reach them; clearing space on the countertop or using a microwave cart solves this problem. Sinks can become too deep and the faucet more difficult to manipulate. Replacing the faucet knobs with a lever faucet or a touch or motion sensor system makes controlling the water easier. The sink depth can also be lessened by adding sink bottom grids. An ideal sink for aging in place is about 6.5” deep to eliminate excess bending and reaching. Raising the dishwasher can also help in the same way, though this can create a bump in the countertop. Dishwasher and microwave drawers, while an interesting concept, are not the best ideas for older adults because hot air and steam will rise into their faces when opening the unit. Along the same lines, setting the hot-water gauge to a lower temperature will avoid scalding. The stove in Figure 8 has large, easy-to-turn knobs that are located at the front of the stove. The location of the knobs ensures safety, and the size will be easy to manipulate in the future. Figure 8: Stove Controls
Figure 7: Cabinets and Drawers
Note. From Western Schools, © 2018. Countertop choices tend to be a matter of preference for the older adult. They can be useful as alternative storage places for items in kitchen cabinets or microwaves that are too tall to use. Countertops may need to be lowered to 28” to 34” to accommodate potential wheelchair use; a kitchen might include counters of varying heights for all users. Corners should always be rounded to avoid potential injuries during inadvertent collisions. Changes in vision can make it difficult for people to discern objects and dirt, especially with busy granite countertops. Plain countertops with good contrast between the counter and appliances make it easier to clean and discern between objects in the kitchen. Matte countertops are also ideal for reducing glare. The clinician should also pay attention to windows, sun directions, and lighting to determine the glare at various points of the day. Appliances in the kitchen become difficult to use due to decreased hand function and the introduction of mobility devices. Transporting objects from the refrigerator can be tricky, especially when using a walker. The clinician should assess whether the swing of the refrigerator door blocks islands and counters; if so, some refrigerators have the capacity to switch the sides of the door hinges. Side-by-side-door refrigerators with slide-out bins and shelves are best. Some refrigerators come with large lettering, long door handles, and lighting on the ice maker and water dispenser. Stovetops can be potentially dangerous. Moving controls to the front or top front of the stove reduces the need to reach over hot areas. Some stoves also come with larger knobs, which will be easier to manipulate as someone ages. Microwave placements are also a common problem for older adults who can no longer Entryways Difficulty exiting and entering the home is one reason older adults become housebound. Ideally at least one entrance to the home should have no step to enter and enough space for the door to open and not block the person or hallways. During the home assessment, the clinician should check that sidewalks, porches, and handrails are in good condition so as not to pose an extra safety hazard. Ideally, the entryway should be covered as weather protection. Homeowners can speak with the local post office to move mailboxes from the curb to the front door. The post office should review the request with provision of appropriate documentation from a physician that indicates the homeowner’s inability to access the mailbox safely. The new location of the box should be accessible to the homeowner; at times, people move it without considering its use, making the relocation moot. Installation of a package shelf at the entrance also helps older adults. They can place purses, bags, etc. on the shelf by the door, allowing them to safely retrieve their keys and manage the door. For those who have permanent steps, vertical platform lifts can be installed. These are especially common on inner-city row homes in certain parts of the country.
Note. From Western Schools, © 2018. Lighting concerns in the kitchen are the same for any room in the house. Placing lights above workstations and in cabinets and dark pantries will help illuminate the area. Kitchens typically have a natural light, which should be taken advantage of through skylights and the use of blinds and shades to reduce light angles. Before changing light sources, analyze the shadows from current light fixtures and see if a change in light bulb does not solve the problem. It is ideal to spread the light as evenly as possible across the kitchen. Adhesive puck and rope lights can be used to increase lighting and create task lighting; other light sources, such as light bars, can be installed and may require the use of an outlet or electrical work. With the doors themselves, no thresholds are best to reduce tripping hazards. However, thresholds do keep drafts and debris out while delineating different rooms. If thresholds are needed, they should be less than ¼” high, or ½” high with an angled edge and a 45° slope. If they are too big or steep, people will trip on them, or not be able to ambulate over them with mobility devices or wheelchairs. People have many options when it comes to doors. Each has its own unique properties to be considered given the space in the area, the person’s preferences, and current and potential needs. A common issue with doors is the width of the doorway. ADA requires 36” in public buildings; this is too wide for resident homes. In residences, 32” often suffices. If more space is needed and it is not possible to widen the doorway, installation of an offset door hinge will widen the door an extra two inches. Door hinges can also be replaced with double hinge door hinges to allow them to swing in either direction. Table 3 compares door types in more detail.
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