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Falls, and making the home safe

A fall is one of the common reasons a person can no longer stay home. The numbers are large and the fixes are mostly boring: exercise, a look at the medicine list, an eye exam, and some work on the house.

The numbers

  • More than one in four adults 65 and older falls each year, and fewer than half of them tell a doctor.[1]
  • The CDC counts about 4.5 million emergency room visits a year for falls among older adults. 3.1 million are treated and sent home, and 1.4 million are admitted to the hospital.[1]
  • Nearly 319,000 older people go into the hospital with a broken hip each year. Falls caused 88% of the emergency visits and hospital stays for broken hips.[1]
  • About 37% of people who fall report an injury that needed treatment or limited what they could do for at least a day.[1]
  • One study followed 1,103 people over 71 who lived at home in the 1990s. Those who went into the hospital for a serious fall injury were about ten times more likely to be admitted to a nursing home afterward. That is a link found in one group of people thirty years ago. It is not a rule about any one person.[8]

What has been shown to work

Exercise is the clearest finding. A major review by a group called Cochrane combined 81 studies with 19,684 people living at home. It found exercise cut the rate of falls by 23%, and rated that evidence as very strong. The same review found 15% fewer people fell at least once.[2] The exercise that was studied works on balance and strength, and includes tai chi. Many Area Agencies on Aging offer free classes that have been tested, such as A Matter of Balance and Tai Ji Quan.

The US Preventive Services Task Force is a national panel of experts. It recommends exercise programs for adults 65 and older living at home who are at higher risk of falling (Grade B, 2024). Broader programs combine a check-up with some mix of a medicine review, eye care, work on walking, and fixing hazards at home. For those, the Task Force says doctors should decide case by case and not offer them to everyone (Grade C).[3] That is worth knowing before someone tells you a package deal is proven.

So here are things to bring up with a doctor. None of them is sure to prevent a fall:

  • A look at the medicines. Ask the doctor or pharmacist to look for drugs that cause dizziness or sleepiness.
  • An eye exam. NIA suggests a full exam with eye drops every one to two years from age 60, and keeping glasses up to date.
  • A look at the house: grab bars at the toilet and shower, handrails on both sides of the stairs, brighter bulbs and night lights, no throw rugs or clutter, non-slip mats. A doctor can order a home visit from an occupational therapist, who will walk through and turn this into a list.

Our Elder Care Essentials page lists the usual gear for each situation.

What the bigger changes cost

These are price ranges from national contractor price guides published in 2025–2026. They are not quotes and not a survey. Grab bars, installed: about $100–$500 each. A taller toilet: $400–$1,000. Changing a tub to a walk-in or roll-in shower: $2,000–$7,500. A stair lift on a straight staircase: $2,000–$8,500; on a curved one, $7,500–$15,000. A wheelchair ramp: about $55–$275 per foot, usually $1,100–$3,600 in all. Widening a doorway: $700–$2,500. Prices differ by region. Get more than one bid.

Who helps pay

  • Original Medicare covers medical equipment, but changes built into the home are not on its list.[4] Some Medicare Advantage plans add a bathroom-safety benefit, though fewer do each year. KFF, a health research group, found that 21% of people in individual plans could get one in 2026, down from 32% in 2025. 10% could get in-home support services, and 0.04% could get building changes to the home.[5] Read the plan's own coverage document, not a summary.
  • Medicaid waivers for care at home (home- and community-based services waivers) can pay for changes that make a home easier to use, such as ramps, grab bars and bathroom work. These are 1915(c) waivers. That means your state sets the services, the care-level test and the limit on how many people can sign up. A waiver covering something does not mean a given person gets it.[6]
  • Veterans: the VA's HISA grant pays for home improvements that are medically needed. It is a once-in-a-lifetime amount. It is $6,800 for a disability tied to military service. It is also $6,800 for a disability not tied to service, if the veteran has a service-connected rating of 50% or higher. Otherwise it is $2,000.[7] Larger grants, called SAH and SHA, exist for some service-connected disabilities. Ask the local VA Prosthetic and Sensory Aids Service what you can really get.
  • Rural homeowners 62 and older: the USDA Section 504 program offers repair loans of up to $40,000 at a fixed 1% rate. It also offers grants of up to $10,000, a lifetime limit, for owners with very low incomes. Grant money must be spent on removing health and safety hazards. A grant must be paid back if the home is sold within three years.[9]
  • Local programs: many Area Agencies on Aging, and groups like Rebuilding Together, pay for small safety repairs. Ask your Area Agency on Aging what exists in your county.

What only the program can tell you

Does a program exist where you live? Does your person qualify? The agency that runs it decides. We cannot tell you that part. Here is who has the answer and what to ask.

Who to ask: your Area Agency on Aging (1-800-677-1116); for veterans, a Veterans Service Officer; for Medicaid waivers, your state Medicaid office.

What to ask them:

  • Does our county have a program for home changes or small repairs for older adults?
  • Does the state's Medicaid waiver cover changes to the home? Who checks the home? Is there a waiting list?
  • Can a doctor order a home-safety visit from an occupational therapist? Will insurance cover it?
  • For a veteran: do we qualify for the HISA grant? What is our lifetime amount? What paperwork starts it?

Free local help. Your Area Agency on Aging will talk through your choices with you for free. Find yours through the federal Eldercare Locator at 1-800-677-1116 or eldercare.acl.gov (run by the Administration for Community Living).[10] To learn about the four kinds of local helpers and what each one does, see Who helps me locally.

Quick answers

How much does it cost to make a home safe for aging in place?

Small fixes are cheap. Grab bars cost about $100–$500 each with installation, and better lighting costs very little. National contractor price guides for 2025–2026 put changing a tub to a walk-in shower at about $2,000–$7,500, a straight stair lift at $2,000–$8,500, and a wheelchair ramp at about $1,100–$3,600. Those are rough market prices, not quotes. Programs that may help pay include state Medicaid waivers, the VA's HISA grant ($6,800 or $2,000 over a lifetime, depending on the disability), and USDA Section 504 grants of up to $10,000 for rural homeowners age 62 and older with very low incomes. [5, 6, 7]

Does Medicare pay for grab bars or a stair lift?

Original Medicare covers medical equipment, but changes built into the home are not on its list. Medicare Advantage plans sometimes add a bathroom-safety benefit, but fewer do than before. KFF, a health research group, found that 21% of people in individual plans could get one in 2026, down from 32% in 2025. Only 0.04% had a benefit for building changes to the home. Check the plan's own coverage document. [3, 4]

What actually prevents falls in older adults?

The strongest finding is exercise. A major review by a group called Cochrane looked at 81 studies with 19,684 people living at home. It found exercise cut the rate of falls by 23%, and rated that evidence as very strong. The US Preventive Services Task Force, a national panel of experts, recommends exercise for adults 65 and older living at home who are at higher risk of falling (Grade B, 2024). For broader programs that combine several steps — a look at medicines, eye care, fixing hazards at home — the Task Force says to decide case by case, not to offer them to everyone. [1, 2]

Sources and what they support

Sources checked 2026-09-19 using AI-assisted editorial research. This is a source check, not a clinical review.

  1. CDC, Older adult falls data. Supports the one-in-four figure, the 4.5 million emergency-department visits and the 3.1 million / 1.4 million split, the 319,000 hip-fracture hospitalizations, the 88% of hip-fracture visits caused by falls, and that fewer than half of fallers tell a doctor. These are national estimates drawn from survey and administrative data of differing years, not a forecast for one household.
  2. Cochrane review, exercise for preventing falls in older people living in the community. Supports the 23% reduction in fall rate and 15% reduction in people falling, from 81 trials and 19,684 participants, rated high certainty. Participants were community-dwelling and enrolled in supervised programs; it does not establish that any particular class or home routine will produce the same effect.
  3. US Preventive Services Task Force, falls prevention in community-dwelling older adults (2024). Supports the Grade B exercise recommendation for adults 65+ at increased risk, and the Grade C individualized position on multifactorial interventions. It applies to community-dwelling adults at increased risk, does not cover people in nursing facilities, and the 2024 statement does not address vitamin D.
  4. Medicare, durable medical equipment coverage. Supports what Medicare covers as equipment. The page lists covered categories rather than enumerating exclusions, so treat "not covered" as the absence of home modifications from that list and confirm with the plan before buying.
  5. KFF, Medicare Advantage in 2026: supplemental benefits. Supports 21% bathroom-safety access in 2026 against 32% in 2025, 10% in-home support services and 0.04% structural home modifications. These are shares of individual-plan enrollees with access to a benefit; scope, cost-sharing and annual limits differ by plan.
  6. CMS, 1915(c) home- and community-based services waivers. Supports the institutional level-of-care test, target groups, enrollment caps and the range of services a state may cover. It does not guarantee access to any particular service, and environmental adaptations are a state option rather than a federal entitlement.
  7. VA, Home Improvements and Structural Alterations (HISA) grant. Supports the $6,800 and $2,000 lifetime amounts and the 50%-rating condition. Projects must be medically justified, and the amount available to an individual veteran depends on their own circumstances.
  8. Tinetti ME, Williams CS, New England Journal of Medicine, 1997 — PubMed 9345078. Supports the roughly tenfold adjusted relative risk of nursing-home admission after hospitalization for a serious fall injury, in a prospective cohort of 1,103 community-dwelling people over 71. An association, not proof a fall causes placement. The abstract could not be re-opened in this pass, so it is cited from the indexed record; an earlier draft of this site cited the wrong identifier for it.
  9. USDA, Single Family Housing Repair Loans and Grants (Section 504). Supports the $40,000 loan at 1%, the $10,000 lifetime grant, the age-62 and very-low-income conditions, the health-and-safety-hazard restriction on grant funds, and repayment if the property is sold within three years. Eligibility also requires a rural location and inability to obtain affordable credit elsewhere.
  10. Administration for Community Living, Eldercare Locator. Supports the referral route to a local Area Agency on Aging. Which services a given agency offers, and whether it has funding, varies locally.

The cost ranges under "What the bigger modifications cost" come from national contractor cost guides (Angi, HomeAdvisor, HomeGuide) published in 2025–2026. Those are commercial market estimates, were not re-verified in this pass, and are no substitute for local bids.

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