Questions 1. Based on the above information, what concerns would you have thinking about Nancy, John, Frank, and Jane regarding their future aging process? 2. What potential proactive recommendations could you make to support them in aging in place? Responses 1. John appears to be healthy but could experience age- related concerns such as decreasing memory, decreased balance, and decreased vision. Nancy already has decreased endurance due to her heart condition and pain on her right side due to the rheumatoid arthritis. It is likely that she will continue to have pain and develop decreased range of motion in her arms and hands due to the arthritis and experience further cardiac complications. She also has a history of ocular conditions in her family, as seen by her parents’ medical histories. Both Frank and Jane have low vision concerns, and Jane also has decreased stamina and balance. Trip hazards should be eliminated, items placed within reach to decrease risk of falls and to protect joints, and attention paid to lighting, with increased light in important areas while also reducing glare. In the future, any family member could require a mobility device and a place to sit while completing tasks. 2. Below is a list of design considerations to meet the future needs of all four people living in this house: ○ Hallways and doorways are 32 ” wide to accommodate future mobility devices. ○ Multiple rod heights and shelves were installed in closets; all closets are walk-in closets in anticipation of mobility devices.
○ Lever handles were installed on all doors, rocker switches for all light switches, and lever handles on all faucets. ○ Light switches have been lowered to 48 ” above the floor, and electrical outlets raised 15 ” ○ above the floor. ○ Matte, hardwood, and tile floors with no thresholds were chosen to eliminate glares and tripping hazards. ○ Soft-close hardware was used on drawers that are easy to open and close with the push of a finger. ○ A shallow pantry was installed, as well as pullout drawers and shelves in all kitchen cabinets. ○ Task lighting was placed above bathroom and kitchen counters. ○ Toe kicks have been added under all cabinets in the kitchen and bathrooms. ○ Comfort height toilets were installed in all bathrooms. ○ Two bathrooms have walk-in showers; one has a tub. ○ One bathroom has a wheelchair-height sink that can be used with a seat during hygiene tasks. ○ Blocking was placed behind the walls in the bathrooms for grab bar installation, with small portions of the walls protruding from the shower stalls for future grab bars. ○ Codes for drainage prevented a no-step entry; however, the garage has been situated far enough from the house that a ramp could be placed at the back door if needed. ○ Nancy and John chose a white/neutral theme, which may prove problematic for Frank’s and Jane’s eyesight; however, the molding and features in the home would be easy to modify with paint.
Resources Home Assessment Acquisition Please note that this is not an extensive list, nor does the author endorse any given assessment. This is for clinician reference, and the clinician should examine each assessment prior to use. Home Assessment Acquisition Information Rebuilding Together http://www.nj.gov/humanservices/doas/documents/checklist.pdf CDC Check for Safety https://www.cdc.gov/steadi/patient.html Craig Hospital Inventory of Environmental Factors (CHIEF) https://craighospital.org/uploads/CraigHospital.ChiefManual.pdf Housing Enabler http://www.enabler.nu/Screeningtool.pdf CASPAR http://homemods.org/hmap/courses/chmpp/CASPAROverview.pdf In-Home Occupational Performance Evaluation (I-HOPE) Contact for purchase: Susan Stark, PhD, OTR/L, at starks@wusm.wustl.edu Safer-Home v.3 http://www.vha.ca/wp-content/uploads/2015/07/SaferHomeOrderForm.pdf Home Environmental Assessment Protocol (HEAP) Available through Skills2Care training: http://www.jefferson.edu/university/health-professions/jefferson-elder-care/services.html Home Safety Self-Assessment Tool http://agingresearch.buffalo.edu/hssat/ Home for Life Design Home Assessment Solution (Electronic) http://www.homeforlifedesign.com/homeassessmentsolutions Available for an annual fee. Home Accessibility and Safety Assessment Checklist (Electronic) http://livinginplace.institute/valueofclipp Only available if Certified Living in Place Specialist certified and available with an annual fee. Home Modification Certifications Resources Description and Link Certified Aging in Place Specialist (CAPS) Designation after completion of a 3-day course from the National Association of Home Builders: https://www.nahb.org/en/learn/designations/certified-aging-in-place-specialist/how-to-earn- caps.aspx Certified Living in Place Specialist (CLIPP) Designation after completion of a 2-day course from the Living in Place Institute: http://www.livinginplace.institute Executive Certification in Home Modifications A series of online courses with a designation on home modifications: https://www.homemods.org/online-courses/legal/certificate.shtml
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