may bring additional features into the design beyond what is minimally recommended by legislation or guidelines to increase people’s independence and safety. Americans with Disabilities Act (ADA) The Americans with Disabilities Act of 1990 was considered groundbreaking legislation that advocated for equal access for people with disabilities. The initial legislation created the 1991 ADA Standards for Accessible Design. These guidelines apply to public buildings and those receiving federal funding. They do not apply to residential housing. In 2010, revisions were made to the ADA, titled the 2010 ADA Standards for Accessible Design. These new standards became enforceable in 2012 and address new construction, accessibility, and barrier removal in public buildings (U.S. Department of Justice Civil Rights Division, 2017). These guidelines serve as a good start to designing for private homes; however, some standards are not appropriate for individual people or would not fit into a residential home. Many designers and builders consider ADA to be strict rules, and if ADA does not require a feature for safety, then they do not need to add that feature. They also may apply the rules to all environments, including private residences – an environment ADA was never intended to address. As occupational therapists, we should treat ADA as an initial starting point, but then be ready to recommend further modifications and features to The American National Standards Institute monitors the creation and use of standards in the United States. There is also a portion of ANSI that concerns itself with standardization of international codes and guidelines. ANSI was founded in 1918; some of the regulations and directives set forth by ANSI were incorporated into ADA legislation (ANSI, 2017). Builders, contractors, and designers may mention ANSI codes during projects. Fair Housing Act enhance safety and independence for our clients. American National Standards Institute (ANSI) The Fair Housing Act is an important piece of legislation in regard to home modifications. While there are rare exceptions based on the type of housing, the Fair Housing Act ensures that people cannot be discriminated against based on age or
disability. There are additional protections in the Act that allow for home modifications. A landlord may not refuse to house based on disability or need for modifications. A landlord also may not deny the implementation of reasonable modifications to individual units and common areas, provided it does not affect the value of the property. The owner is not required to pay for the modifications and is allowed to request that the property be returned to its previous state upon vacancy. Newer buildings with more than four units and an elevator must now have kitchens, bathrooms, common areas, and elevators that are wheelchair accessible. They must also have reinforced walls in the bathrooms for potential grab bar installation. If there is no elevator in the building, then the ground-floor units must follow these guidelines. However, if an older adult is living in an older condominium building without an elevator and needs to make modifications, the landlord must allow it (Castro, 2016). Building codes Building codes vary by municipality and can come into conflict with aging in place recommendations. However, these codes must be followed in order for the inspector to provide approval for the project; compromises must be made. Many municipalities require permits for various structures and final inspections. For custom-built homes, the house must be built according to code for the inspector to provide a certificate of occupancy. The following real-life example deals with a no-step entry for a custom-built private retirement home on a hill overlooking a lake. The homeowner, a man in his mid-50s, agreed to a no-step entrance at a side door for future use with a potential mobility device. However, due to the slope of the hill and drainage requirements for that site set forth by the code, the home had to remain at least 6” above ground level, making a no-step entry impossible. Therefore, it was decided to make the step at that entrance a single step as low as allowed. The detached garage location was also adjusted by a few feet to make room for a possible future ramp. This sort of proactive thinking allows for possible future modifications for the home, but also allows the home to meet the necessary building codes. Builders and architects are required to check for code compliance.
TEAM MEMBERS
The best work is done in a team. Every person on the home modifications and design team brings his or her unique viewpoint and scope of practice to the project. Good projects should always include a variety of professionals. Ideally, the other professionals on the team hold aging in place certifications and are trained to consider the unique needs of the older adult. Architects Architects are trained and licensed to plan, design, and supervise the construction of buildings and living spaces. They manage coordinating building codes, ADA regulations, and design to create a home that is both functional and aesthetic. There are two reigning schools of thought within architecture. One is that form and function go together, meaning that people must be able to utilize the space designed. The other is that form comes before function, meaning a provocative design is what is most important; therefore, it does not matter if people can utilize the space (Chabot, 2017). Fortunately, most architects who work in the aging-in-place market believe that form and function go together. They will start their assessments and ideas with the built environment first, working their way down to the person living within the space, making the occupational therapy perspective integral at the start of the design process. Builders and contractors Contractors are construction professionals who complete larger- scale projects that can last over several weeks or longer. They are typically the people who will perform the actual construction of the building and will work with architects to ensure that the facility is being built properly, within the confines of the landscape, and is in compliance with building codes. Licensure varies by state and specialty area. Builders are specialty
contractors who specialize in the actual construction of the home itself. They often coordinate and manage all other workers on site. Other contractors can be subcontractors to the builder for elements such as plumbing and electrical work (Chabot, 2017). Municipalities will have varying regulations regarding the licensure and certification of these professionals. Interior designers Interior designers are trained and licensed to address the layout and aesthetics of spaces. They focus on the functionality of an area, incorporating lighting, room colors, flooring, and furniture choice/layout. Interior designers have the option to specialize in healthcare, residential, and kitchen/bath design, among other specialties. They concern themselves with the human element of interacting with a space in every project they encounter (Chabot, 2017). Physical therapy As previously mentioned, home modifications and aging in place are emerging areas for physical therapists. Becoming part of the team will require much education on a physical therapist’s contribution and networking with design professionals. Physical therapists have the medical background but also understand the relationship between independent functioning during daily tasks, medical conditions, prognosis and the aging process, and the wants and needs of the individual. Physical therapists may review designs and advocate for either an alteration of ADA features or extra safety features beyond ADA guidelines in order to individualize and enhance the environment as necessary. Physical therapists bring the person back into the environment.
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Book Code: PTNY3622B
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