Elderproofing Our Home

“Each year, one in every three adults age 65 and older falls…fortunately, falls are a Public

Health problem that is largely preventable.”

–Centers for Disease Control and Prevention–

With our own elder years looming before us, I have been guiding my husband in safety changes as he renovated our home.  We were lucky to get a head start because we completed some modifications in preparation for my parents’ arrival. Indeed, Home Safety Evaluations had been a major function of my years as a Home Health Nurse.

Symptom:  Elderly Often Find Performance of ADLs Difficult
As we age, we lose more of our functional ability for various reasons.  Arthritis and other debilities make ambulating more difficult.  Balance can become impaired. Medication side effects might cause dizziness or generalized weakness. The progression of many disease processes makes a potential fall a real threat.  Performing ADLs, or activities of daily living, simply becomes a challenge.
Diagnosis:  Our Environment Can Present Safety Hazards
What was a safe environment in our 60’s may not necessarily be safe for us in our 80’s.  Our home was built in the 1950’s.  Since our plan is to stay in our home until we die, we knew we needed to make changes.  This became very concrete for us when my husband’s parents visited.  My mother in law could not get her walker into the bathroom due to a narrow doorway.  She would turn it sideways and shuffle into the small space … truly a fall hazard for her!
Treatment:  Eliminate or Reduce Environmental Hazards
Upon entering any home, my eye was trained to look for safety issues.  A simple question I asked was, “What needs to be changed to facilitate the safe performance of ADLs?” ADLs include mobility, eating, dressing, bathing and showering, oral hygiene, grooming, and toileting.
Are there steps to deal with?
According to the National Safety Council, incidents related to stairs are second only to automobile accidents as the major cause of unintended injuries in the U.S.
My husband had already eliminated the step at the front porch when he transformed the front pathways with pavers.  No one needs to negotiate steps to enter our front door. A short ramp with railings can serve the same purpose.  Our home is ranch style, so all rooms are on the same level and easily accessed.
But if one did need to negotiate steps, a few simple rules would make it safer.
1.  Keep the area well lit with light switches at the top and bottom of the steps.
2. Keep the steps clear of clutter.
3. Make sure handrails are sturdy and well anchored.
4. Any carpeting on steps needs to be secure (not bunched up).
5. Steps that are not easily visible can be taped on the edge with a bright masking or duct tape.
Bathroom Safety
Once the decision was made to move Mom and Dad into our home, we began bathroom renovation in earnest.  The master bath was small with a shower measuring 29” x 29”.  It had an 8” step to hop over just to get in.  Both my parents needed assistance with their shower so I knew it would be impossible to accomplish this task in the existing shower space.
My husband’s design left us with an open shower space and a built- in seat.  Now, we are able to roll them into the shower on their seated walker and transfer them to the seat in the shower space.  It works perfectly. Several handrails were strategically placed to facilitate the transfer and keep fall risks at a minimum.
The door was removed and a pocket door was installed to make the doorway wide enough to accommodate a 4 wheel walker.  Tile was chosen to minimize slipperiness. And the commode was handicap height.  There was not enough space near the commode for handrails so eventually we placed a bedside commode over the regular commode since it has arms to assist in standing.
Safety with Mobility
We had already removed carpeting in all rooms except the bedrooms.  The family room has an area rug but it is not thick and we did not place any padding underneath.  Throw rugs are dangerous for anyone using a walker.  And we need to be mindful whenever going from a smooth surface to carpeting.  Mom and Dad are always assisted by one of us when they walk so fall risk is minimal.
While there are many other safety issues to consider (to be addressed in a future blog), elder proofing our home was the first step.