Preventing Falls and Accidents for Older People at Home

Daily-life support skills（生活支援技術）· Material

転倒予防と住環境の安全 · Updated 26 October 2026

Falls （転倒） are one of the leading causes of older people coming to need care, and most falls happen in their own homes. The 生活支援技術 field stresses prevention: recognising risk factors, preparing the living environment （住環境整備）, and building habits of vigilance through near-miss reports （ヒヤリハット）.

Why falls are dangerous

The most feared direct result of a fall is a fracture, especially of the femoral neck, which can keep an older person in bed for a long time and lower their overall functioning. Head injuries also carry a risk of bleeding inside the skull whose symptoms appear later.

The indirect result is just as important: fear of falling again （転倒への恐怖感） makes older people reduce their activity, muscles weaken, and the risk of the next fall actually rises. This chain of declining function must be broken with gradual support.

• Direct results: fractures and head injuries
• Knock-on effect: fear of moving → declining function → falls again more easily
• Most falls happen at home

Risk factors: from the body and from the environment

Factors from within the body （内的要因） include weak leg muscles, balance problems, declining vision, drug side effects (such as sedatives and blood-pressure medication), and a drop in blood pressure on standing （起立性低血圧）.

Environmental factors （外的要因） include floor level differences and thresholds （段差）, slippery floors, rugs and mats that slide easily, cables across walkways, poor lighting, and objects scattered in walking paths. Risk assessment always combines both sets of factors.

• 内的要因： weak muscles, medication, 起立性低血圧
• 外的要因： 段差， slippery floors, cables, poor lighting
• Both are always assessed together

Arranging a safe home environment

Handrails （手すり） are installed on stairs, in corridors, in the toilet, and around the bath. Thresholds and floor level differences are reduced or fitted with a slope （スロープ）, and footwear and mats are chosen to be non-slip and not easily moved.

Lighting is made bright enough, including a night light from the bedroom to the toilet; walking paths are cleared of objects; and frequently used items are placed between waist and eye height so there is no need to bend down or stretch up. Every near-miss is recorded and shared through ヒヤリハット so it does not recur as a real accident.

• 手すり on stairs, in the toilet, and in the bathroom
• Reduce 段差， provide night lighting
• ヒヤリハット： record and share near-misses

Accidents when bathing and eating

When bathing, a sudden temperature change from a cold changing room to hot water can shift blood pressure sharply （ヒートショック） and trigger fainting or a heart attack. Warm the changing room and bathroom first, do not make the water too hot, and do not leave the person bathing entirely alone without periodic checks.

When eating, the main risk is choking and aspiration （誤嚥） — food or drink entering the airway. Keep an upright sitting position, cut food to match swallowing ability, watch the eating pace, and maintain oral hygiene to prevent aspiration pneumonia （誤嚥性肺炎）.

• ヒートショック： danger from sudden temperature change when bathing
• 誤嚥： food/drink entering the airway
• Sit upright when eating, keep the mouth clean

Key terms

Frequently tested points

• Fall risk factors always have two sides: 内的要因 (body) and 外的要因 (environment).
• ヒートショック is prevented by warming the changing room and bathroom before bathing.
• ヒヤリハット are reported and shared, not hidden — the aim is to prevent real accidents.
• After a fall, be alert to head injuries whose symptoms appear later.

Independent study material for the Japanese national Certified Care Worker exam (介護福祉士国家試験). Official terms and rules may change — always cross-check with the latest official sources.