Home Safety for Large, Multi-Level and Hillside Homes

This article is general educational information, not medical advice.

Homes in Bel Air, Beverly Hills and the surrounding hills are often wonderful places to live: generous rooms, sweeping views, bedrooms on one level and the kitchen on another. Those same features can quietly become challenges when strength, balance, vision or stamina change. A home that was perfect at 50 may ask a lot of a person at 80, or of someone recovering from a stroke, a surgery or a long illness. Thoughtful planning can help a home keep working for the people who live in it.

Why larger homes call for a different kind of review

In a compact apartment, the distance between the bed and the bathroom is a few steps. In a large home it may be a long hallway, a turn, a step down, and a stretch of polished stone floor. Multiply that by every trip in a day and the demands add up, both in effort and in opportunities to lose balance. Fatigue matters too: a route that feels fine in the morning can feel very different late in the day.

An occupational therapist looks at the whole pattern of a person's day, not just one room. The questions are practical. Where do you spend most of your time? Which trips do you avoid? Where do you feel unsteady, rushed or tired?

Stairs and changes in level

Multi-level homes often have several sets of stairs, and some have open risers, curved staircases or a single step between rooms that is easy to miss. Areas a therapist commonly considers include:

• Handrails — whether they are present on both sides, continuous, and comfortable to grip along the full length of the staircase.
• Visibility of edges — good lighting at the top and bottom, and a clear way to see where each step begins and ends.
• Hidden single steps — sunken living rooms, thresholds and landings that are easy to overlook, especially in low light.
• Carrying and balance — habits like carrying laundry or a tray on the stairs, which take away the hand that should be on the rail.

Sometimes the best answer is changing the routine, such as keeping essentials on the level where the person spends the day, rather than changing the house.

Hillside and outdoor access

Steep driveways, garden paths, stone steps and long walks from the car to the front door are common in hillside properties. Wet leaves, uneven pavers and dim path lighting can all make a short walk riskier than it looks. A home visit allows the therapist to see how a person actually gets from the car to the door, and to talk through options such as clearer lighting, sturdier handholds, and a safer way to arrive and leave.

Bathrooms, bedrooms and everyday routes

Large homes often have large bathrooms with glass showers, freestanding tubs, and smooth tile that becomes slippery when wet. A therapist considers how a person gets in and out of the shower, whether there is something sturdy to hold, and whether a seat or other equipment would help. In the bedroom, the height of the bed, the path to the bathroom at night, and the lighting along the way all matter. Night-time trips are one of the situations worth planning for carefully, since low light and drowsiness make them more demanding.

For a room-by-room checklist you can use yourself, see our guide to preventing falls at home.

Planning for the long term

It helps to think a few steps ahead. Some families discuss whether a main-level bedroom would be useful, where equipment could be stored discreetly, and how caregivers or helpers will move through the house. The conversation is easier when it happens before a crisis rather than after one. You can read more about how this kind of planning works on our page for fall prevention and home safety, and about care for homeowners in Bel Air.

About Karina

Karina Fakheri holds a Master of Science in Occupational Therapy from Ithaca College and spent more than 15 years at Cedars-Sinai Medical Center, working in neurological rehabilitation. She has additional training in Neuro-IFRAH and neuro-vision retraining, and in John F. Barnes myofascial release. You can read more on the about page.

Questions people often ask

What makes large or hillside homes different for home safety?
Distance, stairs, and changes in level. A person may need to climb several flights, cross long hallways, or use steep driveways and outdoor paths to get through an ordinary day, so safety planning looks at the whole route rather than a single room.

What does an occupational therapist do during a home safety evaluation?
The therapist observes how you actually move through your home, including getting in and out of bed, using the bathroom, preparing meals, and using stairs, and then suggests practical changes to layout, lighting, equipment, and routines that fit your space and goals.

Can a home be made safer without changing its look?
Often, yes. Many improvements, such as better lighting, rearranged furniture, and discreet grab bars and handrails, can be chosen to blend with the existing design while still supporting safe movement.