Home Improvement Tips for the Aging and Elderly – Part 3

How to Create a Safe Haven for Independent Living

Part 3 of 3

House Wide General Improvements

Floors and Stairs

Steps pose a major danger to the elderly, particularly those with impaired strength, movement or balance. Attention to small details like proper railing installation, non-slip stair treads and the removal of area rugs from the tops and bottoms of staircases can help reduce the risk of injury. (Photo courtesy of IstockPhoto.com)

Since slipping and falling is a major cause of injury in the elderly, it’s important to pay particular attention to the condition of floors and stairs. There are many steps you can take to minimize the chance of injury by making sure floor and stair surfaces throughout the home are both safe and secure.

For Floors:

  • Secure carpets and area rugs with adequate grips so they don’t move or shift when people walk over them. Carpets with a high-quality rubber backing will grip smooth floor surfaces well. If existing carpets or area rugs don’t have rubber backing, install carpet tape or non-slip rug pads to keep them firmly in place.
  • Don’t place area rugs on top of wall-to-wall carpeting. They will not lie as flat as they should and edges that stick or curl up can cause trips and falls.
  • Consider replacing tile or hardwood floors with safer non-slip flooring, especially in bathrooms and kitchens.
  • Make sure transitions from room to room are completely seamless and flat and that transition pieces are not loose or sticking up. If there is a step (or steps) from one room down or up into another, be sure to provide handrails if possible and make sure steps are very obvious and easy to see. If the step is constructed of hardwood or tile or another smooth surface, be sure to install rubber stair treads or anti-slip tape for traction. Stair treads come in traditional styles or more decorative styles. Be sure to secure treads with an appropriate adhesive to keep them firmly in place.
  • Make sure wall-to-wall carpeting is tight and secure.
  • Make sure walkways within the home are clear of clutter and are wide and easy to maneuver.

For Stairs:

  • Ensure all stairs are even in height and are deep enough to comfortably place the entire foot on the step for proper balance. Although most houses have steps with standard-sized rises and depths, some older homes – particularly antiques in older regions of the country – have taller, shallower steps that are harder to navigate.
  • Check that every step is solidly constructed and has no loose boards or nails and fix any that are suspect.
  • For wood, painted or tile steps or steps made out of other smooth materials, be sure to install rubber or abrasive treads or anti-slip tape for proper footing and grip. Stair treads come in traditional styles or more decorative styles. Be sure to secure treads with an appropriate adhesive to keep them firmly in place.
  • For carpeted steps, be sure the carpeting is firmly installed and not sagging or loose.
  • Make sure handrails run the length of the entire staircase, are placed in a position that is easy to reach, provide enough surface area for a secure grip, and are securely fastened to the wall.
  • Consider installing a stair lift for people who have issues with balance, mobility or strength to ensure their safety going up and down staircases.
  • Do not place area rugs at the top or bottom of staircases, where trips or slips can result in serious injury.
  • If an elderly person is unable to use steps or a chair elevator consistently and safely, and their bedroom and/or bath is located upstairs, consider converting existing first level space into a bedroom and/or bathroom or construct a new addition with a bedroom and/or bathroom on the 1st floor.

Anti-Scald devices and Hot Water Temperature

As we age, we sometimes lose the ability to feel differences in temperatures. What might be painful to a younger person does not necessarily feel the same to an older person. Or, an elderly person might suffer from cognitive or memory issues and forget how to correctly set a water temperature when taking a bath or shower. Hot water can cause 3rd degree burns if it’s hot enough and a person’s body is exposed long enough. As such, it’s very important to make sure all household faucets are equipped with devices that help protect an elderly person from scalding water, and that the temperature of a hot water heater is not set to a dangerous level.

  • The temperature of the hot water heater should be set so that it does not output water above 118 degrees F. For most people, that temperature will cause discomfort or some pain, but it will not produce 1st degree burns. If a person living in the household is very sensitive to temperature, or is unable to distinguish between hot and cold sensations, then you may want to adjust the temperature to be 110 degrees F or less instead.
  • Make sure all faucets in the house are equipped with Anti-Scald Devices. There are different types of these devices; those that monitor pressure and adjust the flow of water, and those that monitor temperature and automatically adjust it if needed. Temperature based devices are more expensive than pressure based devices, but are more effective. The best devices are those that monitor both pressure and temperature. Not only is temperature adjusted if it’s sensed to be too hot, but the flow of water is cut or significantly reduced until the temperature has been adjusted to a safe level.

Cabinetry and Countertops

Trying to access high cabinets by using step stools or chairs, or crouching low to access floor cabinets can be very difficult and dangerous for an elderly person. In addition, high counter heights, particularly in kitchens, require a person to stand for long periods of time and are not accessible to those in wheelchairs. Handles and pulls can be hard to grasp, and drawers can be difficult to pull out. There are a number of thoughtful changes you can implement house wide that will improve the ability of an elderly person to interact easily and safely with cabinetry and countertops.

  • Adjust counter heights to accommodate people who are confined to wheelchairs or who can’t bend. They should be 28-34” high for someone in a wheelchair and 40” high for someone who has trouble bending.
  • Place as many every day items as possible – with the most popular items located in the most accessible places – in cabinets that are the easiest to reach and reserve harder to reach cabinets for storage of special occasion or seasonal items.
  • Use ergonomic, easy to grip handles and pulls
  • Use high quality drawer glides so pulling drawers out and pushing them in is simple and effortless.

Doorways

Be sure doorways are wide enough to comfortably accommodate people using wheelchairs or walking devices and gives them plenty of room to maneuver on either side. (Photo courtesy of IStockPhoto.com)

For the elderly (who may sometimes have vision problems, use walking aids, find themselves confined to wheelchairs or suffer from obesity), doorways can present potential obstacles to easy movement and navigation throughout a home. Making sure doorways meet the following criteria will help the elderly or mobility impaired avoid collisions with door jams and will facilitate easier, stress-free travel.

  • Doorways should be wide and tall to accommodate people confined to wheelchairs, who need to use canes or walkers or who are sight impaired and benefit from extra room to maneuver. A good width for a doorframe is 32” to 36”.
  • There should not be any furniture or other obstacles within 48” to 60” of the door to allow for the full movement of the door when opened or closed, and to ensure there is enough room for the person to maneuver around it.
  • Doors should not be unduly heavy or difficult to open or close.
  • Door latches should be easy to grip, ergonomic and not require tight pinching or grasping or twisting of the wrist to operate.

Windows

Depending on the type, windows can be difficult even for healthy young adults to open and so for the elderly, they can be extremely problematic.

  • Casement windows with cranks are the easiest for most people to open or close. There is no need for undue strength and the crank is usually positioned at a height that is easy for most people to reach, even those in wheelchairs.
  • Motorized window blinds can help make the use of blinds easy for people with limited motor skills or who are wheelchair bound.

Lighting

It’s not unusual for middle-aged people to suddenly realize they can’t read small type or see as well in the dark as they used to. And, unfortunately, as we age our eyesight usually becomes worse and our eyes more sensitive to extremes of light and dark. As such, its extremely important that elderly people have strategically placed lighting installed or placed throughout their homes that employ easy to use controls, allowing them to easily brighten and dim a room as needed so they can stay safe at night or during cloudy or stormy days.

Light switches

  • Use ergonomic light switches that have large tilt plates instead of those with small toggles
  • Position light switches so they are no higher than 48” from the floor, so people who have problems stretching or reaching or who are confined to wheel chairs are still able to reach them.

Light fixtures

  • Light fixtures like lamps should be easy to reach. If they are not controlled with a wall switch, pulls are the preferred method of operation because they are easy to grasp and use. If a knob is used, it should be big enough to grab and turn easily.
  • Lights should be placed in areas that are frequently used at night and that don’t require a user to get up and navigate through a dark room to get to the light switch. For example, a lamp should always be placed next to the bed and within easy reach, so if a person needs to get up from bed at night, they can easily turn on the light first in order to navigate the room safely. Similar places would include a light next to a favorite chair or sofa.
  • Night lights are extremely helpful in areas of the house that may be dark if a person must transverse them before turning on a light elsewhere. They may help those with compromised vision to avoid tripping over or bumping into objects until they are able to turn on a light.
  • Be sure shades on lamps or light fixtures let ample light through. Dark shades may look fashionable, but they significantly cut down the amount of ambient light emitted from light fixtures and can make a room too dark for people with compromised eyesight.
  • The amount of lighting in a room or area may need to be increased or decreased depending on a person’s need for brighter or dimmer surroundings. Most elderly people need more light to help them see clearly and more easily. Some who have conditions that make them sensitive to light, like people who suffer from chronic migraines, may need to have light adjusted to be less harsh, and more diffuse. Dimmers are a great way to control the amount of light coming from a ceiling or wall fixture and allow people to adjust the light level as needed.

Electrical Appliances

Electrical appliances are generally designed for the average healthy adult, so they can sometimes be difficult to use by people with compromised eyesight, strength, dexterity or mobility. Because they are electric, they can also be dangerous to those who don’t or aren’t able to correctly handle them.

  • Be sure to contact major appliance manufacturers to enquire about specialty products or options that address physical limitations. Many manufacturers have products available with features like large displays for sight impaired people or larger knobs for those with compromised manual strength or dexterity.
  • Major appliances should be positioned so they are easily accessible from either side. Make sure there is plenty of room around the appliances for people to move about and around each other if necessary.
  • Be sure major electrical appliances are on their own circuits with breakers so that they can be easily turned off if needed, are protected from power surges that may occur in other circuits in the home, and so they don’t overload electrical circuits when other electrical appliances are concurrently running.
  • If an elderly person relies upon an electrical appliance to provide a health benefit, like a specific medical device or space heater, make sure that in the event of an extended power outage, backup power is available for those appliances.
  • Position electrical outlets so they are no lower than 15” from the floor and no higher than 48” so people who have problems bending or crouching or who are confined to wheel chairs are still able to reach them.
  • Position thermostats no higher than 48” from the floor so they are accessible to people in wheelchairs.
  • Never place an electric appliance in the vicinity of a sink or bathtub, or other area where it can be knocked over and fall into water or get splashed with water. This is especially true of space heaters in the bathroom.
  • Be sure countertop and other small appliances remain unplugged when not in use.

General Tips

There are very simple changes you can make to the home that are surprisingly effective at providing a safer and more secure environment for an older individual:

  • Remove hanging tablecloths or other draping linens from tables, beds, coffee tables or other pieces of furniture that may droop to the floor, get tangled in feet or legs, and cause trips and falls.
  • Remove tablecloths or other pads that slip easily on counters or tables to prevent accidental scalding with hot food or liquids.
  • Make sure furniture and other objects in the house do not have broken or sharp edges, nails or screws that are sticking out, and are placed well out of the way of typical foot traffic.
  • If an elderly person lives with pets, try to keep pets from being underfoot. Small pets may be hard to see and cause trips or falls. High-strung pets can cause injury or falls. Crating pets during times when the person is moving about the home or securing the pet in a separate room when they’re highly excited can be helpful.
  • If an elderly person lives with children, be sure to educate the children on interacting safely with the elderly person. For example, ask them to help the elderly person with easy tasks, like retrieving items from other rooms or helping them read a label. Also ask children to be considerate of the elderly person’s mobility and strength issues by not leaving their toys or other items on the floor where they can be tripped over, and to refrain from jumping on or bumping brusquely into the elderly person.

Also see- Part 1 and Part 2 of this article.

Sources:

1. ADA Accessibility Guidelines for Buildings and Facilities (ADAAG); http://www.access-board.gov/adaag/html/adaag.htm#4.16

2. Anti-Scald Device Installation, by Tim Carter; http://www.askthebuilder.com/B55_Anti-Scald_Device_Installation.shtml

3. Bathroom Designs for the Elderly and Handicapped, by Tracey Kelley and contributors Sarah White and Wendy Michaels.

http://homeimprovement.lovetoknow.com/Bathroom_Designs_for_the_Elderly_and_Handicapped

4. Bathroom Toilet Seat Lights, by Tracey Kelley and contributor Sarah White.

http://homeimprovement.lovetoknow.com/Bathroom_Toilet_Seat_Lights

5. Home Caregivers Follow Bed & Bath Safety Tips for Elderly Persons, by Mary King; http://www.suite101.com/content/home-caregivers-follow-bed–bath-safety-tips-for-elderly-persons-a260937

6. Accident-Prevention Tips, by the Editors of Consumer Guide; http://home.howstuffworks.com/home-improvement/household-safety/tips/accident-prevention-tips.htm

7. Security & the Elderly – Tips to Reduce Stress & Be Safe, by Mark McLean; http://ezinearticles.com/?Security-and-the-Elderly—Tips-to-Reduce-Stress-and-Be-Safe&id=4260577

8. Making Your Kitchen “User Friendly”, by Christine A. Price, OSU Extension State Specialist, Gerontology, Department of Human Development and Family Science; http://ohioline.osu.edu/ss-fact/0179.html