1. Americans with Disabilities Act (ADA) in Senior Living
Resources: Pierson and Fairchild, Ch. 12 O’Sullivan text, &
US Dept. of Justice, Disability Rights Section
Heather Braden, PT, MPT, PhD, GCS

2. Objectives
Identify workplace accommodations for seniors who are still in the workforce
Identify public accommodations in stores and transport for seniors
Recognize home accommodation needs for seniors
Discuss and assign a home evaluation for a senior

3. Federal Statutes
ADA requires that goods/services available to the public be available to persons with disabilities
Violations result in fines/injunctions with court orders requiring defendants to make their business more accessible to persons with disabilities
ADA protects those w/ AIDS, cancer, MR, learning impairments, deafness, blindness, traumatic brain injury, and others

4. Workplace Assessment for Seniors in the workforce (some folks never retire)
Title I: Employment- may not discriminate for disability in hiring or promoting if person is otherwise qualified for job
Reasonable accommodations for employees are requested w/out undue hardship on the company
The essential functions of the job must be met
Adjusting & re-arranging equipment, providing readers/interpreters if a vision/language impairment, modifying work schedule, AD such as large print or amplifiers, accessible restrooms & doorways.
Parking size, surface, entry with illumination, platform, access to eating area, elevator, refreshment machines

5. Federal Statutes in the Community
Title II: Public Service- may not discriminate re: public transportation
6 minute video describing benefits of ADA re: transportation
Title III: Public Accommodations- access to
restaurants, hotels, stores, theaters
“Universal design” when building to
minimize re-modeling needs
Public facilities require equal access for
those with disabilities
Remove structural barriers
Install ramps, widen doors, sufficient parking space, grab bars, restroom with w/c access, phone and fountain heights, cut out curbs
Public transportation access, crosswalk indicators, parking spaces, entry to buildings, access to counter tops & checkout areas, aisles, emergency exits
4 minute video- town in TX that needed to improve ADA compliance in certain areas
Universal design= stepless entrances, wide hallways/doors, level transitions b/t rooms w/ no thresholds, nonslip floors, lever door handles, rocker light switches, single-handle sink faucets, no-step shower access

6. Universal Design of public facilities
Steps <7 inches tall and >11 inches deep w/ handrails extending at least 12 inches beyond top & bottom of stairs
Steps with tactile warning strips to alert person a change is coming
5’x5’ area at doors
34” doorway width and lever style door handles
Choose firm furniture with double arm rests and upright backs
Non-slip, level floors w/ matte finish to reduce glare

7. Home, Nursing Home, Assisted Living Assessment
Sidewalk, driveway and garage (detached?), approach to entry w/ steps, porch (lighting?), threshold height
Access to electrical outlets, light switches, access to call lights/phones, access to smoke detectors, emergency exit, heating/cooling controls
Access to sink, tub/shower, medicine cabinet, protection from hot water pipes from w/c level
Access to clothes, closet, bed height
Home Evaluations can be via video taping or in person

8. Assignment: Home Assess/Evaluation ADA W/C Accessible “Home”
Choose a senior citizen 70+ y/o and complete a home assessment. Their home may be a local nursing home, ALF, senior care center, or residence. Bring a tape measure.
Check out w/c or walker from DPT Program Office if need be.
Utilize the ADA w/c accessible home specifications and HOME ASSESSMENT form.
Assess the home recommending WHEELCHAIR LEVEL or WALKER LEVEL needs.
Turn in Home Assessment as instructed by deadline.

9. W/C Accessible Specifications at Home (see ADA w/c accessible home handout)
Garage- 10 feet height w/ direct access to house
Sidewalk – 36 inches (in) minimum
Doorway- 32 inches minimum
Ramp- 1 inch rise for every 12 inches run/distance
Hall width- 32 inch minimum, 40 inch preferred
Threshold- ½ inch or none
Electrical outlets & phone access- 18 inch from floor
Switches- rocker type switch, 40 inches from floor
Door handles (lever) & Windows- 36 inches from floor
Floor- firm w/ no rugs
Cabinets, Outlets, Microwaves access- 36 inch depth clearance in front and to reach

10. W/C Accessible Specifications at Home (See handout for w/c accessible home)
KITCHEN
U/L-shaped floor plan with 5’x5’ turning radius
Counter top, sink height, range height in from floor & knee clearance of at least inches
Electric stoves w/ controls on front or side
Dishwashers elevated 6 in w/ front controls
Side-by-side frig is needed
Counter top microwave is needed
Use glide-out cabinet shelves to improve
access to storage areas

11. W/C Accessible Bathroom
Toilet in from floor, grab bars needed
Roll-in shower- 5’x5’ or regular shower- 3’x3’ w/ grab bars; tub seat, hand held shower head, & adhesive strips to minimize slipping on the tub/shower surface likely needed
Sink- 34 in max from floor (bowl depth slope front to back) and insulate pipes to prevent burns
Thermometer to test water temp prior to bathing
Grab bar inches long attached securely

12. W/C Accessible Bedroom
Bed height in, space for w/c transfer
Closet- slide doors, rods adjustable to in max from floor with wall hooks and shelves around 45 inches
Dressers- 36 in from floor w/ 36 in “reach and access” zones

13. Adaptive Home Features -Disability Connections, 2011
Install hinges allowing door to open and drop back in line w/ frame for extra clearance
Remove trim around inside of door adding ½ inch
Remove hand rims off w/c
Mount adjustable mirrors above stove so can see into pots from the w/c
Buy a “reacher” to turn off burners
Use shelf liner to open jars/bottles
Buy large handled cutlery for arthritis or s/p CVA
Buy oversized, lit key pads for phones (do not pre- program 911)

14. Adaptive Home Features (continued)…….
Mount battery operated lights in closets or pantries (if no light exists already)
Place hats, gloves, scarves, etc in baskets easily reached to avoid top shelves
Place a cut tennis ball over door knobs for comfortable grip and turn or use longer lever handle
Choose keys with large, round tops and apply rubberized, color rims for easy identification
Add tassels, large loops or cords to zippers so arthritic fingers can dress successfully
Rearrange furniture for wider walkways for canes and walkers

15. ADA SUMMARY
PTs are experts of functional movement analysis. Be prepared to assess and recommend adaptations for your patients’ daily needs.
If a pt’s current living environment is not feasible to remodel, be prepared to recommend alternative living quarters based upon pt’s needs and safety.