Oddly, the biggest challenge to making safety modifications for seniors is not the lack of product, or the knowledge to implement these installations nor an understanding of the issues among the healthcare provider and service community. The biggest challenge is making seniors aware of these modifications and convincing seniors that these non-invasive and relatively affordable installations are useful and important to their continued independence and well-being. These installations not only improve quality of life for the senior, but that of their caregiver as well. The reality of today’s family structure has the senior living in isolated fashion, with the concerned caregiver constantly worrying from afar about the senior’s well-being.
Part of this denial by seniors is human nature. No one wants to admit that they are having increasing difficulty navigating their home environment. They might also have the perception that these modifications might “institutionalize” or degrade the aesthetic and potential value of their home. Thanks to a concept known as Universal Design (UD) nothing could be further from the truth. The truth is that billions of dollars are being spent by both large and small companies to develop and offer Age-in-Place (AIP) products that are functional, appealing and cost-effective. In fact, with the senior population projected to double by 2020, homes that have UD elements installed will have enhanced marketability. Apart from awareness, aesthetics and home equity considerations, here are some
• One in three seniors fall each year.
• Ninety per cent (90%) of broken hips in seniors are a result of a fall.
• By the age of 75, falls are the major cause of fatal injuries.
• Forty per cent (40%) of admissions to nursing homes are related to falls.
Falls are a very serious health problem, and they usually have underlying causes. For example, someone who slips or falls on a slippery floor may have weak leg muscles or may be experiencing dizziness as a side effect of medication. Of course simple trip hazards are also a significant cause. Recognizing the general lack of awareness and training deficits that existed in making homes safer for seniors, the National Association of Home Builders (NAHB) developed the Certified Aging in Place Specialist* program which addresses home modifications for seniors and the physically challenged:
*A Certified Aging in Place Specialist (CAPS) has been trained and certified by the National Association of Home Builders (nahb.org) to be sensitive to the needs of seniors and the knowledge of what to do to mitigate the obstacles to remaining at home.
The CAPS program was developed in collaboration with AARP with input from numerous geriatric
Another challenge to implementing AIP modifications, might be the lack of knowledge on the part of the public, particularly the seniors and their caregiver, as to how to initiate the process. While there is a plethora on internet-based information on the subject, a lot of the information exists in fragmented fashion. This likely only causes further confusion, if not frustration. Further, a number of the vendors who offer modification solutions, do so in uncoordinated, piecemeal fashion. While band-aided safety is better than none, it can lead to a false sense of security and have future dire consequences.
In practice, a dialogue about home safety and accessibility modifications should be initiated in one of several ways:
• Directly between the senior and the CAPS specialist
• With the senior, the primary caregiver and the CAPS specialist
• Collaboratively, among the senior, the healthcare professional and the CAPS specialist
In the first two approaches, a comprehensive home audit needs to be conducted, with input from the senior and potentially their caregiver, to identify safety and accessibility deficits that should be addressed. In the latter situation, the home modification plan evolves from the care plan that the health care professional has indicated be followed. Once issues are inventoried, modifications can then be proposed and prioritized to get the maximum value for the allocated budget. A customized home modification approach is preferred over a cookie-cutter set of solutions for these reasons:
• No two houses are exactly the same
• People have different challenges and lifestyle priorities
• A pre-conceived or piece-meal approach might not address all safety concerns, and potentially spend money unwisely.
To briefly illustrate the home audit inventory process, here are just a few key areas that might investigated:
• Difficult access to the home
• Confined areas within the home
• Difficulty maneuvering from room to room
• Poor visibility/ lack of proper lighting
• Difficulty with reaching
• Door handles and faucets that are difficult to operate
• Fear of the inability to communicate in isolation
• Trip hazards
It should be noted that some AIP home modifications are not safety related, but are recommended to
enhance quality of life or home access. Pull-out shelves for example, make it easier for seniors (or
anyone for that matter) to access hard-to-reach storage areas. Obviously, if someone has a stoop or
reach issue, this modified storage can be not only helpful, but essential. Customized technology makes
it easier to monitor remotely and mitigate feelings of isolation. In conclusion, AIP modifications can
eliminate or postpone institutional care thereby allowing the senior to enjoy:
-Access to family, friends and neighbors
-Remaining in familiar surroundings, thereby eliminating relocation trauma
-Better retention of mental and physical functions
-Economic advantage versus other housing or institutional care options