CAPS stands for certified aging in place specialist, and the designation is achieved through training and testing during a multicourse educational program through the National Association of Home Builders (NAHB) in collaboration with AARP.
CAPS remodelers and design-build professionals are not medical or health care professionals. According to AARP, CAPS designees are often remodelers, designers, occupational therapists, architects, but others frequently achieve the designation as well.
This certification makes a difference when talking to a potential customer, who may feel secure knowing you are certified in aging in place design.
Assessing a Home
Every home assessment and every home will be a little different but the structure and goal of what you do should always be the same: Help the customer stay safe.
The toolkit for conducting a thorough home assessment should include a measuring tape, blue painters tape, a camera and a notepad. (Your phone works well for the final two items.)
Begin with sitting down with the customer and discuss which rooms will be used the most. If the client is never going to go in the laundry room because a homecare company or housekeeping service will be coming in to do laundry, then do not waste time assessing that space.
Can the client walk in the front door or do they need to be pushed in a wheelchair? If they can walk in the front door, what is there to assist them if there are steps? Do they need a handrail, a cane or both? Does a ramp need to be installed? Assess the threshold as a trip hazard, and decide if it needs leveling or reflective tape added.
Take measurements of the rise of the steps, depth of the porch, and take pictures. A photo of every detail is probably unnecessary, but it is better to have every angle than to need to return for a second evaluation.
The bathroom is the biggest trouble area for most people. First measure the width of the doorway to make sure the client can get through if they are using a wheelchair or if they need to sidestep with a walker. Many doorways are very small, and not wide enough for someone to get through in a wheelchair. Door widening is an option but can be costly and time consuming, so make sure you have a qualified contractor you trust performing the work.
When I walk into someone’s bathroom I shake the towel bars to see if they are loose. Many people believe using their towel bar as a standing aid is safe, but this is simply not the case and often leads to falls.
Discuss with the client and family about replacing towel bars that the patient is likely to grab hold of, and replace it with a reinforced grab bar towel bar. It may help to have a specialist install these products to ensure bars meet weight requirements. If the toilet paper holder can also be replaced for a grab bar toilet paper holder, it will make that transition easier and safer, as well.
Inspect the tub or shower next. Depending on the situation of the client, installing a grab bar on the outside of the shower/tub to help the person transition in and out is often needed.
A grab bar can be installed on the back wall of the shower. You may run into issues if the shower/tub is made out of fiberglass. Fiberglass showers/tubs can be tricky because they are floating away from the wall a couple of inches, and homeowners do not typically know what is behind the frame. This makes it hard for a grab bar to be drilled in without harming the structure of the shower/tub.
The final place in the bathroom to inspect is the toilet. There are a few options when it comes to the toilet. Does the client need a raised seat with handles, just a raised seat or just handles? Assess the person’s mobility and needs before arranging to complete an install, and be aware that needs may change as the client’s condition worsens.
A customer may want to know if the bedroom is big enough for a hospital bed and their regular bed, or if furniture can be re-arranged to make both beds fit. If the customer is not getting a hospital bed, a bed rail may be needed for their current situation. There are many options for bed rails and having a working knowledge of types, sizes and features will help in determining what will work best with the room’s décor and the client’s habits. If the bedroom is connected to the bathroom, talk with the customer about clearing paths for the patient to walk through. If the bathroom is not connected or close enough to get to in the middle of the night, talk about a 3-in-1 bedside commode. Motion lighting is also helpful. Wall plug-ins can be placed around the perimeter of the room and light up when motion is detected. Low light can contribute to falls in the home.
The Living Room
Again, ensure all pathways are clear for the patient to walk without tripping. It is amazing what people can slip and trip on. This is a great opportunity to talk about a lift chair and therapeutic positions available. I go into a lot of homes where the patient has their favorite chair, but that chair is really hard to get out of or is not conducive to transferring. Educate the customer on the benefits of having a device such as a lift chair. A range of other options is available, that make getting up and down easier, and product knowledge is key to helping customers make informed decisions.
Elsewhere in the Home
Other areas worth mentioning include the stairs and the kitchen. One of the first things you will learn during a family interview is if the patient can make it up and down the stairs. If this area is a concern, it is time to get the measuring tape out and measure for either a railing or stair lift. However, the family may decide to keep the patient downstairs and avoid the stairs all together.
Check the counter and table heights in the kitchen. If someone is in a wheelchair, they may need the height adjusted to eye level. Products such as Rev-A-Shelf put storage at arm’s length. Placing electrical items on motion sensors or timers cuts down on fire risk.
Once your customer has all of the information about the necessary home modifications, they will want to know how much can be done themselves. If plumbing, electrical or major flooring work is needed, it may be best to find a qualified contractor. In some cases, more harm than good can come from taking the DIY approach.