How to do a fall risk assessment at home for an aging parent
Your mother mentions she slipped in the bathroom, then changes the subject. Or you notice your father steadying himself on the furniture on the way to the kitchen. You want to know how worried to be, and his next appointment is not until spring. A fall risk assessment at home is a reasonable thing to do in the meantime, and it is less complicated than it sounds. The same screening a clinic runs takes about 20 minutes at a kitchen table, using a chair, a phone timer, and a walk through the house. Here is how to run it, and what to do with what you find.
What a fall risk assessment at home actually checks
Three things, in this order: what your parent already knows, what their body can do, and what the house is doing to them.
That order matters. Clinicians start with questions because the answers do most of the work, and only then move to timed tests. The CDC’s STEADI program, which packages the American and British Geriatrics Societies’ fall prevention guideline into something usable in a 15-minute visit, is built on exactly that sequence: screen, assess, intervene.
You are not diagnosing anything. You are collecting numbers a doctor can act on, and finding the hazards you can fix this weekend without anyone’s permission.
Step 1: Ask the three questions
Sit down with a cup of coffee and ask these, straight from the STEADI screening algorithm:
- Do you feel unsteady when standing or walking?
- Do you worry about falling?
- Have you fallen in the past year?
A yes to any one of them counts as at risk. If the answer to the third is yes, follow up: how many times, and were you hurt?
Expect some deflection. More than one out of four older adults falls each year, and less than half tell their doctor, which is the whole reason this conversation is worth having at a kitchen table instead of waiting for it to come up at an appointment.
Step 2: Run the three timed tests
You need a straight-backed chair without arms, a phone timer, and 10 feet of clear floor with a piece of tape marking the far end. Stand next to your parent for all three. Do not let them do these alone.
- The 30-second chair stand. Feet flat, arms crossed at the wrists against the chest. On “go,” stand fully, then sit, as many times as possible in 30 seconds. Count the stands. The CDC’s cutoffs are by age and sex: below 12 for a man aged 65–69, below 11 for a woman the same age, below 10 for a man aged 80–84, below nine for a woman. If they need their arms to stand, stop, and record zero. That result is itself the finding.
- The Timed Up and Go. Starting seated, on “go” they stand, walk to the tape at their normal pace, turn, walk back, and sit. Regular shoes, cane or walker if they use one. Twelve seconds or more indicates fall risk. Watch as much as you time: shuffling, short strides, little arm swing, or a hand out toward the wall all belong in your notes.
- The four-stage balance test. Four standing positions, 10 seconds each, no cane, eyes open: feet side by side, then the instep of one foot touching the big toe of the other, then a tandem stand with one heel directly in front of the other toe, then standing on one foot. Stop at the first position they cannot hold. Someone who cannot hold the tandem stand for 10 seconds is at increased risk of falling.
Write down the actual numbers, not your impression of them. Twelve chair stands in September and eight the following September is a trend, and a trend is what a doctor can use.
Step 3: Check the blood pressure and the medicine cabinet
This is the step most home checklists skip, and it is often where the fixable cause is hiding.
If you have a home cuff, measure your parent’s blood pressure lying down after five minutes of rest, then again at one minute and three minutes after standing. A drop of 20 mm Hg systolic or 10 mm Hg diastolic, or lightheadedness on standing, is considered abnormal and is worth a call to the prescriber.
Then photograph every bottle in the cabinet, prescription and over the counter. Sedatives, sleep aids, some antidepressants, and blood pressure medications all show up on fall risk reviews, and the pharmacist or doctor is the one to sort out which combination is doing what. Confusion about doses is its own signal here, and the early signs of medication confusion are worth reading alongside this.
Step 4: Walk the house
Now do a lap of the rooms with the CDC’s Check for Safety checklist. The highest-value fixes are dull and cheap:
- Stairs. Handrails on both sides, running the full length, tight to the wall. A working light and switch at the top and bottom. Nothing stored on the treads.
- Floors. Throw rugs gone or taped down. Cords coiled against the wall. A clear path through each room that does not require going around furniture.
- Bathroom. Grab bars anchored into studs by the toilet and inside the tub, not suction cups. Non-slip strips in the tub and a mat outside it.
- Bedroom. A lamp within reach of the bed, and a nightlight on the path to the bathroom.
- Kitchen. Daily items moved to waist height. A step stool with a handrail, and never a chair.
One more, easy to miss: shoes. Grippy shoes or slipper-socks with tread, indoors as well as out. Stocking feet and loose slippers cause a surprising share of indoor falls.
Step 5: Do something with the results
A page of numbers helps nobody sitting in a drawer.
Bring the chair stand count, the Timed Up and Go time, the balance result, and the standing blood pressure readings to the next appointment, or send them through the portal beforehand. Ask two specific questions: is a referral to physical therapy appropriate, and can we review the medication list for anything that raises fall risk.
Physical therapy is the ask worth pushing on. In 2024 the US Preventive Services Task Force recommended exercise interventions for adults 65 and older at increased fall risk, a B recommendation, with gait, balance, and functional training the most commonly studied components. Supervised sessions or a group class, in other words, rather than general advice to stay active.
Then repeat the whole thing yearly, and after anything that changes the picture: a hospital stay, a new prescription, a first fall. If your parent has already had one, the details belong on their one-page emergency information sheet too.
What Katika Care does about this
Numbers only tell you something when you can put this year’s next to last year’s. If you want a single place to keep all of this, the chair stand counts, the standing blood pressure readings, the date of the last screening, Katika Care does that. It’s free, no ads, no data resale, and works alongside Apple Health or Health Connect.
For more on the rest of this work, the aging parents hub collects everything we’ve written about helping a parent stay in their own home.
The short version
A fall risk assessment at home is three questions, three timed tests, a blood pressure check, and a lap of the house. Twenty minutes, once a year, and the result is a set of numbers your parent’s doctor can act on rather than a vague worry you carry around. If it turns up something, the next appointment is where it goes.
Start your free family health timeline and keep the whole picture in one place.
Frequently asked questions
How often should an older adult be screened for fall risk?
Yearly. The CDC's STEADI algorithm tells clinicians to screen adults 65 and older once a year, and any time someone comes in after a fall. At home, once a year is a reasonable rhythm too, with an extra check after anything that changes the picture: a hospital stay, a new medication, a new diagnosis, or a first fall. Put it on the calendar near a birthday so it does not quietly slip.
What is a normal Timed Up and Go score?
Under 12 seconds. The CDC's STEADI assessment says an older adult who takes 12 seconds or longer to stand from a chair, walk 10 feet, turn, walk back, and sit down is at risk for falling. The number matters less than the trend and what you see while timing: shuffling, short strides, no arm swing, or reaching for the wall are worth mentioning to the doctor even when the clock says 10 seconds.
Can I do a fall risk assessment at home without any equipment?
Almost. You need a straight-backed chair without arms, a stopwatch or phone timer, and 10 feet of clear floor with a piece of tape to mark the line. That is the whole kit. A home blood pressure cuff helps for the standing blood pressure check, but if you do not have one, ask the doctor's office to do that part instead.
Does Medicare cover a fall risk assessment?
Fall risk screening is part of the Medicare Annual Wellness Visit, which Original Medicare covers with no coinsurance when the provider accepts assignment. A home visit from an occupational or physical therapist to assess the house itself is different, generally requiring a doctor's order and meeting coverage rules. Ask the office directly what applies, and bring your at-home results, since they make the case faster.
What actually reduces falls once you know the risk?
Exercise has the strongest evidence. In 2024 the US Preventive Services Task Force gave exercise interventions a B recommendation for adults 65 and older at increased fall risk, with gait, balance, and functional training the most-studied components. That usually means supervised physical therapy or a group class, not a walk around the block. A medication review and fixing hazards at home are the other two levers worth pulling.
My parent gets defensive about this. What do I say?
Lead with what they want, which is almost always staying in their own home. Falls are the leading cause of injury death for adults 65 and older, and the fastest route out of the house is a hip fracture, so framing the check as protecting independence is both honest and easier to hear than a safety lecture. Asking to do the tests together, with you doing them first, tends to land better than asking to test them.