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Introduction

Like many people with epilepsy and their families, you may have concerns about safety in relation to seizures. On this webpage we look at some of the aspects of everyday life, both at home and elsewhere, where you may wish to take precautions to reduce the risks of injury during a seizure. These are suggestions only, and it is important to remember that only some may 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. On the other hand, if you have fairly frequent seizures without warning, you may need to take extra care.

Bathing

A shower rather than a bath is considered to be the safer option for people with epilepsy, although neither is entirely risk free. A shower should ideally be in a free-standing cubicle, preferably with a flat floor rather than a shower tray, where water could collect. The shower screen should be made of plastic or safety glass. A shower curtain is an alternative. Taking a shower while sitting, if this is possible, will reduce the risks of injury if you have a seizure.

You may also need to look at your bathroom fittings. These need to be as flush to the wall as possible to reduce the risk of injury if you have a seizure and fall. Where fittings do stick out, or if you use a shower over a bath, you could cover the fittings with protective material to reduce the risk of injury if you fall. Even a thick towel can be effective. It is important that the temperature control works well, preferably with a safety ‘cut-off’, in order to avoid scalding yourself.

If you are using a bath rather than a shower, it is best to keep the water shallow to reduce the risk of drowning. The taps should be turned off before you get into the bath. Some people prefer to sit in the bath without putting the plug in the plug hole, and have a wash using a sponge/flannel with the water running. If you decide to do this, it is advisable to use a shower attachment where the water can be mixed to a comfortable temperature. Using single taps or a mixer tap is not recommended, as the hot water could scald you.

Rather than lock the bathroom door, you could use an ‘engaged/vacant’ sign to protect your privacy if there are other people in the house. If it is possible, the door should be hinged outwards so that you would not block it by falling against it if you had a seizure. If it is not possible to have the door opening outwards, you could consider having a ‘concertina’ door (where it folds open and closed). If you have seizures, you will need to do everything you can to reduce the risk of drowning during bathing. One effective way of doing this is by asking someone to be in the bathroom with you or just outside. You will, however, want to balance this against your need for privacy.

Cooking

Using a gas or electric cooker during a seizure could be dangerous. A microwave oven is a safer alternative. If you do use a cooker, turning the saucepan handles away from the front edge will help to prevent knocking over the saucepan. It will reduce the risk of scalding if you carry the plates or serving 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. There may be other safety aids that could be helpful. Contact the Disabled Living Foundation (UK) for further details. A limited range is also available from some shops, such as ‘Do It Yourself’ (DIY) stores. Some of these safety aids may be mainly intended for child safety, but could still be useful.

Possible hazards in the home

Electric flexes

It is wise to avoid trailing flexes, particularly those attached to appliances which could cause a fire or burns if pulled over. You can use cable tidies, available from DIY stores, to make sure that flexes are kept out of the way. You could also consider using a cordless kettle and iron.

Heating

It is advisable not to have free-standing heaters as they could be knocked over during a seizure. If you have an open fire be sure to use a substantial fixed fire guard. Radiator guards are an added precaution.

Flooring

If at all possible, avoid having very hard surfaces for flooring as these 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. These can be used in areas where the floor is likely to get wet such as bathrooms and kitchens. Carpets with a high wool content are less likely to cause friction burns during a seizure than those with a high synthetic content.

Glass

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

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 DIY store may stock other options.

Stairs/stair lifts/vertical lifts

If you have frequent and unpredictable seizures, stairs can be a major hazard. Even so, with careful thought and consideration, it is possible to reduce the risks. Keep your staircase clear of obstructions at all times and consider having a soft rug or carpet at the bottom of the stairs to help cushion any falls.

If you also have mobility difficulties, you may need the assistance of a stair lift or vertical lift. Neither of these options is risk-free. If you have a vertical lift, it should, if possible, have a padded interior to reduce the risk of injury if you have a seizure. If you use a stair lift, keep the safety straps to simple lap straps, because being restrained by a full harness could cause injury during a seizure. However, this needs to be balanced against the risk of injury from a fall during a seizure. There is no perfect solution where stairs/lifts are concerned and, to a certain extent, it is a matter of arriving at a compromise between your different needs and what is practical in your home.

Protective headgear

If you have frequent, unpredictable seizures which might cause injury to your head and/or face, you may wish to consider wearing a protective helmet. These are available to buy privately, or your hospital consultant can prescribe on the UK National Health Service where they feel it is appropriate.

Electric wheelchairs

If you use a wheelchair and have chosen to use an electric one, you will need to think about safety if you have a seizure. You would need to talk to your doctor to find out if it would be safe for you to use an electric wheelchair. Note: in the UK this type of vehicle is not legally defined as a motor vehicle so you don’t have to have a driving licence to use one.

Alarms

There are different types of alarm available.

  • Personal alarms can alert another person nearby.
  • Telephone alarms, operated by remote control, can be used to call someone for help.
  • Bed alarms can pick up different things, such as unusual sound or movement or dribble, during sleep.
  • Baby intercom alarms transmit sound and can alert someone in another room to a sleep seizure.
  • Fall alarms sense when someone has fallen to the ground and can alert someone nearby.

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 personal alarm. Baby alarms only pick up noise, not movement. Generally, you would need to have a warning of a seizure for a telephone alarm to be useful, although you can use it when the seizure is over to call for help if you need to.

Beds

If you have seizures during sleep, 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, which will reduce the risk of injury. It is wise to keep sharp-edged objects, and furniture such as bedside tables, away from the bed.

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.

REMAP can provide advice on safety brakes for prams. Contact them directly for further details. Tel. (+44) 08451 300 456. http://www.remap.org.uk/

Carrying identification

You may feel reassured by carrying or wearing some form of identification, particularly if you are out on your own. Identity cards or medical identity jewellery, on which you can put details about your epilepsy, are available.

Medical record/translation service

DoctorBabel is an online medical records service. It allows you to record details of your medical conditions, treatments and any relevant medical information into a password protected site on your computer. This information can then be printed out in a card-sized printout to carry in your purse and wallet. This service is free.

In addition, your records can be translated into many different languages if you wish to travel abroad. The full translation feature can be activated at a cost of £20. You can then update and translate your record into any of a number of languages as often as you wish. If travelling to Spain for example, you print your medical record in English and Spanish in a card-sized printout and carry this in your wallet.

www.doctorbabel.com

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 may require extra precautions/supervision.

Additional precautions

If you have frequent seizures you may feel the need to take additional precautions. Information on other daily living aids can be obtained from: Disabled Living Foundation (UK).

A factsheet giving details of suppliers of daily living aids, like alarms, medication aids, protective headgear etc, is available from the Epilepsy Helpline, freephone 0808 800 5050 (UK), helpline@epilepsy.org.uk

To view any file in Portable Document Format (PDF) downloaded from this site, you need the latest version of the Adobe Reader program. If you don't already have it, it can be downloaded free from www.adobe.com.

Further information on these issues can be obtained from Epilepsy Action by using the Email Helpline or if you live in the UK, by phoning the Freephone Helpline on 0808 800 5050.

29 March 2007

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