• Universal Design: Helping Older Adults Maintain Their Independence

    IMAGE The principles of universal design making a home as easy to live in as it is beautiful can allow older adults to live independently longer.
    Not thrilled with the prospect of moving during their older years, baby boomers Lew and Ellen Petticrew added universal design features to their Charlotte, North Carolina dream house. When relocating to Virginia, middle-agers Dean and Betsy Frazen bought a life-span-design home because it felt comfortable and homey. And New Yorker Rosemary Bakker made simple modifications to her mother's home, enabling her mother to live independently for an additional eight years.
    "We're planning ahead for our empty nest and retirement years," says Ellen Petticrew. "But a lot of the decisions were made for aesthetic reasons."

    Functional and Attractive

    Unobtrusive, attractive, and practical, universal design creates environments with minimal hazards that people of all ages and abilities will find useful. Many elements decrease the need for bending, lifting, or reaching, but the term also applies to consumer products designed for simplicity and convenience.
    Universal design is meant to blend in with the home, not stand out. The features are part of the design, so they are attractive and useful. A casual observer may not even notice the features are present.

    Age and Independence

    Advancing age and conditions such as arthritis can make getting around, opening doors, and stepping into the tub more difficult. Not surprisingly, studies show that most middle-age or older adults want to continue living in their own homes for as long as possible. Universal design features can help make that possible.

    Home Modifications

    Some universal concepts, such as step-less entries and wider halls and doorways, entail more effort and are sometimes only possible during the building of a new home or the remodeling of an existing one.
    Some examples of home modification include:
    • Different levels of kitchen countertops or bathroom vanities to accommodate people of different heights or someone who uses a wheelchair
    • Contrasted countertop trim and surface colors in kitchens and bathrooms
    • Placing light switches in convenient locations
    • Using levers instead of doorknobs
    • Skylights to brighten hallways and rooms

    Renovation Ideas

    The best time to introduce universal features to an existing home is when you are renovating for another reason. If you are in this situation, consider the following suggestions:
    • Install a tub with front-mounted faucets, wider and softer edges, or a built-in door.
    • Substitute a shower with a built-in or fold-down seat, a hand-held water control, and an infrared soap dispenser.
    • Install kitchen vanities or adjustable-height vanities in the bathroom to decrease bending.
    • Add carousel and pull-out shelves to lower kitchen cabinets, and pull-down shelves to wall cupboards.
    • Put in granite or another heat-resistant countertop near cooking areas, so a person can quickly put down hot items (granite tiles are more affordable than a custom-cut piece).
    • Leave an 18-inch landing area next to each appliance and make countertop corners rounded.
    • Replace cabinet knobs with loop-style hardware.
    • Purchase appliances with universal design, such as a side-hinged, wall-mounted oven, a ceramic flat-surface cooktop with front or side controls, and a side-by-side refrigerator.
    • Raise the washer and dryer.
    • Remove interior doors to provide clearer openings.
    • Replace dead bolts that have small twist knobs with slide bolts.
    The experts say that little things count, too. For example, reorganize cupboards to store frequently accessed items between waist and shoulder height, and switch to lever-style handles and faucets to aid in opening doors and turning on water.

    Putting It All Together

    Minor changes can have a major impact on the quality of life
    Using concepts like contrasting colors go a long way in helping people who have low vision problems. They can help people see steps, furniture, countertops, or grab bars. Handles, switches, and reachable controls make it easy for anyone, regardless of height or impairment, to stay in their own home longer.
    Assistive devices and home modifications help people to age gracefully and with dignity, because they enable them to do more for themselves. By incorporating universal design when planning renovations or building new homes, older adults can enjoy the best of all worlds: convenience, aesthetics, and peace of mind.

    Quick Fixes

    Inexpensive and easily implemented modifications and assistive devices can dramatically improve an older person's well-being even when large-scale renovations are not possible. A controlled trial found that frail older adults who used assistive devices experienced less functional decline and pain and needed less health care assistance than did similar functioning elders without devices.
    By "giving people what they needed, they remained more independent," Mann says. "The devices were not really expensive high-tech devices. They assisted with bathing, grooming, dressing, mobility."
    The experts recommend several relatively minor things people can do in an effort to stay independent:
    • Use a reacher to pick up items on the floor.
    • Install a bedrail on a regular bed or instead use an electric bed.
    • Use a shower chair with rubber feet.
    • Add grab rails in the bathroom.
    • Add a second handrail to the staircase, a light switch at both the bottom and the top of the stairs, and nonslip strips.
    • Place a wire rack in the sink to ease bending.
    • Mount a jar opener under a wall cabinet.
    • Use lightweight cookware, nonslip bowls, and thicker, padded-handle utensils and molded glassware to make eating and drinking easier.
    • Use a tab grabber to open soft-drink cans. This is especially helpful for people with arthritis.
    There are tens of thousands of other assistive devices available that will help make life easier and safer.

    RESOURCES

    Center for Assistive Technology http://cat.buffalo.edu

    Center for Inclusive Design and Environmental Access, State University of New York at Buffalo http://www.ap.buffalo.edu/idea

    CANADIAN RESOURCES

    Canadian Healthcare Network http://www.canadianhealthcarenetwork.ca

    Seniors Canada On-line http://www.seniors.gc.ca

    References

    Falls in the elderly. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated September 25, 2013. Accessed October 11, 2013.

    Fixing to stay: a national survey on housing and home modification issues. American Association of Retired Persons website. Available at: http://www.aarp.org/home-garden/housing/info-2000/aresearch-import-783.html. Accessed October 11, 2013.

    What is universal design? The basics of building homes for the safety, comfort and convenience of everyone. American Association of Retired Persons website. Available at: http://www.aarp.org/home-garden/home-improvement/info-09-2009/what%5Fis%5Funiversal%5Fdesign.html. Accessed October 11, 2013.

    Mann W, Wilson DJ, et al. Effects of assistive technology on functional decline in people aging with a disability. 2009;21(4):207-217.

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