Sample plan. Fictional family for illustration only.
Sample: Home Safety Plan
This is a short excerpt of what a plan looks like. The family, names, and details are made up.
Fictional Every name, date, and detail below is made up. Beside each piece, "What you do yourself" shows what stays with your family. Kinhaven drafts and organizes. Your family decides, contacts providers, and sends anything out.
1. Intake answers
| Who is the plan for? | Grandma Pat, 84, Dayton |
|---|---|
| How does she get around? | Uses a cane |
| Any falls this year? | Yes, one |
| Who lives in the home? | She lives alone |
| Who is helping? | Sam (grandchild) and Aunt Lee |
Health questions are optional and asked only after consent.
Situation summary
Grandma Pat, 84, lives alone in a two-level house. She had one fall on the back steps this spring and now uses a cane. Her grandchild Sam lives a few hours away and helps by phone. The family wants Pat to stay safely at home as long as she can.
2. A prioritized plan
| Priority | Task | Owner | Target date | Status |
|---|---|---|---|---|
| High | Handrail on both sides of the back steps | Sam | In two weeks | Open, waiting on quotes |
| High | Ask Pat's doctor about a fall risk check and a medication review | Aunt Lee | This month | Open |
| Medium | Grab bars by the toilet and in the shower | Sam | In two weeks | In progress |
| Medium | Brighter lighting and night lights, bedroom to bathroom | Aunt Lee | This month | Done |
Your next 3 steps
- Add a sturdy handrail on both sides of the back steps.
- Ask Pat's doctor for a fall risk check and a medication review.
- Install brighter lighting and night lights from the bedroom to the bathroom.
A few checklist items
- Grab bars by the toilet and in the shower (target date in two weeks)
- Remove loose rugs in the hallway
- Put a phone or a medical alert button within reach of the bed
- Write an emergency information sheet for the refrigerator
3. A draft letter
Hello, I am writing to ask for a written quote to install two grab bars in a bathroom and a handrail on four back steps for my grandmother. Please include the price, the start date, and your license and insurance details.
4. A reminder
Email reminder: "Grab bars by the toilet and in the shower" is due in 3 days. Open your checklist to mark it done or change the date.
5. A family update
Monday update for Pat's family. Done this week: night lights are in. In progress: grab bars, quotes arriving Thursday. Open decision: which contractor to use for the back steps. Needs help: someone to go with Pat to the doctor on the 22nd.
Sample plan. Fictional family for illustration only.