use the restroom multiple times within a short time frame as the fluid is removed from their system. Therefore, bath locations in the home close to commonly used spaces and the ease of entering and utilizing the commode would be very important. Diabetes Complications from diabetes, such as peripheral neuropathy and diabetic retinopathy, have already been touched upon in above sections. Difficulty with blood sugar control impacts every body system and the person’s daily functioning. Not only might he or she need special considerations for insulin storage, but minimizing the risks of wounds and other injuries should be a top priority. With diabetes, wounds heal much more slowly, leading to an increased risk of infections and amputations. With poor blood sugar management, people are also at a higher risk of falls. A good clinician should assess eyesight, sensation, balance, pain, and medication/blood sugar management when meeting a client in order to adapt the environment to reduce the risk of injury. Falls Falling is the number one concern with older adults. As mentioned above, many condition symptoms can place someone at a higher risk of falling. Older adults may also experience orthostatic hypotension when going from sit to stand, or simply when standing still. This drop in blood pressure may cause a fall. Other causes of falls not previously mentioned include syncope, fear of falling, and presbyastasis, which is an unknown cause of disequilibrium. Low vision also contributes to an increased fall risk. Home modifications greatly decrease the risk of falls with older adults and proactive design also reduces their risk of falls and injuries. An older adult who falls and breaks a hip has an increased risk of death in the near future; therefore reducing the risk of falls increases longevity and quality of life. Conclusion Despite the myriad of conditions older adults may face on a daily basis, it does not mean they are not incapable of remaining at home with the proper physical and social supports. Good proactive home design and home modifications can lessen the impact of the environment on the aging process and support older adults’ health and well-being in their homes.
also can develop peripheral neuropathies. Because multiple sclerosis does affect the central nervous system, people also experience cognitive deficits, which have been described as a brain fog. Symptoms can vary based on the day, the individual’s fatigue level, and the type of multiple sclerosis. Other conditions Older adults may also live with other conditions not mentioned above. These also require considerations to help them maintain their safety in their home, reduce potential injuries, and decrease the impact of these conditions on their daily lives. Chronic obstructive pulmonary disease Chronic obstructive pulmonary disease (COPD) is a progressive disease of the lungs. People who were smokers or sustained environmental exposure to smoke or other chemicals/irritants to their lungs often develop this in their later years. It impacts their ability to breathe and expel oxygen. The misconception is that people with COPD cannot get enough oxygen into their bodies. The reality is that with poor exhalation, carbon dioxide remains in the lungs and cannot be replaced with fresh oxygen. Some people may be on 24-hour oxygen, therefore outlet locations and ensuring power during outages would be very important. Because people with COPD became out of breath and fatigued with simple activities, consideration of the size of spaces is important. It is not uncommon for someone to move their entire daily life into one or two rooms of a larger house because moving between multiple rooms is too exhausting or the oxygen saturator tubing cannot reach all areas of the home. Congestive heart failure Congestive heart failure is another progressive disease in which the heart pumps become weaker, causing fluid buildup in the system and more pressure placed on the heart. Heart muscles have to work very hard to move blood through the body, and oxygen often does not reach where it should. Edema in the extremities due to the lack of blood flow may also occur. The edema causes balance problems; it can be difficult to stand on swollen legs and feet. People with congestive heart failure experience fatigue through the day, and may also be on supplemental oxygen, as a person with COPD. A congestive heart failure consideration is the medications used to manage the fluid. Diuretics are often prescribed; once taken, someone may need to All aging in place and home modification recommendations should always be made with the needs of the individuals utilizing the space in mind. However, there are some basic concepts, guidelines, and principles that serve as a strong foundation when Universal Design principles Universal Design (UD) is a concept created by the Center for Universal Design at North Carolina State University. The basic idea behind UD is that products and environments are to be accessible and usable by as many people as possible (North Carolina State University, 2016). Table 2 describes the seven UD principles in more detail. It is very important to note that actual usability of any modification or recommendation should be individualized to the client in question. Physical therapists should use their
BASICS OF AGING IN PLACE RECOMMENDATIONS
making these suggestions. These are not meant to be one-size- fits-all, but are a great place to start when considering how to serve your client best.
clinical reasoning skills to determine whether the desired recommendation would be appropriate. Some people will require specific modifications to address particular challenges. Clinicians should also recognize that designs, products, and environments may address a few UD principles, but many will not address all seven simultaneously. Regardless, UD is a good place to start when considering home modifications; it also considers the needs and ability of other people using the space while accommodating the clients themselves.
Table 2: Universal Design Principles Principle Definition
Example
Automatic doors at the grocery store: They will open for everyone. Lever handles on doors: They can be opened by gripping or with a fist or elbow. A ramp leading to a door: People know to walk up a ramp rather than stairs to access entrances/exits without specialized instructions.
1. Equitability in use People with varying abilities can use the device/environment.
2. Flexibility in use.
Accommodates a wide range of abilities and preferences. Easy to manipulate the item/ environment without training or instructions; easy to comprehend.
3. Simple and
intuitive design.
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