We have a light at the top of the stairwell in our townhouse that's like this. I've seen mom put a stepladder next to the railing and be standing partly on the railing to reach the bulb. We made things slightly better by installing a new fixture on a chain, so at least she can pull the thing closer to herself and have it within reach. Otherwise I just don't turn that light on unless I have to, no need to have it prematurely burn out...