When Dan Bawden teaches contractors and builders about ageing-in-place, he has them get into a wheelchair. See what it’s like to try to do things from this perspective, he tells them.
That’s when previously unappreciated obstacles snap into focus.
Bathroom doorways are too narrow to get through. Hallways don’t allow enough room to turn around. Light switches are too high and electrical outlets too low to reach easily. Cabinets beneath a kitchen sink prevent someone from rolling up close and doing the dishes.
It’s an “aha moment” for most of his students, who’ve never actually experienced these kinds of limitations or realised so keenly how home design can interfere with – or promote – an individual’s functioning.
About two million older adults in the United States use wheelchairs, according to the US Census Bureau; seven million more use canes, crutches or walkers.
That number is set to swell with the ageing population: 20 years from now, 17 million US households will include at least one mobility-challenged older adult, according to a recent report from Harvard University’s Joint Centre for Housing Studies.
How well has the housing industry accommodated this population?
“Very poorly,” said Bawden, chair of the remodellers division at the US National Association of Home Builders and president of Legal Eagle Contractors in Bellaire, Texas. “I give them a D.”
Researchers at the Harvard centre found that fewer than 10% of seniors live in homes or apartments outfitted with basic features that enhance accessibility – notably, entrances without steps, extra-wide hallways or doors needed for people with wheelchairs or walkers.
Even less common are features that promote “usability” – carrying out the activities of daily life with a measure of ease and independence.
We asked several experts to describe some common issues mobility-challenged seniors encounter at home, and how they can be addressed. The list below is what they suggested may need attention.
Getting inside. A ramp will be needed for homes with steps leading up to the front or back door when someone uses a wheelchair, either permanently or temporarily.
Doors. Getting through doorways easily is a problem for people who use walkers or wheelchairs. They should be about 1m wide to allow easy access, but almost never are.
Clearance. Ideally, people using wheelchairs need a 1.5m path in which to move and turn around, Bawden said. Often that requires getting rid of furniture in the living room, dining room and bedroom.
Another rule of thumb: People in wheelchairs have a reach of 60cm to 1.2m. That means they won’t be able to reach items in cabinets above kitchen counters or bathroom sinks.
Also, light switches on walls will need to be placed no more than 1.2m from the floor and electrical outlets raised to 45cm from their usual 35cm height.
Lighting. Older eyes need more light and distinct contrasts to see well. A single light fixture hanging from the centre of the dining room or kitchen probably won’t offer enough illumination.
You’ll want to distribute lighting throughout each room and consider repainting walls so their colours contrast sharply with your floor materials.
Kitchen. Mark Lichter, director of the architecture programme for Paralysed Veterans of America, recommends that seniors who use walkers or wheelchairs take time in the kitchen of a unit they’re thinking of moving into and imagine preparing a meal.
Typically, cabinets need to be taken out from under the sink, to allow someone with a wheelchair to get up close, Lichter said. The same is true for the stove-top: The area underneath needs to be opened and control panels need to be in front.
Refrigerators with side-by-side doors are preferable to those with freezer areas on the bottom or on top. Slide out full-extension drawers maximise storage space, as can lazy Susans in the corner of bottom cabinets.
Laundry. Get a side-by-side front-loading washer and drier to allow for easy access, instead of machines that are stacked on top of each other.
Bathroom. When Jon Pynoos’ frail father-in-law, Harry, who was in his 80s, came to live in a small cottage in the back of his house, Pynoos put in a curbless shower with grab bars and a shower seat and a hand-held shower head that slid up and down on a pole.
Even a relatively small lip at the edge of the shower can be a fall risk for someone whose balance or movement is compromised.
Also, Pynoos, a professor of gerontology, public policy and urban planning at the University of Southern California, installed non-slip floor tiles and grab bars around a “comfort height” toilet.
Cabinets under the sink will need to be removed, and storage space for toiletries moved lower. A moveable toilet paper holder will be better than a wall-based unit for someone with arthritis who has trouble extending an arm sideways.
“It really wouldn’t take much effort or expense to design homes and apartments appropriately in the first place, to make ageing-in-place possible,” Pynoos said. Although “this still doesn’t happen very often”, he noted that awareness of what’s required is growing and well-designed, affordable products are becoming more widely available. – Kaiser Health News/Tribune News Service/Judith Graham