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Advanced-Senior-Support---Home-Health-&-Mobile-Therapy-logo
Advanced Senior Support

614-891-7480

Locally owned & operated near Central College

Home Health & Mobile Therapy
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Westerville, OH

Safety Starts with Awareness

A fall risk self-check is a proactive way to look at your daily mobility and home environment with new eyes. For seniors living at home in Westerville, understanding these small factors can help prevent accidents before they happen, ensuring you stay independent and comfortable in the space you love.

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If you'd like guidance, you can fill out this form and submit it to our team - we're happy to walk through it with you. You can also download the PDF version to use on your own or share with family.

Fall Risk PDF

Take a Moment to Check In

We invite you and your family to answer a few simple questions about balance, home safety, and any recent falls. This check-in is designed to build awareness and help you decide on the next steps for maintaining independence at home in Westerville.

Fall Risk Self-Check

Recent Experiences
Have you had any slips, trips, or stumbles in the past 3 months?
No
Yes, once
Yes, more than once
Have you fallen in the past year?
No
Yes
Do you ever feel unsteady when walking or standing?
Never
Rarely
Sometimes
Often
Balance & Mobility
Do you use any mobility devices?
When you get up from a chair or bed, do you feel:
Steady
A little wobbly
Very unsteady
Can you walk across a room without holding onto furniture?
Yes
Sometimes
No
Only with mobility device assistance
Health & Medication
Have you had any changes in medications lately?
No
Yes
Do any of your current medications, or medications you recently stopped, make you feel dizzy, tired, or light-headed?
No
Sometimes
Often
Do you ever feel confused, forgetful, or unsure of your surroundings?
Never
Rarely
Sometimes
Often
Home Enviroment
Are walkways clear of clutter, loose rugs, and cords?
Yes
Mostly
Sometimes
No
Is lighting bright enough to see clearly, especially at night?
Yes
Mostly
Needs Improvement
No
Do you have grab bars or support in the bathroom?
Yes
No
Daily Routines
Do you rush when getting to the bathroom?
No
Rarely
Sometimes
Often
Do you feel tired or weak during the day causing you to need assistance or not being able to do things?
No
Rarely
Sometimes
Often
Do you feel safe and confident moving around your home?
Yes
Mostly
With assistance only
No

If you checked "Sometimes" or "Often" in several areas, you may benefit from small home adjustments or extra support. We're here to help you stay safe, steady, and confident at home. Please fill out your name and contact information below and someone from our team will contact you to discuss how we can support you.

We’re Here to Help You
Stay Safe

If you have any concerns about balance or home safety after completing your self-check, we invite you to reach out. Our team provides professional in-home safety assessments in Westerville and surrounding areas to help you identify next steps for staying independent at home.

Contact Us Now
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