Safety advice for people with epilepsy

Introduction

Like many people with epilepsy and their families, you may have concerns about safety in relation to seizures. In these web pages we look at some aspects of everyday life, where there could be a risk of injury during a seizure. We also make suggestions on how to reduce risk.

It’s important to remember that our safety suggestions are not right for everyone. So some things may not be relevant – or necessary – for you. For example, if you are seizure-free, you may only need to take the same precautions as someone without epilepsy. If you get a useful warning of your seizures, you may be able to reduce risk of injury by stopping what you’re doing. However, if you have fairly frequent seizures without warning, you may need to take extra care.

Our thanks

Epilepsy Action would like to thank Pam Mantri, epilepsy nurse specialist (Sapphire Nurse), County Durham PCT, UK and Alison Holmes, Sapphire epilepsy specialist nurse, Derby City PCT, UK for their contribution to this information.

Disclaimer

Epilepsy Action makes every effort to ensure the accuracy of information in its publications but cannot be held liable for any actions taken based on this information.

In this section

• Safety assessments
• Bathing 
• Kitchen safety 
• Ironing 
• Electric flexes
• Heating 
• Flooring 
• Stairs 
• Lifts 
• Electric wheelchairs 
• Glass doors and windows
• Sharp edges 
• Protective headgear 
• Alarms 
• Beds 
• Parents with epilepsy caring for young children 
• Sport and leisure 
• Carrying identification  

Safety assessments

If you have unpredictable seizures you could be at risk of injuring yourself at home. If you live in the UK, you could ask your local Social Services to arrange for an occupational therapist (OT) to do an assessment of your home. This is to be as sure as possible that you are doing everything you can to reduce risk in the home. You could also discuss safety with your epilepsy specialist nurse, if you have one. If you have learning disabilities, you could ask your learning disabilities nurse to do a formal risk assessment.

Bathing

If you have seizures, you will need to do everything you can to reduce the risk of drowning during bathing. One way of doing this is to have someone in the bathroom with you or just outside. You will, however, want to balance this against your need for privacy.

A shower is considered to be safer than a bath for people with epilepsy. However, neither is entirely risk free.

Showers

A shower should ideally be in a separate cubicle, rather than over the bath. If possible, the cubicle should have a flat floor, instead of a shower tray. This is because water could collect in a shower tray, increasing the risk of drowning. The shower screen should be made of plastic or safety glass. A shower curtain is an alternative. A wet room that doesn’t need a cubicle is another alternative.

You may also need to look at your bathroom fittings. These need to be as flush to the wall as possible. This will reduce the risk of injury, if you have a seizure and fall. If fittings stick out, or if you use a shower over a bath, you could cover the fittings with protective material. Even a thick towel can be effective in reducing the risk of injury if you fall.

It is important that the temperature control works well. It should have a safety ‘cut-off’, in order to avoid scalding yourself. Taking a shower while sitting, if this is possible, will reduce the risks of injury if you have a seizure.

Baths

If you use a bath, it’s best to keep the water depth shallow to reduce the risk of drowning. However, this will not remove the risk entirely. The taps should be turned off before you get into the bath. Some people prefer to wash with running water, without putting in the plug. If you decide to do this, you could use a shower attachment. This way the water can be mixed to a comfortable temperature. However, shower attachments don’t have a safety ‘cut-off’, so can’t prevent scalding if the water temperature changes.

Bathroom doors

You could use an ‘engaged/vacant’ sign to protect your privacy, instead of locking the bathroom door. If possible, the door should be hinged so that it opens outwards. This way, if you have a seizure and fall against the door, you won’t block someone getting into the bathroom if you need help. If it’s not possible for the door to open outwards, you could consider having a ‘concertina’ door (where it folds open and closed).

Kitchen safety

It’s safer to use a microwave oven than a gas or electric cooker. If you use a cooker, turn saucepan handles away from the edge so you are less likely to knock the saucepan over.

To reduce the risk of scalding yourself, take plates or dishes to the cooker, rather than carrying hot pans to the table. Using a toaster can avoid the danger of leaving a grill on. Kettle tippers and teapot pourers are available to avoid lifting containers of hot liquid, although these will not remove the risk completely.

There may be other safety aids that could be helpful. Contact the Disabled Living Foundation for further details. A limited range is also available from some shops, such as hardware stores. Some of these safety aids may be mainly intended for child safety, but could still be useful. 

If you have memory problems, you could forget you’ve turned on the grill or cooker. You might, therefore, decide to get a smoke detector. The smoke alarm will sound when smoke hits the sensor, for example from burning food.

Ironing

If you have unpredictable seizures, you may decide not to iron when alone in the house.

Electric flexes

It is wise to avoid having trailing flexes. This is particularly important where they are attached to appliances which could cause a fire, or burns, if pulled over.

You can use cable tidies, available from hardware stores, to make sure that flexes are kept out of the way. You could also consider using a cordless kettle and iron.

Heating

If you have free-standing heaters, try to place them where they are least likely to be knocked over during a seizure. Some modern electric heaters have a safety cut-off if they are knocked over. However, you will still need to think about having guards on your heaters or radiators to minimise the risk of being burned if you fell against them.

If you have an open fire, be sure to use a fire guard that is fixed to the wall, so it can’t fall over if you knock it.

Flooring

If at all possible, avoid having very hard floor surfaces -  they can increase the risk of injury during a seizure. Different types of flooring are available which will provide a softer landing if you should fall. Examples are vinyl cushion, linoleum, cork and rubber. Carpets with a high wool content are less likely to cause friction burns during a seizure than those with a high synthetic content.

Stairs

If you have frequent and unpredictable seizures, stairs can be a major hazard. Even so, it is possible to reduce the risks. For example, keep your staircase clear of obstructions at all times. And consider having a soft rug or carpet at the bottom of the stairs. This will help to cushion any falls.

Lifts

If you have mobility difficulties, you may need to use a stair lift or vertical lift. Neither of these options is risk-free if you also have seizures.

Vertical lifts

If you use a vertical lift, it should, if possible, have a padded interior to reduce the risk of injury if you have a seizure.

Stair lifts

Most stair lifts have simple lap straps. These are unlikely to cause injury if you have a seizure. Some people may need the added protection of a full harness, to prevent them falling. Where this is the case, it’s important to be aware that the harness could cause injury during a seizure.

There is no perfect solution where stairs or lifts are concerned. To a certain extent, it is a matter of arriving at a compromise between the safest option and what is practical in your home.

Electric wheelchairs

If your seizures are not controlled, and you want to use an electric wheelchair, you will need to think about safety. You could discuss this with your doctor. They would consider what dangers there might be for you, if you have a seizure while using an electric wheelchair. They will also consider the type of seizures you have and if you have a warning of your seizures.

Glass doors and windows

Falling against glass doors or windows could cause serious injury. You can reduce the risk by using toughened safety glass, or by covering ordinary glass with safety film. Contact your local glass merchant or hardware store for more information and advice.

You may also want to make sure that any wide-opening upstairs windows, or doors from upper balconies, have suitable locks in place so that you can’t fall from them.

Sharp edges

You may want to cover sharp edges, or any that stick out, for example on furniture. You could use padding, such as pieces of foam rubber that come in sheets, or tubes that are designed for lagging pipes. A hardware store may stock other options. When buying new furniture, you could consider making sure these have rounded edges or corners.

Protective headgear

If you have frequent, unpredictable seizures, which might cause injury to your head or your face, you may wish to consider wearing a protective helmet. If you live in the UK, your hospital consultant can prescribe one if they feel it is appropriate. You can also buy these privately. For details of companies that sell protective headgear contact Epilepsy Action.

Alarms

Some people are worried about having seizures when they are alone. There are different types of alarms that can alert other people that you may need help.

• Baby intercoms can pick up sound.
• Bed alarms can sense different things when someone’s asleep, such as unusual sound, movement or dribble.
• Fall alarms can be used when someone has fallen to the ground.
• Telephone alarms, operated by remote control, can be used to call someone for help.

Before investing in any of these alarms, you need to consider whether they are necessary and if they would be effective for you. For example, there would need to be somebody else available to hear a fall alarm. Baby intercoms only pick up noise, not movement. Generally, you would need to have a warning of a seizure for a telephone alarm to be useful. However, a telephone alarm can be used when the seizure is over to call for help if you need to.

• For details on alarms systems, contact the Disabled Living Foundation

Beds

If your seizures involve convulsions or jerking movements, try to avoid placing your bed against a wall or next to a radiator. This can prevent you knocking your limbs on the wall, or burning yourself.

Placing protective cushions or a mattress around the bed can help to reduce any injury caused by falling out of bed. The lower the bed, the less distance there is to fall. This will reduce the risk of injury. It is also a good idea to keep sharp-edged objects, and furniture such as bedside tables, away from the bed, to prevent injury.

Parents with epilepsy caring for young children

If you are a parent with epilepsy you may worry about your children’s safety, if you have a seizure. Besides following general safety measures for all parents of young children, there may be other ways to reduce the risk of injury and accidents. These include, for example, fitting a safety brake to the pram, and special ways of feeding, bathing and looking after your baby or young child. Child reins, harnesses and wrist straps can keep your child close to you when you are out and about. If you fall during a seizure you may pull your child over. However, this is safer than allowing your child to wander off unsupervised.

• More information about caring for young children  

Sport and leisure

Most sport and leisure activities are possible for people with epilepsy, as long as common sense precautions are taken, where relevant. Sports on or near water, or at heights, may need extra safety measures or supervision. 

• More information about sport and leisure 

Carrying identification

You may feel reassured by carrying or wearing some form of identification, particularly if you are out on your own. Epilepsy awareness cards, or medical identity jewellery, are available.