Making an older parent's home safer

1. 1

   Contact adult social services at the council

   Free, any income

   Ask for a home assessment, sometimes called a care needs assessment. In many areas you can refer yourself, by phone or online, without waiting for a GP appointment first.
2. 2

   An occupational therapist visits

   Waiting times vary by council

   They watch how your parent moves around the house and ask about the tasks that have become hard, then recommend the equipment and changes that would help, in the order that matters most.
3. 3

   Small items are loaned or fitted free

   Whatever the income

   Grab rails, a raised toilet seat and similar small adaptations recommended by the OT are provided at no cost if they cost under £1,000, regardless of your parent's savings.
4. 4

   Bigger work goes through a grant

   Means-tested

   A wet room, a stairlift or widening a doorway usually costs more than that and is instead covered by a Disabled Facilities Grant, covered under what is free and what is funded below.

A district nurse or GP can also arrange this if that is the route already open to your parent, for example after a hospital discharge, but it is worth knowing you do not have to wait for one. If the wider worry is trip hazards specifically, from loose rugs to poor lighting on the stairs, reducing fall and trip risks in the home has a full room-by-room walk-through to do either before this assessment or alongside it.

Winter adds its own risks on top of all this: a cold home, a bad flu, dehydration that is easy to miss without a hot day to notice it. Surviving winter covers keeping an older relative warm, well and safe through the coldest months, including the signs of hypothermia and what help is available with heating costs.

The right equipment to aid the elderly goes room by room through what an occupational therapist typically arranges, what you can safely buy yourself without waiting for anyone and how the separate NHS wheelchair service works.

Why the bathroom is worth tackling earlySection titled Why%20the%20bathroom%20is%20worth%20tackling%20early

Water on a hard floor, a high bath edge and very little to hold onto make the bathroom a room where falls are a particular worry. Two moments stand out: stepping over the edge of the bath or shower tray, and standing on a wet surface. A wall-fixed grab rail beside the bath or shower and a non-slip mat inside it cover both, and a raised toilet seat with a rail beside it makes standing up far less of an effort. These are small adaptations, usually fitted free once an occupational therapist has assessed the room, and bathroom aids for the elderly covers each of them, including how a rail should be fixed so it holds.

If getting over the edge of the bath has become the main obstacle to washing safely, there is a ladder of options before any building work. A bath board or a powered bath lift keeps the bath your parent already has. Above that sit a walk-in bath and a level-access shower, which are building work rather than a simple fitting and are worth planning alongside any other bathroom changes. Walk-in baths for the elderly sets out what to check before buying one privately, including the running costs and the questions worth asking a supplier.

None of these guides recommend a brand or a supplier. They set out the features that matter for different needs, the published price ranges where reliable ones exist, and where to find independent views on particular makes.

For opinions on particular makes, go to the organisations that test equipment independently rather than to a supplier's own reviews. Which? tests and reviews some of this equipment, including stairlifts. The Research Institute for Disabled Consumers carries out independent research with disabled and older people. Living Made Easy, run by the Disabled Living Foundation, lists equipment by type with impartial guidance on what to look for. The British Healthcare Trades Association sets a code of practice for its members, so it is worth asking a supplier whether they belong and checking on the BHTA site. Citizens Advice explains cancellation rights in plain terms if a sale has already gone ahead.

Care & Repair England is a national charity that helps people find a local handyperson or Home Improvement Agency scheme, which is worth knowing about even where it does not operate directly. Keeping their home secure covers door security and doorbell cameras, including what to look for so a key safe or alarm is not simply an easier way in for the wrong person.

1. 1Changes you make yourselfFreeArranged by: You, this weekMoving everyday items to a reachable shelfTaking up loose rugsTucking away cablesA lamp within reach of the bed
2. 2Equipment loaned after an assessmentFree, whatever their incomeArranged by: An occupational therapistA raised toilet seatA wall-fixed grab railA walking frameA profiling bed
3. 3Minor building adaptationsFree if the job costs under £1,000Arranged by: The council, once an OT recommends itA second stair railA door threshold rampOutdoor step repairsA garden handrail
4. 4Major adaptationsUp to £30,000, means-testedArranged by: A Disabled Facilities GrantA level-access shower or wet roomA stairliftA ground-floor extensionWidening a doorway

A Disabled Facilities Grant in England is worth up to £30,000 and is means-tested against your parent's household income and any savings over £6,000, so what they receive can be less than the maximum. The council has to be satisfied the work is necessary for your parent's needs and reasonable for the property before approving it, and work should not start before that approval is given or the grant can be lost. GOV.UK says the council must give a decision within 6 months, and the work should be finished within 12 months of approval. The Disabled Facilities Grant explains what it pays for, the means test and the amounts in Wales and Northern Ireland, and GOV.UK's Disabled Facilities Grants page has the current application details for England.

VAT relief on mobility aids and adaptationsSection titled VAT%20relief%20on%20mobility%20aids%20and%20adaptations

Two separate VAT reliefs can lower the price of equipment your parent pays for privately. The supplier applies both on the invoice; there is no claim to HMRC.

• The zero rate for disability. Someone with a chronic illness or disability pays 0% VAT instead of 20% on equipment designed for disabled people and on some building work, such as building a ramp, widening a doorway or adapting a bathroom, when it is for their own personal use. They, or someone on their behalf, sign a short declaration for the supplier.
• The reduced rate for people over 60. Someone aged 60 or over who does not qualify for the zero rate pays 5% VAT on the supply and installation in their own home of grab rails, ramps, stairlifts, bath lifts, built-in shower seats and walk-in baths with sealable doors. It applies only when the item is installed, not when it is simply bought, and not to later repairs or replacements.

GOV.UK sets out the over-60 rate and the declaration wording, and HMRC's VAT Notice 701/7 has the full rules for both reliefs. VAT relief on mobility aids goes through which items qualify, and the council tax reductions, Pension Credit and other help worth claiming is worth reading before anything is ordered. Local authority funding explains how the wider council assessment and funding process works if money for ongoing care, not only equipment, is also part of the conversation.

Visits can also fill the gap while you wait for an adaptation. A council decision on a Disabled Facilities Grant can take up to six months, and a stairlift or a level-access shower is not fitted overnight even when you pay privately. A carer who comes in at the time your parent washes can be there for the moments that carry the risk: getting in and out of the bath, standing on a wet floor, drying and dressing. Bathing and toileting an elderly parent covers how that help works and how to talk about it.

A regular companionship visit does something no piece of equipment can. A carer who comes every week will notice a rug that has crept back, a grab rail that has worked loose, a walking frame left in the hall or a bath lift with a flat battery, and can tell you about it. On PrimeCarers you choose the carer yourself from their profile, and every carer has had an ID check, a right to work check, an enhanced DBS check (or PVG in Scotland, Access NI in Northern Ireland) issued within the last 2 years, and an online interview. We do not check qualifications, training or references, so ask the carer about their experience with the equipment your parent uses.

If a hospital stay is what has brought this on, what to do when the person you care for is leaving hospital covers the days that matter most around a discharge, and hourly care after a hospital stay covers visits in the weeks after discharge. Hourly care explains what a daily visit looks like in practice, and companionship care covers visits built around company rather than personal care.