If you are helping a parent stay in the home they love, a good first step is simple: walk through the house one room at a time and note what could cause a fall. This guide gives you that room-by-room checklist. It also goes further than most and shows you what to do with whatever the walk-through turns up: when to bring in a professional, how to pay for the fixes, and how to hire someone you can trust.
You can do the first pass yourself, with the person who lives there. More than 1 in 4 adults age 65 and older fall each year, over 14 million people, and less than half of those who fall tell their doctor about it (the Centers for Disease Control and Prevention (CDC), verified July 2026). A planned walk-through brings those quiet risks into the open before anyone gets hurt. This is a smart plan for independence, not a sign of decline.
Step 1: Assess, room by room#
Start at the front door and move through the home the way the person living there moves through it every day. Look for anything that could cause a slip, a trip, or a hard reach. Keep a notepad or your phone handy and mark each item as fine, needs a small fix, or needs a bigger project.
Entrances and steps
- Are outside steps even, with no cracks or loose boards?
- Is there a secure handrail on at least one side of any entry steps?
- Is the entry well lit at night?
- Is there a level, clear place to set down bags while unlocking the door?
Stairs and hallways
- Are there handrails on both sides of the stairs, running the full length?
- Is there a light switch at both the top and the bottom of the stairs?
- Are stair treads even, with no worn or slippery spots?
- Are hallways clear and bright enough to walk through at night?
Bathroom
- Are there grab bars by the toilet and inside the tub or shower? (Towel bars do not count; they are not built to hold weight.)
- Is there a non-slip surface in the tub or shower and a non-slip mat outside it?
- Is the toilet a comfortable height to sit down on and stand up from?
- Can the person get in and out of the tub or shower without stepping over a high wall?
Kitchen
- Are everyday dishes, food, and pans stored between hip and shoulder height, so there is no need to climb or bend low?
- Is the counter and stove area well lit?
- Is there a sturdy, stable step stool if higher shelves must be reached, and is a wobbly one thrown out?
Bedroom
- Is there a clear, unobstructed path from the bed to the bathroom?
- Is there a lamp or light switch within reach of the bed?
- Is there a night light along the route to the bathroom?
Floors throughout
- Are throw rugs removed or secured with non-slip backing?
- Are electrical and phone cords kept out of walking paths?
- Are floors kept clear of clutter, boxes, and pet items?
Whole home
- Do smoke and carbon monoxide detectors work, and are batteries fresh?
- Are emergency numbers posted by the phones the person actually uses?
- Is outdoor lighting working at all entrances and along walkways?
You do not have to build this list from scratch. Two free, printable checklists from federal health agencies cover the same ground and are worth keeping on the fridge. The CDC offers a checklist called "Check for Safety," part of its STEADI fall-prevention materials. The National Institute on Aging publishes a free home safety checklist worksheet you can print and fill in room by room. Both are external resources, and both are a fine companion to your own walk-through.
Step 2: When to bring in a professional#
A do-it-yourself walk-through is enough for many homes, especially when you are planning ahead and no one has had a health change. But some situations call for a trained eye. The professional here is an occupational therapist, or OT, a licensed clinician who evaluates how a person actually functions in their space and recommends specific changes.
Consider a professional home assessment when any of these is true:
- The person has had a fall, or a near fall.
- They are coming home after a hospital stay.
- They have a new diagnosis that affects balance, strength, sight, or memory.
- They have started using a walker or wheelchair.
- You are about to spend real money on modifications and want the plan right the first time.
An OT looks at the fit between the person and the home, not just the home alone. That is the difference between a checklist and an assessment. A professional home assessment typically ranges from $200 to $500. To understand what that visit includes and how it leads to a work plan, see our guides on OT home assessment cost and the OT-to-CAPS contractor workflow.
Step 3: Fund the fixes the checklist finds#
Once you know what needs to change, the next question is how to pay for it. There is more help available than most families expect. Start with the programs the person may already qualify for.
Veterans. If the person is a veteran, look first at HISA, the Home Improvements and Structural Alterations benefit. HISA is a U.S. Department of Veterans Affairs (VA) health benefit, not a housing grant, and it helps pay for changes like a roll-in shower or improvements that let you enter and exit the home. The lifetime benefit is $6,800 for a service-connected condition (or for a non-service-connected condition rated 50% or more), and $2,000 for other non-service-connected cases (verified July 2026). You apply with VA Form 10-0103 through the Prosthetics and Sensory Aids Service at your VA medical center, with a prescription from a VA provider. Our HISA grant guide walks through the paperwork. For larger housing grants and questions about which VA program fits, use the VA grant decision tree rather than guessing.
Medicare. Original Medicare does not cover structural changes to a home, so it will not pay to install grab bars or widen a doorway. Some Medicare Advantage (Part C) plans do cover items like grab bars as a supplemental benefit, but this is entirely plan-specific, so check the plan's own benefits. Medicare can, however, cover the occupational therapy itself in some cases. If the person qualifies for the home health benefit, covered home health services, including OT, are $0. Outpatient occupational therapy is covered at 20% of the Medicare-approved amount after the Part B deductible, which is $283 in 2026 (verified July 2026).
Medicaid. Many states help pay for home modifications through Medicaid home and community-based services (HCBS) waivers. What these waivers cover, and who qualifies, varies from state to state, so check with your state's Medicaid agency.
Area Agency on Aging. Every region has an Area Agency on Aging, or AAA, a local office that connects older adults to services, including help with home modifications and referrals. Reach the one near you through the Eldercare Locator at 1-800-677-1116 or eldercare.acl.gov, weekdays 8 a.m. to 9 p.m. ET.
Finding a provider who knows this program: Not every contractor has handled VA HISA paperwork or worked with an OT's plan. Adapta Home USA lets you filter for providers who carry the HISA Experienced and CAPS Certified (Certified Aging-in-Place Specialist) badges, so you can find professionals who have done this before. See verified providers who have handled these projects →
Step 4: Hire and verify#
Small fixes and big projects call for different help. A single grab bar, professionally installed, typically ranges from $150 to $350 per bar, the scale of a quick visit. A full bathroom conversion or a stairlift is a larger project. For those numbers, see our cost guides on accessible bathroom remodels, stairlifts, and wheelchair ramps.
For accessibility work, look for a contractor who holds the CAPS credential. The Certified Aging-in-Place Specialist designation comes from the National Association of Home Builders (NAHB) and requires three courses focused on modifying homes for aging in place. A CAPS contractor should also show proof of insurance before any work begins. Our guide to what a CAPS contractor is explains the credential in full, and if you are comparing designations, see CAPS vs CEAC vs UDCP credentials.
Before you sign anything, ask the right questions. Our list of questions to ask an aging-in-place contractor covers licensing, insurance, references, and how the work will be scheduled. This is also where a verified directory saves time. To see how we check the providers we list, read how Adapta verifies providers.
Frequently asked questions#
What is included in a home safety assessment?#
A home safety assessment is a room-by-room review of the places a fall or injury is most likely: entrances and steps, stairs and hallways, the bathroom, the kitchen, the bedroom, and the floors and lighting throughout. It checks for grab bars, handrails on both sides of stairs, non-slip surfaces, good lighting, clear walking paths, and working smoke and carbon monoxide detectors. A professional assessment adds a look at how the specific person moves through their own home.
Who performs home safety assessments for older adults?#
You and your family member can do a first pass yourselves using a checklist. For a clinical assessment, an occupational therapist (OT) is the trained professional who evaluates how a person functions in their home and recommends specific changes. Your local Area Agency on Aging, reachable through the Eldercare Locator at 1-800-677-1116, can also point you to local help.
How much does a professional home safety assessment cost?#
A professional home assessment by an occupational therapist typically ranges from $200 to $500. The cost depends on your area and how detailed the visit is. In some cases Medicare may cover the occupational therapy itself: covered home health OT is $0 when the person qualifies for the home health benefit, and outpatient OT is covered at 20% of the approved amount after the 2026 Part B deductible of $283.
Does Medicare pay for a home safety assessment?#
Original Medicare does not pay for structural home modifications like grab bars or ramps. It may cover the occupational therapy portion in some situations, either as part of the home health benefit at $0, or as outpatient therapy at 20% of the approved amount after the Part B deductible. Some Medicare Advantage plans cover items like grab bars as a supplemental benefit, but that is specific to each plan, so check the plan directly.
Can I do a home safety assessment myself?#
Yes. A do-it-yourself walk-through with a printable checklist is a solid first step, especially when you are planning ahead and no one has had a recent health change. Bring in an occupational therapist when there has been a fall, a hospital discharge, a new diagnosis, or new use of a walker or wheelchair, or before you spend significant money on modifications.
How often should you repeat a home safety checklist?#
A yearly walk-through is a reasonable rhythm for most homes. Repeat it sooner after any change in health, a fall, a hospital stay, or a new diagnosis, and again after any modifications are made, to confirm the fixes are working as planned.
Whatever your walk-through turns up, you do not have to sort it out alone. Adapta Home USA lists verified accessibility consultants and CAPS contractors who handle exactly this work. See verified accessibility specialists and CAPS contractors near you and filter for the experience your project needs.
This article is for general educational purposes only and does not constitute medical, legal, or financial advice. Consult a qualified professional about your specific situation.
Program amounts, eligibility rules, and application procedures change. Figures on this page were verified against official government sources on the date shown, but you should confirm current details at VA.gov or with the administering agency before making decisions. Adapta Home USA is not affiliated with the U.S. Department of Veterans Affairs or any government agency.