Society for the Advancement of Gerontological Environments (SAGE) In addition to running the EFA conference every year, the Society for the Advancement of Gerontological Environments is dedicated to advocating for age-friendly environments, reform of regulations of environments for aging in place, and implementation of design research (SAGE, 2017). Membership is Conclusion Aging in place and home modifications for older adults is a multifaceted project. Attention must be given to both the client’s current abilities and future concerns, so the environment never becomes an inadvertent barrier to independence. The proper environment will support an older adult through normal age- related changes and progression of diseases. Physical therapists focus on the interplay of the person, environment, and occupation when determining interventions to increase independence in the home. When considering aging in place in the home, a focus on both compensation and proactive modifications will serve to allow individuals to stay at home longer. Clinicians should consider the use of a comprehensive home assessment to initiate home modification work and ensure thorough recommendations. Attention to many different details within the home, ranging from colors of walls and floors, to materials used in construction, location of lights, types of light switches and doorknobs, hallway widths, and direction of door Case study Nancy and John are a 58-year-old married couple preparing for their retirement. They have bought a plot of land on which to custom build their retirement home. John is healthy with no major health concerns other than a bicep tendon tear in his left arm from a ski accident that has left him with less strength in his nondominant hand. His wife, Nancy, has some health concerns. She has a mitral valve prolapse, which causes her to experience an irregular heartbeat with too much exertion. She also has rheumatoid arthritis, which currently presents itself with pain in her fingers and her right shoulder. They intend to move into their home once John retires in 10 years; however, Nancy’s parents, Frank and Jane, have moved south from the northeast United States to live in the home. Frank and Jane are in their early 80s. Frank has diabetes, an intention tremor, and the start of glaucoma, which is under control with medication. Jane also has a mitral valve prolapse, causing her to become fatigued very easily, and is starting to lose her eyesight due to macular degeneration. Jane also trips often when she walks. When Nancy and John visit Frank and Jane in their custom home, the family dog, a miniature Schnauzer, accompanies them. In planning a custom-built home, there was a unique opportunity to address current health concerns but also to plan proactively. All four individuals intend to remain in this home for the rest of their lives. The home is a 2200-square-foot ranch with three bedrooms, three bathrooms, a basement, living room, and office. 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
composed of many different professions, ranging from students and healthcare professionals to manufacturers, regulators, and design professionals. SAGE also hosts design competitions, webinars, and educational sessions; they also will complete post occupancy evaluations. By becoming a member, you receive a discount to the EFA conference and networking opportunities. swings can increase the potential of someone to live in his or her home for many years to come despite possible changes in function. Serving as consultants to design professionals is an emerging niche in therapy practice and could be an interesting business endeavor for interested clinicians. As the population of older adults grows, more aging-in-place-certified clinicians will be needed to address their home modification needs. The unique perspective of a physical therapist enhances the design of architects and interior designers and the work of contractors to create a truly supportive environment. Interested clinicians should pursue other educational opportunities to advance their skills in home modifications and aging in place while taking advantage of networking opportunities provided within some of the certification courses. With all the available resources in development, physical therapists are poised to be influential in the upcoming years. 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.
EliteLearning.com/Physical-Therapy
Book Code: PTNY3622B
Page 129
Powered by FlippingBook