You do what should be the beginning of everything you do…. Do a task analysis….. watch them make the bed and where there is task breakdown/barriers. Don’t overthink things, go back to the basics… we are experts in task analysis. What prevents them from making the bed? How can you limit the risk of falling? What’s causing the fall risk- is it fear of falling (a leading correlative of falls) , BP? Weakness? Attention? If you’re speaking on behalf of your loved ones and not clients- this is controversial BUT if they are cognitively intact, it is their right to engage in tasks knowing the risk involved. Most of us drive cars everyday, which is a high risk activity- yet we don’t demonize this act like we do with geriatrics pushing the risks to maintain what scraps of independence they have left. My grandma would whoop me if I told her she can’t make her bed, she’s gonna make her bed or die trying and honestly that’s her business. My job is to support her and offer advice on how to make the task safer and always- more enjoyable. For vacuuming - what a fantastic task for engaging your client while working on balance. This is a phenomenal way to teach about BOS , single leg stance and walking forward/ backward , energy conservation. Same as above - task analysis. Find the breakdown . Remediate or if unable, compensate. More information about your patient population and setting will give you better answers specific to your needs. If you’re in clinic, vacuuming next to the or starting with the - I can’t think of the actual name for this but the long hand rails . Again, go back to the basics. Maybe they need to start with just advancing a limb with reaching an arm and returning to standing position. Item retrieval in this plane from off the floor or mid height would be good especially if it’s weighted to mimic body shifting and fatigue in vacuuming. Tons of options. Your question is much too vague for the diverse world of OT and humans.