that may come with aging, such as vision loss or mobility problems

• Medications that increase fall risk, such as zolpidem (Ambien) or insulin

• Trip-and-fall hazards inside and outside your home

A 2021 study from the Washington University School of Medicine in St. Louis suggested that simple home modifications could reduce the rate of falls among older people by 40%.

What are the benefits of a home risk assessment?

The information you get from a home safety and fall-risk review helps you make your home safer for aging in place. You can:

• Understand personal risk factors that could cause you to take a tumble

• Identify hazards, so you can fix them

• Prioritize and budget for home modifications, so you can spend wisely

• Create peace of mind for yourself and your family

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You can informally review your space using the CDC’s home fall prevention checklist. But having a risk expert look around your home with fresh eyes can also be helpful. Some fall hazards are obvious, while others aren’t, explained occupational therapist Brittany Ferri, Ph.D, OTR/L, CPRP, in an email.

Ferri noted common safety hazards such as poor lighting, unstable stairs, and exposed wires. In addition, she said, some risk factors are specific to you. These might include medication side effects, muscle weakness, or balance issues.

How does a home risk assessment work?

Consult a professional to get a robust review. There are two approaches:

1. A home fall risk assessment (HFRA) ordered by your healthcare provider. This evaluation centers on you, looking at fall risks posed by your health as well as your home environment.

2. An aging-in-place assessment (AIPA) that you can request yourself. Also known as a home safety assessment, this process spotlights ways to make your home safe for anyone who’s aging in place there. It doesn’t typically focus on your health or personal habits.

Each one lasts between 45 minutes and an hour.

What to expect during a home fall risk assessment

Doctors order this evaluation when they’re concerned that your physical condition or a particular medical issue could make you more likely to fall. The HFRA includes:

• An objective look at slip, trip, and fall risks throughout your home

• An assessment of your physical abilities and how you function within the space

• Recommendations of furnishings and equipment to make household tasks easier for you

• Demonstrations of risk-reduction practices for daily living and exercises to improve strength and balance

What to expect during an aging-in-place assessment

When you request an AIPA or home safety assessment, you get:

• A review of common improvements and renovations, plus input on decluttering and furniture placement

• Guidance on safety equipment, such as smoke and carbon monoxide detectors and fire extinguishers

• Product recommendations and referrals to designers and contractors who specialize in risk-reduction projects

What happens after a home risk assessment?

Regardless of which kind of assessment you get, you should come away knowing how to increase your overall day-to-day safety. The assessor will create a plan for home improvements that would reduce or remove risks and refer you to contractors who specialize in such projects.

You’re also likely to be more aware of your balance, mobility, and pain levels. The specialist may recommend a medical exam to further evaluate your personal fall risk.

The CAPS or healthcare professional may schedule a follow-up visit. They will check your progress, troubleshoot, and make additional recommendations as needed.

If you’re willing to consider renovation, the contractor can provide an estimate for the recommended work. You review the estimates to prioritize and create a budget, maybe with the help of a banker or CPA. If you’re concerned about the cost of risk-reducing home improvements, local nonprofits may be able to help. You can also ask the assessment experts about nonprofits that help do the work or help pay for it.

How do I sign up for an in-home risk assessment?

For a home fall risk assessment, talk to your doctor or home healthcare provider. For an aging-in-place home safety assessment, contact your Area Agency on Aging. If you want to work with a CAPS, you can find a directory at the National Association of Home Builders website.

What is the cost of an in-home fall risk assessment?

The price of an in-home assessment depends on who does the review. Professionals charge clients in various ways.

There are some services you may be able to get at no charge, such as:

• Aging-in-place assessments by local government agencies

• Recommendations and estimates from home-building contractors

For others, you’ll likely pay a fee. Always ask what services are included for the cost.

Some aging-in-place specialists charge from the beginning. Others offer a free consultation and then charge for ongoing services. That may include the actual recommendations and referrals.

There’s usually a fee for the professionals who do fall risk assessments ordered by your doctor. Prices depend on where you live. Ferri, based in upstate New York, says that the cost of an assessment there ranges from $150 to $200. Your insurance may cover some of these costs (see below).

Even if you have to pay for the assessment, it’s likely to cost far less than the medical bills for any fall-related injuries. One study found that each dollar invested in a community-based fall-prevention program saved roughly $2 on medical care.

Does my homeowners or medical insurance cover the cost of a home risk assessment?

Your homeowners insurance doesn’t cover these assessments or renovations. And creating a safer home doesn’t usually qualify you for premium discounts. Check with your insurance agent to make sure.

If you have medical insurance, though, you may be able to recoup at least some of the assessment cost.

Many Medicare plans cover 100% of the cost for therapy visits that are medically necessary. This includes in-home assessments by occupational or physical therapists. For the best chance of meeting this standard, ask your doctor to order the assessment.

Ferri cautions that your healthcare provider may recommend more frequent visits or services that Medicare won’t cover. In those cases, you may have to pay some or all of the costs.

Medicare Part B includes a yearly wellness visit for people who’ve had Medicare coverage for 12 months or more. Fall risk identification and recommendations are part of the review.

If you have private health insurance, you may be able to have an occupational or physical therapist do your home assessment for the cost of a copay (usually between $20 and $50). Contact your insurer to ask about the details of your policy.

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Written by:

Margot Lester

Margot Lester began her journalism career as a teenager, reporting news from the high school for her local paper. In the course of her 38-year career, she has written for national magazines, big-city newspapers, business journals, and trusted websites.

Edited by:

Caren Weiner, MSIS

Caren Weiner, MSIS, began her personal finance journalism career in 1986. She worked as a reporter for Money magazine and co-wrote its book-length “Guide to the 1986 Tax Reform Act.” From the beginning, she immersed herself in data on mutual fund total returns and marginal tax rates.

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