Consideration of your own safety and the client’s safety is an important aspect of providing care in someone’s home. Generally, HCAs are working more independently in home support, with access to supervisors via a phone. Sometimes a client’s care will require two HCAs. It is important to continuously observe and evaluate the environment to identify and address safety concerns. 

Below is a Sample Home Safety Evaluation Guide (Table 11.2.1). HCAs can use this guide to determine the safety of the home environment for the client, themselves, and others. Depending on agency policy, any concerns should be reported to the supervisor or appropriate person. It is important to remember that the HCA should leave the situation if they feel unsafe.

Managing the Environment

As the eyes and ears of the health care team, the Health Care Assistant plays a very important role in preventing client injuries. They will be the person spending the most time in the home and will become very knowledgeable about their client, their family, and any changes in their condition and within their environment.

The key for the Health Care Assistant in preventing injury with clients is to properly manage the environment, and to use all of their senses as they observe the client within their environment. By completing assigned household tasks within the home, they will be helping to keep the client’s home free from clutter, dirt, pests, and infection. By assisting their client with daily living tasks, such as bathing, they will help to maintain their well-being and general health. 

Where Household Injuries Commonly Occur

Two areas in the home, the kitchen and the bathroom, are the places where most household injuries occur (Leahy, Fuzy & Grafe, 2013). People tend to spend a lot of time in both of these areas in the home. They are also places where many dangers lie.

In the kitchen, using appliances improperly or near water could result in electrical injury. Other hazards in the kitchen include walking on a wet or greasy floor, improperly using knives, fire hazards while using the stove, and ingesting spoiled food or dangerous chemicals.

In the bathroom, potential hazards involve slipping on a wet floor or in the bathtub, using appliances such as hair dryers near water, unsafe use of razors or scissors, and the ingestion of medications and other potentially dangerous substances.

Health Care Assistants should take special precautions in the kitchen and bathroom to ensure that floors are dry, non-skid rugs and bath mats are used, handrails and grab bars are available, and sharp objects are put away when not in use. Cleaning solutions, chemicals, and medications should be kept in locked cabinets and out of reach of children and confused clients.

Factors Contributing to Injuries among Older Adults

As people age, they may experience physical, sensory, and cognitive changes that make them more likely to suffer an injury. Adults over the age of 65 are the most likely age group to fall (WHO, 2012). Older adults tend to have more physical diseases and take more medications. The more medications a person takes, the more they are at risk for potential medication interactions and side effects. Muscle weakness, injury, disability, coordination, or balance problems also put older adults at risk for falls. Health Care Assistants should teach clients to properly use ambulatory aids such as walkers and canes. Encourage clients to wear good non-skid footwear while ambulating.

Older adults who experience confusion, as a result of dementia or illness, may not be completely aware of their surroundings and may not be as cautious while moving about as they normally would. Sensory impairments, such as vision problems and hearing loss, also put older adults at risk for falls as they may not adequately see or hear what is going on in their surroundings. As we age, we also have a reduction in our ability to taste and smell. This makes us more likely to not smell smoke if there is a fire, or to eat food that is spoiled without being aware.

Emergencies and Injuries in the Home 

The home is a common place for many unintentional injuries. Unintentional injuries are injuries that happen accidentally and are not on purpose. In Canada, unintentional injuries are the leading cause of death among people between the ages of 1–34 years (Public Health Agency of Canada, 2021). The most common household injuries include falls and poisoning. We will discuss these these common injuries and several others, with a focus on how to prevent them.