After a dementia diagnosis, safety at home is often a big concern in care for the elderly. When our abilities change our homes can disable and isolate us. Most current environments do not meet our needs at every age and ability, and this is equally true when it comes to ageing in place. There is an elegant and empowering solution known as inclusive design.
Nichole Kain, an environmental gerontologist and inclusive housing specialist, defines inclusive design as “a way to design to be truly inclusive of all people. For example, taking into consideration the languages spoken, people’s religious practices, and physical or cognitive abilities. This method of design and planning can feel big and broad, but we do not have to do this alone. Inclusive design is a collaborative effort. Creating an inclusive space can be done by creating an inclusive design process.”
Home safety changes for seniors who are ageing in place can range from new inclusively designed construction to simple things you can do with no extra help or money. This also applies to aged care services and aged care providers. To get you started, here are some room-by-room inclusive design ideas!
Safety at Home: Make Entranceways Usable
Jude Meyers Thomas, co-founder of The Eden Alternative and Minka Homes and Communities reflects that “the tragedy of ageing in place is that it can become ageing in solitude if the home is not inclusively designed. People are being isolated in their own homes and in parts of their own homes. Inclusive design offers the ability for people to interact with the outside world and be comfortable in their own environment. Thresholds are a huge part of maintaining engagement with nature and community.”
If you only make changes to one in home location, start with the entryway, paying attention to the following:
- Level threshold. Make sure that there is no level change at the door threshold so that it can be easily traversed in a wheelchair, with a walker, and with any step height.
- Width. Make sure the walkway and doorway are wide enough for a wheelchair, walker or two people arm-in-arm, such as having a nurse at home, to cross.
- Covered entrance. Make sure the area by the door is covered to make entering and exiting easier in all weather.
- Door clearance. Be sure there is ample room to manoeuvre around the door on the inside and outside.
- Single solid flooring. Options include hardwood, laminate, and concrete. Concrete has the added benefit of being very easy to clean and durable. Throw rugs can be potential tripping hazards. Concrete can have radiant heat built-in, which eliminates the need for rugs.
- Lever doorknob. For folks with cognitive changes, physical ability changes and arthritis, full lever door handles are much easier to operate.
- Motion sensor lights. Anywhere there is a level change, put a motion sensor light. Make level changes high contrast such as painting a stripe on the edge of stairs. You want to maintain as much control over the environment so do not put motion sensor lights in areas like the bedroom.
Keep the Kitchen at the Heart of the Home Environment
Often kitchens are the hub of community in the home. It is important to make sure the kitchen can continue to serve this purpose throughout our lifetime, especially when one is ageing in place.
Thomas suggests you “think of your everyday activities in the kitchen and ask yourself would this drawer, would this appliance, would this cabinet be available to me if I was sitting, using a walker, accompanied by in home care services or have arthritis?”
Thomas goes on to remind us that “whenever we create a design that is accessible and universal it is good for all. I don’t like to think of designing for someone with a disability, I think of designing for all abilities and for visitability. Design that is good for us all.”
Improve home safety in the kitchen by looking at the following:
- Open spaces. Make sure you could open all cabinets and doors using a wheelchair or walker. Creating wide walkways and open spaces increases access and decreases the risk of falls from having to walk backward or sideways. Independence needs to be maintained when in home health care is not at the ready.
- Drawer appliances. As your appliances fail, consider replacing them with drawer options for the dishwasher and fridge/freezer. Drawers are easier to access from a seated position.
- Rearrange. Place objects you use frequently in easy to reach spaces. Consider storage options that offer visibility even when closed such as open shelving or glass cabinets. If you can see what is in a cabinet, you do not have to remember where things are. This is helpful for folks living with dementia as well as for guests and home care agency staff.
- Induction cooktops. As your stove fails, consider replacing it with an induction cooktop to reduce the risk of fires and burns for everyone.
- Technology. Smart fridges can help make sure fresh food is always available and fill in the gaps as cognitive abilities change. You can use devices like Google Home or Amazon Echo to remind you of appointments or medications. Many people living with dementia also finds these digital assistants a great resource for patient question answering. Many of them now also have communication abilities built in to stay connected when the company of in home care services is not present.
Bathroom Usability Tips
Hygiene is a huge part of our ability to live well in the place of our choosing. Setting up the bathroom for success and control is a crucial part of making it possible to enjoy ageing in place for as long as possible.
- High contrast. Swap out light switch plates to a colour that contrasts with the wall to make them more visible to those with vision changes. Do the same for taps and doorknobs.
- Rocker switch. The easiest light switches to use are the rocker style and can be used with an elbow, a closed fist, another object, etc.
- Disable heat lights. If left on accidentally these can be a fire hazard. You can easily swap out the switch plate for a blank one without a switch to make it impossible to turn these on.
- Lower water temperature. Many hot water heaters can be set to a heat that can scald. Avoid this risk by lowering the temp to 45 degrees or below. Reach out to your Council on the Ageing or the Fire Department for local recommendations of temperature and help.
- Raise the toilet. This will make it easier to sit down and get up when using the bathroom. Options range from seat boosters all the way to new toilets or the ‘Toilevator’ because it allows you to maintain the look and feel of your own toilet with the added benefit of height.
- Add grab bars. Install grab bars to prevent falls. An occupational therapist who could be arranged through the My Aged Care service finder could do a home visit. They will be able to recommend the right placement, colour and size grab bars for your family.
Inclusive design is more a way of thinking than a checklist. Use these ideas to spark thoughts and conversations.
Talk to the Experts
The best expert in inclusive design for your home is your loved one who is living with dementia or Alzheimer’s disease. Collaborate with them to find what works so they can maintain independence at home. Inclusive design is a way we can learn from those living with dementia to create spaces that are more usable and liveable for us all.
Try to become an expert in watching and observing and listening. Listen to the people who are living through these mismatches of their abilities and the space that they are living in. Look for clues in the environment and talk to your home care assistance team to cross reference your ideas and observations.
If talking isn’t an option, hang out with your loved one and see how they use the space. Focus your age-friendly home improvements on empowering them to continue to utilise their home in the ways they always have and continue to enjoy ageing in place.
By working with and learning from people with different abilities and needs, even in the same family, inclusive design can move from being mystifying too simple. “It is all about finding solutions that work for everyone,” shares Thomas.
Inclusive design is instinctual if people stop and think about it. There is no magic to it. Just think about the different positions that a person, visitor or in home health care provider might be in. Ask ‘how is this kitchen, bathroom, house usable for everyone that may be in it?’ Our circumstances can change in a heartbeat at every age. Building anything that doesn’t accommodate all abilities just doesn’t make sense.
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