Handrails and Stair Lifts for Older Adults

Handrails first

A handrail is a fixed support that a person can hold while climbing or descending. It does three jobs: it takes some body weight off the legs, it gives a point of balance and it gives something to grab in a stumble. A good rail reduces falls; a bad one, too thin, too high, loose or too short, can give false confidence.

### What makes a good handrail

• Both sides of the stairs, if the width allows, so that the stronger hand can always be used and a person can hold on going up and down.
• Full length, from the top step to the bottom, extending beyond the first and last step by about 30 cm so the user can hold on while stepping on or off.
• Continuous around corners and landings, without breaks.
• Height: about 85 to 100 cm above the front edge of the steps, roughly waist height, and consistent along the flight.
• Grip: a round or oval section of about 3.5 to 5 cm that the hand can wrap around, with a smooth, non-slip surface. Avoid flat wide bars or rails with sharp edges.
• Clearance: at least 5 cm between the rail and the wall so that fingers can wrap around.
• Strength: fixed into solid wall, studs or masonry with proper brackets, able to take the full weight of an adult pulling on it. Test it by hanging your weight from it.
• Material: wood or coated metal, warm to the touch and not slippery when damp. Stainless steel is durable but cold.
• Contrast with the wall so it is easy to see.
• No loose ends that can catch clothing.

### Fitting

Brackets must be fixed into a solid structure, so this is a job for a competent carpenter or builder, not a quick DIY with small screws and wall plugs. Check the wall: plaster over brick, concrete and lath-and-plaster need different fixings. In rented homes, ask permission; see fitting grab bars in rented or apartment homes for a similar approach.

### Other rail locations

• Outdoor steps and entrances, where rain and algae make surfaces slippery; see stairs, steps and thresholds.
• Ramps, with rails on both sides; see portable ramps for thresholds.
• Corridors and hallways, for people who need support at home, with a continuous rail.
• Bathrooms, with grab bars, not handrails; see grab bars.

### Combine with other measures

A rail works best alongside good lighting, visible step edges, non-slip treads and sensible habits; see stairs, steps and thresholds, lighting and colour contrast at home and using a walking stick on stairs and slopes.

When a handrail is not enough

Consider more than a rail if your parent:

• cannot climb a flight of stairs without stopping, or becomes breathless, dizzy or in pain;
• has fallen on the stairs;
• needs help from another person on the stairs;
• uses a walker or wheelchair, which cannot go up stairs;
• has severe arthritis, heart or lung disease, or weakness;
• avoids stairs and has stopped using part of the home; or
• has dementia and may forget how to use the stairs safely.

Ask a physiotherapist or occupational therapist to assess; see occupational therapy home assessment.

Options beyond the rail

1. Rearrange living so that daily activities are on one floor: bedroom, toilet and living area downstairs; see ground-floor or upper-floor living in later life. This is often the cheapest, safest option, though it takes planning and may feel like a loss. 2. A bedside commode, to avoid night-time stairs. 3. A second set of essentials on each floor. 4. A stair lift, a motorised chair that carries a person up and down the staircase. 5. A through-floor or platform lift, for wheelchair users or where space allows; costly and structural. 6. A ramp or a lift for entrance steps. 7. Moving to a ground-floor flat or a building with a lift.

Stair lifts in detail

### What a stair lift is

A stair lift consists of a rail fixed to the stairs (usually to the treads, not the wall) and a seat that travels along it, driven by an electric motor. The user sits, fastens a belt, presses a switch or joystick and is carried up or down. When not in use, the seat, arms and footrest fold to leave space for others on the stairs.

### Types

• Straight stair lifts for a single straight flight, the simplest and cheapest.
• Curved stair lifts, custom-made for stairs with turns, landings or spirals, more complex and costly.
• Perching or standing stair lifts, for people who cannot bend their knees or have limited space; the user perches on a small seat or stands.
• Outdoor stair lifts, weatherproof, for external steps.
• Wheelchair platform lifts, which carry a wheelchair, for those who cannot transfer.

### Who benefits

A stair lift suits a person who can transfer to and from a seat safely, sit upright and operate a switch, but who cannot climb stairs. It is not suitable for people who cannot sit safely, or follow instructions, or who need hands-on help to transfer, unless a carer is present.

### Choosing and checking

• Weight limit: check against the user's weight.
• Seat: comfortable, with a padded seat, armrests, a footrest and a seat belt. Swivel seats at the top make it easier to step off.
• Controls: easy to use, with a large switch or a joystick on the armrest; a remote call button to bring the lift to the other floor.
• Safety features: sensors that stop the lift if an obstacle is on the rail, a seat belt, an emergency stop, a key switch to prevent unauthorised use.
• Power and backup: battery back-up so it works in a power cut, and a way to finish a journey; see hospital beds and power cuts for similar thinking.
• Rail position: does it block the stairs for others? Does it leave enough width? Will it obstruct fire escape routes?
• Folding: the seat and rail ends should fold away.
• Noise and speed.
• Installation: done by trained engineers, with the rail fixed securely.
• Warranty and servicing: a regular service plan, with availability of spare parts and a response time for faults; see equipment returns, warranty and servicing.
• Building rules: check with the owner, housing society or authorities if fixing to common stairs.

### Costs

Stair lifts are significant purchases, and prices vary by type of stairs, brand, features and installation. Straight lifts cost far less than curved ones. Ask for written quotes that include delivery, fitting, any structural work, warranty and servicing. Consider second-hand or reconditioned lifts carefully, with warranties and checks. Renting may be possible for a short period. Compare the cost with alternatives such as moving a bedroom downstairs. See home modification budget for ageing in place in India.

### Using a stair lift safely

• Sit well back and fasten the seat belt every time.
• Fold up the arms and footrest as needed.
• Keep the stairs clear of objects.
• Do not let children play on it.
• Do not carry items that could fall.
• Do not use if the lift behaves oddly, and call for service.
• Have a plan for power cuts and faults.
• Keep the stair lift remote and keys safe.

Questions to ask a supplier

• What is the weight limit and seat size?
• How does it work on our staircase, with turns, landings and width?
• What happens in a power cut?
• What safety sensors does it have?
• How long does installation take, and what structural work is needed?
• What is the warranty, and what does it cover?
• How often must it be serviced, and who does it?
• What happens if it breaks down?
• Can it be removed, and who pays?
• Can I see a demonstration or speak to another customer?

Other lifts

For wheelchair users or those who cannot transfer, a platform lift or through-floor lift may be needed. These are major structural projects that need architects, permissions and larger budgets. An alternative is to move to a ground-floor home. In apartments, check the building's lift; see lifts and apartment living for seniors.

Making the decision

Ask these questions with your parent and a therapist:

1. Can stairs be avoided by rearranging the home? 2. Is a rail, with lighting and visible edges, enough? 3. If not, can your parent safely transfer to a stair lift and operate it? 4. Is the staircase suitable, and will the lift obstruct others? 5. What are the costs and running costs? 6. What will happen if needs change, for example if your parent can no longer transfer?

Review the decision every year, as needs change.

When to ask a professional

An occupational therapist or physiotherapist can assess stairs, ability and equipment needs. A builder or carpenter fits rails. A qualified lift engineer installs stair lifts. A structural engineer may be needed for lifts and ramps. Our care advisors can arrange assessments and obtain quotes.