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 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
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.
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.
accessible and usable by as many people as possible (North Carolina State University, 2016). Table 2 describes the seven UD principles in more detail.
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. Brightly colored bump dot on the stove: Both the color contrast and the tactile cue provides location information of a desired setting or switch to the chef. The person can locate the switch setting through visual or tactile cues. Rocker light switches: The large switch plate can trigger the light without as much precision or force as a regular toggle light switch. Comfort-height toilets: The higher commode reduces pain and fatigue on knees and is more comfortable for many people to use.
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.
3. Simple and
Easy to manipulate the item/environment without training or instructions; easy to comprehend. Design gives important information to the person, regardless of his or her abilities.
intuitive design
4. Perceptible information
5. Tolerance for error Design can still be used successfully even if not manipulated as intended.
6. Low physical effort Will cause a minimum amount of fatigue and is efficient and comfortable to use.
7. Size and space for approach and use Bathrooms with the 5” turning radius: People with wheelchairs and walkers as well as those without mobility impairments can access the commode. Note. Adapted from North Carolina State University. (2016). The center for universal design. Retrieved from https://projects.ncsu.edu/www/ncsu/ design/sod5/cud People can access and use the device/ environment regardless of personal attributes.
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 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.
LEGISLATION AND GUIDELINES
The following legislation concerns itself directly with building guidelines of the actual environment. It is important to note that all of these are merely guidelines and a starting point.
Much like the UD Principles, people’s individual needs should always be considered when making home modification and design recommendations. The consideration of individual needs
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