Anything that affects consciousness, awareness or judgement can increase the risk of accidents and injury.
When diagnosed with epilepsy your clinician will give you advice on what is recommended for things like driving, the use of dangerous machinery, working at heights and general safety issues. Advice on how to avoid injury will vary from person to person and will consider the type and frequency of seizures, your age, the effect of medication, personal behaviour and any other health conditions you may have.
Take some time to consider your environment and lifestyle for possible risks. Identifying and planning to reduce risk will help you to live a full and active life, as safely as possible.
Talking to your clinician about your own plan to reduce risk and also talking to others with epilepsy may be helpful in making changes.
What can I do to reduce the risk of incidents or injury?
Seizures can lead to loss of awareness and falls, so accidents and injuries such as drowning, burns, bruises, cuts, fractures, suffocation, or pneumonia (if fluid is inhaled during a seizure) can occur.
Take time to assess your home, work and any leisure activities you do. Ask yourself:
- what risks exist for anyone in this setting
- what are the potential hazards if you have a seizure?
- what actions can you take to reduce the risk of harm to yourself and others?
The information below isn’t an exhaustive list, but can get you started on self-assessing your risk which you can also discuss with your clinician:
Nocturnal seizures or seizures during sleep?
Is there someone to assist you if a seizure occurs at night? If you live alone are you aware of what options may be available to you to increase support in case you have a seizure?
If there is someone available to help you if you have a seizure, check they know how to put you into the recovery position (onto your side) and what to do in case of emergency. See our First Aid page for advice.
There are a number of devices for night-time seizure monitoring that are now available for use in the home. They are designed to recognise that a seizure has occurred or that breathing has been disrupted, triggering an alarm so that assistance can be provided. This is a rapidly developing area of research. Investigation into the development and the benefit of such monitors is ongoing and at this time there is no evidence to show that using an alarm or device can guarantee the safety of a person experiencing nocturnal seizures. However, some families have found monitors to be a useful part of a risk reduction plan. Speak to your clinician about whether a device is something that you might choose to use.
Because many epilepsy-related deaths occur overnight with people found lying face down there is speculation that this position may interfere with breathing and contribute to the deaths. However, the use of special pillows has not been proven to prevent death from suffocation or SUDEP. Some people advocate for the use of special pillows to allow better airflow around the face. Nevertheless, using such a pillow cannot guarantee the safety of a person having nocturnal seizures. The use of such pillows is a personal choice.
Take care around water, particularly if you have a child with epilepsy or if you are a parent with epilepsy, as baths, showers, spas, pools, ponds or any body of water can be dangerous if a seizure occurs.
Have a shower instead of a bath:
- use either plastic or safety glass shower screen/cubicle, or a shower curtain in case you have a seizure
- if possible, have a shower with a flat floor (instead of a shower tray) so water doesn’t collect
- if your shower is over a bath, wrap a towel around the taps of the shower to help avoid injury if you fall
- consider timing your shower when someone is nearby and if your seizures have a pattern, shower when they are least likely
- avoid locking the door and if possible have someone nearby who can help you if you have a seizure or fall
you may wish to consider fitting a bathroom door which opens outwards in case you have a seizure behind the door.
Swimming & other water activities:
Never swim alone. Ensure that someone who knows about your epilepsy is with you or watching you and that they are able to help you if you have a seizure. Public swimming pools with lifeguards are the safest places to swim; let them know you have epilepsy so they can support you if needed. See more safety tips here.
If you take part in water activities (eg: fishing, boating, water sports), use a life jacket and speak to the activity organiser about your epilepsy so they can support you in reducing any risks.
- make sure that hot water, heaters, radiators and spas/hot-tubs are temperature controlled
- use a guard for open fires, fireplaces and radiators/heaters. Avoid using lightweight free-standing heaters if possible
- turn the cold water tap on first and off last
- use a microwave where possible instead of a stove or oven. Keep the microwave below head height
- place saucepan handles away from the cooker edge when cooking in case they are knocked during a seizure
- serve meals from the counter rather than carrying hot food to the table
- avoid lighting candles or fires when alone
- switch off heated appliances as soon as you have finished using them
- take care around barbeques and bonfires, especially if your seizures cause you to wander or fall.
- avoid having hard flooring or cover them with non-slip rugs/mats to reduce your chances of injury during a seizure
- keep stairs and walkways free from obstacles
- consider covering sharp edges (ie: of furniture)
- consider using toughened safety glass or double glazing for doors and windows – or use a safety film to cover existing glass
- if you have seizures during sleep choose a low bed. Keep furniture or hard objects away from the bed.
- use cordless appliances with automatic switch off and ensure electrical cables are not trailing
- make sure wide opening windows and balconies have suitable locks or barriers to prevent falls during a seizure
- avoid activities at height unless using a harness (eg ladders, zip-lines, rock climbing).
- wear a helmet for activities such as cycling and a mouth guard for sport where required
- stand back from the road or platform edge when waiting for a bus, train or ferry
- use a lift instead of stairs or escalator if you can
- use non-breakable crockery and minimise the use of knives by buying sliced food where possible
- wear gloves to wash dishes and load a dishwasher with sharp points downwards
- have an electrician install a circuit breaker on your power supply
- use an electric shaver instead a razor
- use power tools with safety guards and automatic stop switches, and wear protective gear.
Child Care Safety
- if you are caring for a child and you are at risk of seizures, start by childproofing the house
- instead of carrying the child, use a stroller when possible
- change the baby on the floor
- do not bath the baby when you are alone
- feed the baby whilst sitting on a couch or bed so the child is supported easily.
For more tips on childproofing your home.
Help in an emergency
- explain your seizures and what to do in an emergency to your friends and family so they can be prepared if you need assistance. Offer a copy of the first aid brochure.
- ensure that someone who knows about your epilepsy has a key to your home, especially if you live alone
- wear a medical alert or carry a wallet card so emergency services can quickly find out about your epilepsy
put your emergency contact details into your phone
- carry a copy of your epilepsy plan or a summary of your medications and allergies to assist with emergency care.
SEE HERE FOR MORE TIPS AND RESOURCES TO HELP AVOID INJURY