Aging in Place By Design

Posted by: Pierson W. Backes | Posted on: April 15th, 2014 | 0 Comments

Planning to Age in Place:  Should You Consider Home Modification?

Americans are living longer and overwhelmingly wish to stay in their own homes as long as possible.  At the same time, most housing in our area – whether newer or older – has not been well designed for people of differing heights, sensory abilities and physical strength.  Unfortunately, most people’s first association with home modifications is a mental picture of an ungainly wood ramp interrupting the curb appeal of a home, or other unattractive make-do solutions.  Fortunately, there are more and more professionals who are trained in the issues of making housing accessible AND beautiful.

Universal Design is – Well – Universal.   “Universal design” was developed by Ron Mace, a visionary architect who founded the Center for Universal Design at North Carolina State University,  http://www.ncsu.edu/ncsu/design/cud/. Mace was a wheelchair user who recognized that features designed to make life easier for people with disabilities tend to make life easier for everyone.  (Rosemary Bakker, Revitalizing Your Home:  Beautiful Living for the Second Half of Life (AARP and Lark Books, New York, 2010)).  Bakker explains:
“One of [Universal Design’s] primary goals is to create a house – the structure, everything that fills it, and the outdoor spaces that surround it – that is usable by everyone right now – boomers with knee replacements, young families with baby carriages, elderly parents, teenagers on crutches after a snowboarding accident, or anyone who uses a walker, scooter or wheelchair.”

Although it may not be possible to plan for every imaginable scenario, certain design features can improve safety, comfort and convenience for all users of the home – a mother carrying a child, an older adult or an individual with limitations on mobility or sensory issues.

How Do You Evaluate Your Home for Safety and Accessibility?
Where do you start in evaluating your home?  The state of New Jersey’s website includes a useful Home Safety Checklist: http://www.state.nj.us/humanservices/doas/documents/checklist.pdf, developed by a nonprofit organization, Rebuilding Together (http://rebuildingtogether.org/).    There are also many books on universal and accessible design that include checklists, photographs and design ideas, including Rosemary Bakker’s book described above. Another excellent book, The Accessible Home:  Designing for All Ages and Abilities, by Deborah Pierce, AIA (Taunton Press, Newtown, CT 2012) addresses the question, “Who Needs an Accessible Home?” and notes in part:
“People planning to stay put through their later years need accessible homes.   AARP surveys report that over 85%  of people want to age at home.  By age 75, however, it is estimated that 73% of the population will have some functional limitations.  Due to medical advances and healthy lifestyles, the portion of the population over age 55 is predicted to reach 35% by 2050.” 

Why Be Proactive?  Fall Prevention
Even if people may be interested in the idea of home modification to serve their long-term needs, they may think it would be preferable to wait until they need it.  On further reflection, though, none of the long-term accessibility solutions – whether home modification or moving to a different home – will be easier to handle in a crisis created by illness or injury.  Furthermore, hazards in the home can be the CAUSE of disability.

In 2013 New Jersey sponsored a Falls Prevention Awareness Week, and created a fact sheet including the following:

  • More than one third of adults 65 and older fall each year in the United States
  • In 2010, 338 older New Jersey residents died in a fall
  • In New Jersey, each day an average of 194 older adults 60+ are treated in emergency departments or as inpatients due to a fall
  • Falls are the #1 cause of brain injury among older adults

http://www.state.nj.us/humanservices/doas/documents/fallsfactsheet2013.pdf.

The CDC (Centers for Disease Control and Prevention) has published a Home Fall Prevention Checklist:  http://www.cdc.gov/HomeandRecreationalSafety/Falls/pubs.html.

The university-based, nonprofit organization website http://www.homemods.org/ is a service of the Fall Prevention Center of Excellence, funded by the Archstone Foundation. The web site is headquartered at the University of Southern California Andrus Gerontology Center.  The authors explain why  there are good reasons to be pro-active on safety enhancing modifications:

“What is the role of home modification in fall prevention? The addition of supportive features can help reduce accidents such as falls, a leading cause of death for older Americans. Six out of 10 falls occur in homes which typically contain a high prevalence of hazards such as loose throw rugs, the lack of tub/shower grab bars, and obstructed pathways. Home modifications can reduce the demands of the environment while making the home safer and more supportive.”  (http://www.homemods.org/.)

Resources

There are some qualifications that indicate completion of specific training in home modifications.  For example,  an Executive Certificate in Home Modification is offered by homemods.org.  Five courses with challenging assignments are required to obtain the Certificate.   Students include professionals such as occupational therapists and social workers, as well as consultants, designers, builders and architects.

The National Association of Home Builders has a two-part training course for Certified Aging in Place Specialists (CAPS).

Many home modifications are simple, unobtrusive and relatively inexpensive – improved lighting and floor treatments, better handrails, easier to operate switches, doors and locks, and strategically placed grab bars (which, by the way, can look just like a towel bar, rather than the big ugly pipes we are accustomed to seeing in public “handicapped” bathrooms.  For example, see http://www.us.kohler.com/us/Bathroom-Accessories-Grab-Bars/.  Proper installation is the critical issue.)  Other projects, such as kitchen or bath remodeling, may be a bigger investment – but are areas where many homeowners may already be considering a remodel or update (so why not include features that will enhance your ability to stay in your home?)  Financing options may include some public as well as private sources.

Assistive technology also may make a significant difference in the feasibility of staying in your home.
“Assistive technology is any service or tool which can help an older person or a person with a disability perform activities that might otherwise be difficult or not be possible.

Such technology may be something as simple as a walker to make moving around easier or an amplification device to make sounds easier to hear (for talking on the telephone or watching television, for instance). It could also include a magnifying glass that helps someone who has poor vision read the newspaper or a scooter that makes it possible to travel over distances that are too far to walk. In short, anything that helps the elderly continue to participate in daily activities is considered assistive technology.”
http://www.eldercare.gov/ELDERCARE.NET/Public/Resources/Factsheets/Assistive_Technology.aspx

Accessible design can empower people to remain in their homes longer, in greater safety.  We would be happy to help you with the legal details of contracts or financing.

Business Lawyer and Elder Law Attorney