Improve Home Access and Mobility For Seniors – Tune Up Your Doors!

Creating an accessible home with doors and doorwaysAre the doors in your home sticky, narrow or just plain unwieldy? For most of us, this can be a big annoyance. However, for seniors, it can be a significant impediment to mobility in the home.

Fortunately, there are many things you can do to improve the situation and make daily life a little easier.

Here are some ideas:

Door Knobs - Consider replacing door knobs with door levers. These are simply easier for seniors to open than a traditional round door knob. Internal door hardware is affordable and relatively easy to replace. Entry door locksets are more expensive, but won’t necessarily break the bank if you shop around.

Misaligned Doors - When doors are out of alignment, they can rub on the frame and become difficult to open and close. There are a few quick tricks you can try before you resort to re-framing the door.

  • If the problem is very minor, you can sometimes just sand the edge of the door that is rubbing. This is permanent and is not recommended if the problem is seasonal or if too much material must be removed.
  • Use shims to move the upper or lower hinge out from the door frame slightly. While you may be able to use cardboard or washers to accomplish this, it’s probably better to purchase door shims that are specifically designed for this purpose.
  • Another trick is to slightly bend one or both of the door hinge knuckles. Crescent wrenches are frequently used for this, but there are now knuckle bender tools to make it easier.

Narrow Doorways - Some doorways are too narrow to provide access for a walker or wheelchair. You have a few options:

  • ‘Swing clear’ hinges are a great way to improve access. As the name implies, these hinges allow the door to swing completely out of the door opening. In some cases, this can add a couple inches of badly needed clearance.
  • If you don’t need to close that particular door, consider removing the door and hinge altogether. You can also remove the innermost strip of trim that functions as a door stop. If the doorway needs to be even wider, you can try removing the entire door frame and trimming out the opening with thin sheet-rock.
  • Depending on the location in your home and the wall framing surrounding the door, you may be able to replace the existing door with a wider pre-hung door. While this may not be a DIY job, a good contractor can probably do it for a reasonable price.

Garage Doors - Not only can garage doors be difficult to open and close, they can be downright hazardous for some seniors. While most problems with garage doors can be easily fixed, it is recommended that you hire a licensed contractor for significant improvements. Garage door springs are dangerous to work with and some municipalities may even require building permits.

  • If you have a slab garage door, check into getting a roll-up door. These should be much safer and easier for seniors to manage.
  • Remove dirt and debris from the garage door and the areas around it.
  • Lubricate your door hardware. If you are unsure of the best type, look for a lubricant specifically labeled for garage door hardware.
  • Replace your garage door springs. If the springs are old, they may not be functioning as well as they should. They could also be dangerous in the event of a failure.
  • If you don’t have one already, consider purchasing an automatic garage door opener. The quality of these continues to improve and they are more affordable than ever.

Sliding Doors - Sliding doors are inherently more difficult to open than swinging doors and can be even more of a challenge for seniors. These generally require more ongoing maintenance to function smoothly.

  • Clean out the tracks regularly.
  • Lubricate moving parts.
  • Although it can be tricky, many sliding doors have screws to adjust alignment. If needed, replacement parts are generally available as well.
  • Consider replacing a sliding door with a pair of swinging French doors. Because the sliding door opening is typically wide, replacement with French doors is generally easier than many other installations.

Keyless Entry Systems - Some seniors have difficulties when using keys. Door locks with combination buttons and remote key fobs are now available. Some of these can even be activated by other remote devices such as cell phones or security systems.

While these are all great improvements for the doors themselves, don’t forget to address the lighting near your doorways. For example, motion detectors can automatically turn on the lights when approaching the door. This will free up both hands for opening the door, carrying groceries or even stability. Now all you need is a friendly welcome mat!

7 Ways to Make Your Bathroom More Accessible for the Elderly

senior friendly bathroomFor the elderly, using the bathroom effectively – whether it is the toilet, faucets, or the shower and bathtub – can be difficult. For people who have lost mobility and strength, standing in a shower for a long time isn’t possible, and getting in and out of a bathtub is a risky proposition.

Thankfully there has been progress in bathroom remodeling geared towards helping seniors navigate the bathroom with ease. The remodeling covers a wide range, from something as simple as a sprayer attachment that allows for the person to sit while bathing, to curbless showers that remove the need to step up for access. These changes can help the elderly be more independent in the bathroom, and they also help the elderly caregiver give better care to their loved one.

Here are seven ways you can make your bathroom more accessible for the elderly.

1. Install lever faucets. Having a lever faucet gets rid of the twisting and turning that can be difficult for the elderly. There are hundreds of different styles to choose from, including foot operated faucets. Installing a new faucet isn’t as difficult as it once was, but anytime you’re dealing with plumbing, it is good to at least talk with a professional before making the change yourself.

2. Get a sprayer attachment for your shower-head. A shower-head that you can detach and hold in your hand makes bathing really easy. It furthermore eliminates the need to stand while showering, certainly a bonus for those who have problems standing for long periods. Being able to sit and shower also means more independence for the elderly.

3. Install grab bars and rails. This is one of the easiest and cost-effective ways to make your bathroom more elderly-friendly. Installing grab bars and rails in the shower, bathtub and near the toilet makes bathing and using the toilet easier not only for the elderly person, but for the caregiver as well. The grab bars and rails can be installed yourself or you can hire someone to do the work.

4. Raise the height of the toilet. Simply raising the toilet’s height as little as three inches can make all the difference for seniors. There are a lot of options for raising the height of the toilet. You can simply raise the height of your existing toilet with a thick toilet seat, or you can replace your old toilet with a “Comfort Height” toilet. Once again, this can be a DIY project, or a project where you call a plumber.

5. Thick rugs for cushioning. This simple and easy addition to the bathroom is for the elderly caregivers that are spending time on their knees bathing someone. Placing a well-padded rug or pillow under your knees can keep your knees from hurting, making the bathing process less of a chore.

6. Non-slip bath mats and rugs. This is another easy way to prevent falls in the bathroom. Placing a non-slip mat in the shower prevents the senior from falling while showering and a non-slip rug on the floor outside the shower prevents any slipping once the senior is out of the shower. Non-slip tape is a lower cost option for shower pans and tub bottoms.

7. Curbless showers and Walk-in bathtubs. For the seniors that can’t lift their legs, putting in a curbless shower can be a lifesaver. A curbless shower can make the transition from wheelchair to shower seat simple and easy for the senior and the caregiver. Walk-in bath tubs are another popular option, as they are much easier to access than traditional tubs and most have a built in seat as well. There are many different options for installing a curbless shower or a walk-in bathtub. You can buy and have installed a pre-fabricated unit, or you can do it yourself. The advantage to having a new unit installed is that they are specifically designed for senior care.

There are twin goals to redoing your bathroom: the first is to increase the independence of your loved one, and the second is to make life easier for you the caregiver.

What changes to your bathroom have you made? What is the most cost-effective way to change your bathroom to suit the elderly?

Creating a Senior-Friendly Kitchen

Accessible homes and kitchens can keep seniors at home longer. It can be hard to accept the way our bodies change as we get older. Although this varies from person to person, one thing that most seniors have in common is the desire to maintain their independence and the ability to pursue the activities that they love as long as possible. If you have a handicapped or elderly relative living in your home, there are steps you can take to make this easier for them.

In particular, not only do your loved ones want to continue to care for themselves, they also want to feel that they are helping take care of others. One place that this can happen is the kitchen. A good home-cooked dinner often provides the foundation for family interaction and communication. Even something less elaborate like assembling pre-prepared meals or re-heating leftovers can make seniors feel like they are contributing to the general welfare of the household.

When taking on tasks in the kitchen, most seniors face a range of physical challenges. These include:

  • Reduced mobility

  • Reduced flexibility, meaning difficulty reaching and bending

  • Reduced stamina and balance problems

  • General physical weakness and other symptoms of physical decline

Here are some suggestions for how you can help your elderly or handicapped relatives deal with these issues.

1. Challenges Relating to Mobility

Make sure that important areas of the kitchen are accessible to seniors. Create a “working triangle,” that will allow seniors to move through the space comfortably. To ensure that seniors can access important storage areas like kitchen cabinets and pantries, as well as major appliances, find a construction company that focuses on remodeling and retrofitting areas inside the home to make them ADA compliant.

Additionally, for seniors with disabilities — in particular those who use wheelchairs — major appliance manufacturers like General Electric sell ADA-compliant refrigerators, ovens, microwaves, and dishwashers. Making changes to improve ease of access can make using the kitchen more comfortable not only for your older relatives, but for everyone else in the household as well.

2. Challenges Relating to Reduced Flexibility

Because seniors have difficulty both reaching high and bending low, store important items on the shelves in the kitchen cabinets and pantry that are between shoulder and knee level. Smaller and lighter containers or objects (particularly those made of plastic) can go higher, while heavier ones, particularly those made of glass or ceramic, should be placed lower down.

Other strategies to improve accessibility include using pull-down shelves, or even open shelving and eliminating doors entirely. Microwaves should go on counters so that they are easy to reach, with sufficient space for hot food to be put down right away once it is finished cooking.

3. Challenges Relating to Reduced Stamina

It is also difficult for seniors to stand for long periods of time. This is both because seniors grow tired more quickly and because their legs and feet are not as easily able to handle the strain. Make sure that countertops and other surfaces are low enough that seniors can perform tasks like chopping from a seated position.

4. Other Physical Challenges

Seniors need an appropriate level of visibility to ensure that they don’t trip or bump into cabinet doors or appliances while moving around the kitchen. Make sure the kitchen is evenly and brightly lit. In addition, because many seniors have hearing issues, any timers or smoke/fire alarms should be set at a frequency and volume that seniors can hear. Electric can openers and special faucets/cabinet hardware/handles can help seniors with arthritis. Because many seniors have strength issues, cabinet hardware that can be pulled is preferable to that requiring twisting.

Are there other challenges that you have confronted when trying to make your kitchen accessible to older relatives? What steps have you taken to deal with them?

Chris Long is a store associate at a Home Depot in the Chicago suburbs. Chris also writes about kitchen remodeling for the Home Depot website, providing tips to homeowners on kitchen cabinets, faucets, sinks and appliances.


Successful Aging In Place begins with the Right Partners

America is aging and our life expectancy is increasing.   By the year 2030, there will be more than twice as many people aged 65+ years than there are today.  AARP surveys repeatedly indicate that people would prefer to reside in their existing homes.  However, only 16% of survey respondents have done home modifications.

The primary goal of a successful aging-in-place remodel is to gain or maintain the client’s independence over time.  This goal is best accomplished when an occupational therapist and a remodeler work as a team.

It is best to have an occupational therapist available at the beginning stages of a remodeling project because an occupational therapist brings a medical perspective and helps determine what will meet the client’s needs for now and in the future.  Occupational therapists are skilled at recognizing how the home environment affects the ability to participate in activities.   An occupational therapist evaluates balance, endurance, safety awareness, vision, and many other functional areas such as taking a shower or climbing the stairs.

The occupational therapist collaborates with the remodeler whose expertise is needed to determine the structural integrity regarding the installation of the modifications.  The remodeler has knowledge of building codes and specifications.  A remodeler who has a certified aging in place specialist (CAPS) designation understands universal design concepts and customizes the renovations based on the individual’s needs.  Together, the occupational therapist and remodeler create a much better outcome that will meet the client’s needs over time.

To learn more about partnering an occupational therapist with a remodeling professional, contact:

Nancy Dillinger, OTR, SCEM, ATP
AOTA Environmental Modification in SCEM
liveLife@Home, LLC
303/775-4984 (cell)

Home Modification to Reduce Falls?

On the surface, home modification appears to be a straightforward solution to reducing falls.  Free home safety audits are offered by many businesses and organizations at no cost to the consumer.  However, the effectiveness of home safety audits as a valid tool for reducing falls has been controversial and inconclusive.

To address this confusion, Clemson et al. (2008) conducted a systematic review of the highest quality studies that investigated the effectiveness of environmental interventions in reducing falls.  The authors concluded that there is evidence that home visit interventions that are comprehensive, focused, and incorporate an environmental-fit perspective can be successful in reducing falls when targeted to high-risk older adults.

Home Modification reduces falls when interventions include Occupational Therapy

This study also found that the highest reduction in falls was achieved when the home interventions were provided by an occupational therapist.  Occupational therapists are skilled at recognizing the fit between a person and the environment.  A home assessment by an occupational therapist goes beyond hazard identification to an analysis of the environmental-fit.  The occupational therapist problem solves,  identifies solutions, and bases recommendations on many factors including medical conditions, history of falls, daily activity patterns, balance, strength, vision, cognition, and other functional skills.

Fall reduction is further achieved when the older person is willing to change risk-taking behavior.  An occupational therapist teaches behavioral strategies to raise older adults awareness about their environment and how to negotiate it safely.  A follow up visit is vital to the home modification process to ensure the recommendations have been carried out according to the client’s needs and desires.

To learn more about occupational therapy and home modification contact:
Nancy Dillinger, OTR, SCEM, ATP
liveLife@Home, LLC

Source.  Clemson, L., Mackenzie, L., Ballinger, C., Close, J. Cumming, R. (2008). Environmental interventions to prevent falls in community-dwelling older people:  a meta-analysis of randomized trials.  Journal of Aging and Health, 20, 954-972.

Why Involve an Occupational Therapist When Adapting Your Home?

With the rising costs of senior housing and the downturn in the housing market, many boomers and seniors are turning to home modification as a long-term solution for aging in place.  Modifying an existing home can be challenging and frustrating without the right tools in place.  One of those tools is an occupational therapist.

There is a tremendous advantage to having an occupational therapist involved in the home adaptation process because an occupational therapist uses their medical background and clinical experience to determine what will meet the client’s needs for now and in the future.

An occupational therapist is a health care practitioner whose sole purpose is to help people participate in the activities that are meaningful to them.  Occupational therapists are skilled at recognizing how the environment affects the ability to perform desired activities.

Occupational therapy is a client-centered practice in which the client is an integral part of the process.  The occupational therapist provides an individualized evaluation during which the client/family and occupational therapist determine the individual’s goals.  The occupational therapist evaluates balance, coordination, endurance, safety awareness, attention, problem solving, vision, communication, and many other functions while the client performs daily tasks.   Through this process, a customized plan is developed to improve the ability to participate in activities safely and independently.  The intervention plan may include adapting the environment, modifying a task, teaching a skill, and educating the client/family in order to maximize safety and independence.

Home modification is very much a team process in which each player on the home modification team provides valuable information on the client’s behalf.  The occupational therapist collaborates with the builder/remodeler to ensure the recommendations are carried out according to the client’s goals.  The builder/remodeler determines the structural integrity regarding the installation of the modifications and has expert knowledge of building codes, specifications, and resources.  When an occupational therapist and the remodeler work together, they create a much better outcome for the client and family.

To learn more about the role of an Occupational Therapist and Home Modification contact:
Nancy Dillinger, OTR, SCEM, ATP
AOTA Environmental Modification in SCEM
liveLife@Home, LLC