Ladders and Seniors

By Milton Curtis, MD

Photo by Henry & Co. on Unsplash

Seniors should never use step ladders?

Is this advice reasonable or practical?
Are there ways to minimize the risk of a fall to allow some safe ladder use?

At what age should a person stop using ladders? It isn’t dependent on age alone, so it isn’t possible to give an absolute warning like “Never use a ladder after age 65.” It is dependent on strength, balance, good judgement and proper safety precautions at any age. In this article I am discussing step ladders for activities such as getting things out of closets or cabinets, changing light bulbs, or washing windows, not tall 2-legged ladders. It is safer if you can get someone else to do these tasks, or if you can use a reacher for light items that are too high to reach easily.

Absolute Reasons To Avoid Step Ladder Use
  • If you have fallen without a known cause. ⇒ It could happen unexpectedly again.
  • If you have fallen more than once even if you know the cause. ⇒ Repeated falls could represent an unrecognized safety issue such as the medical problems below.
  • If there are known medical issues causing weakness, dizziness, imbalance, decreased vision, nerve damage, or memory or judgement problems. ⇒ If there is a known risk, then ladders should never be used.
Possible exceptions where you could use a ladder
  • If you can eliminate the reason for one previous fall. ⇒ Some falls such as slipping in the tub, tripping on rugs or tripping on uneven sidewalks could be single accidental falls and corrections could have been made to remove the risks. Most people, even young people, have had accidental falls with a specific cause that is unlikely to occur again.
  • If you limit to no more than 2 steps on a ladder with 4 legs on the ground. ⇒ 4 legged ladders are less likely to slip than 2 legged ladders. Limiting to 2 steps may be safe in the right circumstances.
  • If you have someone you can have on the phone to be aware of what you are doing. ⇒ The person on the phone can act as a double check on whether they think it is safe to even attempt the ladder use. This would only be done in a situation where there is no expected risk.
  • If you can pass some simple balance and strength tests. ⇒ If you have good strength and balance, then a 65-year-old probably doesn’t have more risk than a 64-year-old.
simple tests with someone present to test your strength and balance
  • Squat down and get back up 5 times in a row. Don’t lean forward. It is OK to use your arms for balance, but not for pulling yourself up.
  • Go up stairs 2 steps at a time with only a light touch on the hand rail. Do at least 3 double steps.
  • Close your eyes and have someone observe if you stay straight without unsteadiness.
General advice on using a step ladder
  • Use a 4-legged step ladder: Inspect the ladder before use. Make sure it is clean and dry with anti-skid feet and non-slip treads. It should be fully opened and locked with no rocking of the feet.
  • Don’t go up more than 2 steps. If you need to reach higher, then ask for help.
  • Don’t place the ladder in front of doors.
  • Keep your body aligned with the ladder. Go slow. Don’t make sudden movements. Make sure you stay in balance without leaning to the side. Always have 3 points of contact either 2 feet and one hand or two hands and one foot. Don’t carry heavy items up or down ladders.
  • Wear non-slip shoes. Slippers are not safe.
  • If you feel unsafe after the first step, STOP and step back to the floor.
Climbing ladders is never without any risk even if you have taken every precaution.
Don’t ever stand on a chair! There is nowhere to hold on to.