When living with ALS, remaining independent while trying to stay safe can be an ongoing challenge. As the disease progresses, it is important to reevaluate your home safety situation and make adjustments as needed so you can continue to stay safe in your home, enter and exit on your own, and call for help when needed.

​The physical and occupational therapists at your ALS Clinic, outpatient physical or occupational therapy, or home health agency can help you find ways to be safe and maintain your independence.

Home Safety Evaluation

If you’re noticing changes in your mobility and are starting to feel unsafe in your home, schedule an appointment with your neurologist or primary care provider and ask about arranging a visit by a physical or occupational therapist from a home health agency. You can also request a home visit from an ALS United Greater Chicago Care Services Coordinator.

​You can also share photos, videos, and measurements as needed with your physical and/or occupational therapist.

​Once professionals are able to see and assess the safety and accessibility of your home, they can make recommendations such as using assistive devices, installing ramps, and making other home modifications. Their assessment can help you address current challenges and anticipate future needs.

Getting In and Out of Your Home

Whatever your current mobility status, you must have a way to safely enter and exit your home. Your physical therapist can help you determine the best solution for your home.

If you need help navigating a small step or threshold, a relatively inexpensive portable ramp or threshold ramp may be all that you need. 

If you have multiple steps outside your home, you may need to install a longer custom ramp to help you enter and exit. 

If you have multiple steps and not enough room for a long ramp, a motorized vertical platform lift may be a good option for you. 

Ramps and platform lifts are not covered by insurance, but you can ask your ALS United Greater Chicago Care Services Coordinator if you can borrow what you need from their equipment loan closet. If borrowing is not an option, ask if they have suggestions for getting financial or material assistance from charitable organizations in your community. Consult with a professional before purchasing, installing, or building ramps for your home. Depending on your state, you may not need to pay sales tax if your doctor provides a prescription for the ramp or lift. ​

Adaptive Housing Grants for Military Veterans If you are a U.S. military veteran who qualifies for service-connected benefits, you will receive funding that you can use to modify and adapt your home to make it more accessible.

Developing a Safety Alert System

In the event of a fall or medical emergency, it is important to have a way to contact people who can help. Modern technology offers a variety of options.

​Keeping your phone on you at all times is one way to have the ability to ask for help, whether by dialing or using a voice-activated assistant. Smart watches can offer similar capabilities and may even be able to detect a fall and automatically notify others.

Placing voice-activated smart speakers with digital assistants like the Google Assistant or Amazon’s Alexa in rooms where you spend your time is another option. If you use a speech-generating device, there are built-in features as well as apps that you can download that can help you alert others if you need assistance.

​If you have a medical emergency, you will need a way to call 911. Not all voice-activated assistants on your smart devices can call 911. You may want to consider getting a medical alert system that can either dial 911 or an emergency response center.

​Medical alert systems generally fall into two categories: monitored and unmonitored.

An unmonitored medical alert system is not connected to a central response center and will call numbers that are programmed into the system. It generally relies on landlines and does not require additional costs after your initial purchase. You can program your unmonitored system to automatically call 911 or dial your emergency contacts. 

A monitored medical alert system will call an agent who can quickly assess your situation and call 911 or your emergency contacts if necessary. Monitored systems offer more features but do incur a monthly charge.

Methods for accessing medical alert systems include pressing a button on a necklace or bracelet and using voice activation. Your physical and occupational therapists can work with your speech language pathologist to determine the most appropriate device and access method for you.

Once you have your system in place, develop a list of family, friends, and neighbors who will be able to respond, and program their numbers as favorites into your devices.

Keep in mind that your local fire department can also be very helpful. If you fall, are not injured, and just need help getting up, you can call their non-emergency number to request a lift assist and they will come to your home without lights and sirens. Lift assists are a common part of a firefighter’s job, so do not hesitate to ask for help when you need it.

It is also a good idea to inform your local fire department of your diagnosis and provide your number so they can respond if they receive a call from you. This is especially helpful if you are unable to speak. In many instances, you can let them know ahead of time that there is someone in the household who is unable to speak. This way, if they receive a call from your number, they will treat it as a real emergency.

Preventing Falls

It is important to make modifications that will minimize your risk of falling, as falls can lead to injuries. Most falls happen in the home, so identifying potential hazards, problematic areas, and risky activities can help reduce your chances of getting injured.

You can begin by just looking around your space or following the recommendations from your home safety evaluation, such as clearing clutter, removing trip hazards like throw rugs, and installing grab bars.

​​If you have stairs, it is important to have railings that extend from the top of your stairs to the bottom. You can add an extra grab bar at the top or bottom as needed, or perhaps a second rail to have one on both sides. If you have small steps or raised thresholds inside your home, consider installing grab bars and/or threshold ramps as needed.

​If you find that you are tripping, or if you or your loved ones have any concerns that your walking is unsteady, meet with your physical therapist to discuss mobility support options like ankle foot orthoses (AFOs) or walking aids. Having the right mobility device for your current needs is an important part of fall prevention.

Making Safe Transfers Falls can also occur when transferring between your bed, toilet, wheelchair, recliner, and other locations. Learn about safe transfer techniques and assistive devices on our Transferring page.

Here are some other general tips that can help minimize falls around the home:

• Wear supportive, non-slippery shoes or slippers.
• Avoid walking barefoot or in socks when possible.
• If you have an AFO, wear it inside as much as possible.
• Try to avoid rushing and multitasking when you’re standing or walking.
• Try to avoid carrying things while walking, especially on stairs.
• Instead of stepping up on a stool to reach for things, place frequently used objects at a more accessible height.
• Make sure you always have adequate lighting to see where you’re going.
• If you drop something on the floor, try to avoid bending over while standing to pick it up. Instead, either use a reacher, sit down to pick it up, or ask someone else to get it for you.​

If you feel that your needs are changing and your current strategies and devices are no longer keeping you safe, reach back out to your physical and/or occupational therapist to restrategize. Safety must always be the number one priority.

Bathroom Safety

Bathrooms are often the trickiest room to navigate—and they are also where falls and injuries can and do happen. In addition to following recommendations from your home safety evaluation, work with your physical and/or occupational therapist to create a safe bathroom environment for you.

Common bathroom safety recommendations include:

• Removing trip hazards like loose bath mats
• Adding non-skid mats to your tub or shower
• Installing grab bars in and around your shower and near your toilet
• Sitting on a shower chair or transfer bench while bathing
• Using assistive devices to help you get safely on and off the toilet

For more information on safety strategies and assistive devices for the bathroom, visit our Bathing and Toileting pages.

Making Your Home Accessible Creating a safe home environment is one part of making your home more accessible. There are a number of other devices, adjustments, and modifications that can help you remain more independent in your home. Learn more on our Home Accessibility page.