Independence Renovation
Providing a safe environment for aging-in-place works from the outside in
by Linda Wooge

Every single day between now and 2030, 10,000 baby boomers will turn 65, according to the Pew Research Center's The Next America (2014). In fact, this growing population of aging adults will comprise almost 20 percent of the population by that same year. Consider that number of older adults within this context: according to AARP's 2011 "Aging in Place: A State Survey of Livability Policies and Practices," 90 percent of seniors older than 65 want to remain in their homes. However, we know that as people age, they meet challenges in mobility and strength that can cause them to make the decision to leave their homes. Perhaps it's the steep front steps or the cabinets they can no longer reach. Maybe their bedroom is on the second level, and it is a struggle to continually climb the stairs. Whatever the case may be, simple adjustments and renovations to a beloved home can make it "age-friendly," helping its residents age-in-place comfortably, safely and independently. The first step in making any adjustments should be a thorough assessment. As a home care professional, you can bring a fresh set of eyes, a more analytical approach and significant experience to the task. When assessing whether a home is well-suited to aging-in-place, there are several major areas to consider, including exterior safety, interior safety and emergency preparedness.

Exterior Safety

Access to the home is important. Boomers and older adults should be able to come and go from their homes with efficiency and peace of mind, which is especially important when walking the neighborhood or when considering protection from intruders.

  • Is the neighborhood safe in terms of running errands on foot?
     
  • Do all exterior doors have deadbolts? Is there a heavy-duty storm door in place?
     
  • Do all windows lock?
     
  • Can someone easily and safely enter and exit the house?
     

Interior Safety

Inside the home, it's very important to assess pathways so homeowners have less to maneuver around or risk falling into if they lose their balance. Also, if mobility and balance is already an issue, purchase an alert pendant system or be sure to keep a cellphone on you at all times. That way, if a fall occurs, help can be summoned.

  • Are there throw rugs? These are a top cause of falls.
     
  • Are there end tables, plants, chairs, newspapers or other obstacles blocking main pathways?
     
  • Is there a glass-top coffee table or one with sharp edges in front of the primary sitting area?
     
  • Are cooking utensils and food easy to reach without a step stool?
     
  • Is there a bath on the first floor?
     
  • Is there a bedroom or room that could be converted for that purpose on the first floor?
     
  • Are there nightlights illuminating main pathways?
     
  • Does the bath have (or need) grab bars to ease getting into the tub and/or shower?
     
  • Does getting into the shower require stepping into a tub?
     
  • Does the shower floor have nonslip grips?
     

Emergency Preparedness

The home should have a system in place to detect an emergency or alert residents when an evacuation needs to occur. Along those lines, it should be easy for older adults to leave the home in case of an emergency. Nothing should impede their pathway to safety.

  • Are smoke detector batteries working?
     
  • Is there a backup power source if someone uses oxygen and a power outage occurs?
     
  • Is there an emergency plan for how the homeowners would evacuate in a storm or fire? Does a friend or family member know this plan, too? If someone has limited mobility, contact the fire department so they are prepared to evacuate the person in an emergency situation.
     

If the majority of these questions cannot be answered positively, then it may be time for residents to consider making changes. Prioritizing mobility and safety concerns will help ease the transition of creating a more comfortable environment for aging at home. Begin by considering the home's entry. Older adults should be able to easily enter and exit the home without difficulty, but steps into a house often impede this (see image below). Even just a few steps can be difficult for those struggling with arthritis. Suggest creating an entry without steps. Rather than build a ramp, slight slopes can be built into the landscape to accommodate this improvement.

Steps can be difficult for older adults.

Bad weather, such as rain, snow or ice, can affect the safety of an aging adult. Entrances into the home should be protected from adverse weather and fitted with sensor lighting that automatically turns on when movement is detected. In addition, door locks should be automatic in order to protect the home from intruders, especially for seniors whose actions may be hindered for any reason. In addition, doorbells and safety alarms should be outfitted through both audible and visual components. When a visitor arrives—whether a home care provider or a loved one—residents must be fully aware of their guests. For older adults struggling with hearing or vision loss, it's important for these indicators to be both audible throughout the home as well as visual, including flashing lights. An installed intercom or camera will also alert them as to who has arrived before unlocking the door. All necessary functions of the home should be on the first floor for ease of use. Dining, kitchen, laundry, sleeping and bathing must be accessible without obstacles such as steps and stairs. If the bedroom and bath are upstairs, suggest converting a room downstairs into a sleeping and bathing area for convenience. Baths should include nonslip flooring and grips must be installed in the shower or tub in case of a fall. In order to prevent falls, which are the No. 1 cause of both fatal and nonfatal injuries for seniors, motion detected lights should be installed in hallways, basements and garages. Ensure that loose floor mats and throw rugs are removed from hallways, as they are dangerous for older adults who may misstep and lose balance. It's also important to remember that as we age and mobility becomes impaired, people often begin to use walkers and wheelchairs. These require extra space in doorways and hallways, which should be built or expanded to accommodate their use. Consider the kitchen, for example. The space between cabinets should be wide enough that a homeowner using a wheelchair can navigate the room easily. In terms of cooking, make sure that items used most often are within reach. Cabinets and countertops may need to be lowered to ensure access. Water faucets in all locations should be fitted with levers so that they can be used no matter the finger mobility of the person. Beyond the home's interior structure, another consideration is interior decorating. All furniture within the home should facilitate ease of sitting and standing. Older adults should not need to struggle to get up from a chair, sofa or even their beds. Think about which objects can be bumped into and cause injury. Homeowners may want to remove low-lying coffee tables or other furniture. The peripheral vision of an older adult is not as sharp as it used to be, so it is common for them to bump or trip over items. If the home of the person you care for was not built with these features, you may want to suggest updates or renovations. If he/she is going to age at home with the help and assistance of senior home services, it is important to ensure the home is a safe place to live.