1. Aging well Supporting Aging adults with Developmental Disabilities Home Adaptations

2. This training was made possible by generous grants from the New Jersey Council on Developmental Disabilities and from Spectrum for Living’s Endowment Fund.

3. Home Adaptations The information for this presentation was adapted from the manual, “A Home For Life: Home Modifications for Aging in Place with an Intellectual Disability.” By Richard V. Olsen, Ph.D and B. Lynn Hutchings, M.Arch.

4. GETTING INTO THE HOME Driveway: – Needs to be wide enough to transfer safely from the vehicle to the driveway and vice versa. – Flat, wide, and level and not-too-steep driveways and walkways are safer for older people, whether or not they use a wheelchair, cane or walker.

5. Getting into the home Walkways and Entrances: – well lit and free from shrubs or trees that obstruct access – Trim back or remove all shrubbery and grass that encroach on the sidewalks.

6. GETTING INTO THE HOME Steps: – All steps between the driveway and the front door should have double railings. Even single steps should have railings – Build rectangular steps, not curved or semi- circular steps, which are dangerous – On wide steps, railings should be installed close to the most direct path to the door so that they are within easy reach. – Sensor lights

7. GETTING INTO THE HOME Ramps: Should have: – Non-skid surfaces, not smooth surfaces – Cylindrical railings on both sides – A smooth transition to the sidewalk at the bottom or to the porch/landing/vehicle at the top

8. GETTING INTO THE HOME Ramps, Cont’d… – Additional space for opening the door if there is an entry at the top of the ramp – A lip or curb at the side edges to prevent the wheelchair from veering off the ramp – A proper width (36” between the two railings) – A landing with ample turning space and wide enough for a large wheelchair

9. GETTING INTO THE HOME Doorways should be well lit and free from shrubs or trees that obstruct access. Design/Redesign Tips… Repair/repave all uneven walkways Re-grade walkways to create a more gradual incline. Or, install a cylindrical railing on each side of a steep or sloping walkway. Trim back or remove all shrubbery and grass that encroaches on the sidewalk. Repair or repave transitions between different walking surfaces to ensure that they meet as smoothly and as seamlessly as possible. Remove steps (if possible) and re-grade the walkway. If removing steps is not possible, install railings on both sides.

10. Older people need more light, and they also have more difficulty adjusting from one light level to another. Walking from a well-lit house into the dark can be difficult and dangerous.

11. General “outside” Considerations Mail boxes should be accessible All exterior spaces that people use at night should be well lit: – driveways – parking lots – garages – trash areas.

12. General “outside” considerations Patios and pathways should be free of tripping hazards. Spaces between pavers can be tripping hazards.

13. Inside the home: Hallways & Doorways Good lighting: People should never have to walk through a darkened hallway to turn on a light. Night lights, particularly for hallways that lead from the bedroom to the bathroom. Low (preferably no) thresholds on door sills.

14. Inside the home: Hallways & Doorways Handrails in hallways Sunken rooms that have steps must have handrails or grab bars. Hallways and doorways must be wide enough to accommodate wheelchairs. Tripping hazards should be corrected or removed

15. Inside the Home: Stairs Good lighting with light switches at top and bottom of stairwell Anti-skid strips at the end of each stair tread Stair treads should be the same size and in good condition Top and bottom steps clearly marked. Secure handrails on both sides of the stairs. Carpets should be in good condition and firmly tacked down. A grab bar at the top of the stairway Low hanging ceiling beams should be padded with brightly colored padding to remind tall people to duck their heads.

16. No telephones on stair landings. People could trip and fall down the stairs in their haste to reach a ringing telephone

17. Inside the home: living, dining & family rooms Adequate lighting and light switches The following are some furniture problems to correct or avoid: – Furniture with hard, sharp edges. – Chairs and sofas that are too low, too soft and/or are armless – Too many pieces of furniture (and throw rugs)

18. Inside the home: living, dining & family rooms CLUTTER is a serious concern. – Clutter places people at risk for tripping – Can obstruct emergency exits from the house/apartment in case of a fire – Can make it hard for people with poor memory or intellectual disabilities to find things – It can increase tension and frustration levels in the home.

19. Inside the home: Bedroom Adequate lighting Drawers should not be too high or too low for people to reach into and retrieve items Broken or sticking drawers must be repaired. Explore the use of open shelving to make clothes more accessible “C” pulls make dresser draws, closets and cabinets easier to grip and open

20. Inside the home: Bedroom Beds should be adjusted to suit the height of the older person Bedside tables Furniture risers There should be a bedside lamp within easy reach on the beside table. Easy to switch on/off. Invest in “tap on” lights

21. Inside the home: Bedroom De-clutter bedrooms as much as possible by: – Building additional shelving units – Better organized (or larger) dressers/closets – Storage containers Grab bars/poles to help people get into and out of bed Wheelchair accessibility issues – Widen bedroom doorways enough to easily maneuver through – Arrange furniture along the perimeter of the bedroom to allow easier maneuvering for wheel chairs. – Electrical outlets should be raised to allow people to easily reach them

22. Inside the home: Bedroom Windows: Ensure that older people are able to easily open/close the windows in their homes and in their bedrooms. – There are physical, psychological and personal safety significance to this – Move furniture that is blocking windows – Repair windows to make sure that they are easy to lock/unlock Remove tripping hazards

23. Inside the home: Bathroom The most dangerous zone of the aging adult’s home. Various reasons: – Tight spaces – Hard surfaces – Harp edges – Slippery surfaces.

24. Inside the home: Bathroom General Renovations: Bathroom renovations can be costly, but there are improvements that can be made to maximize the space and make it less dangerous: – Replace bathtubs with walk-in or roll-in showers – A wall hung toilet increases the floor area and provides more room for a wheelchair or walker – Grab bars, grab bars, grab bars – A word about soap dish holders and towel bars…

25. Inside the home: Bathroom General Renovations, cont’d Easily accessible hooks on doors/walls for hanging clothing Easy –to-reach and easy-to-locate shelving for toiletries Remove clutter! Lighting Issues…

26. Inside the home: Bathroom General renovations, cont’d: Replace door knobs with lever handles. Install anti-scald devices to control temperature. Sensor faucets for sinks Use “double cueing” on faucets. Cover all pipes attached to a wheelchair- accessible sink.

27. Inside the home: Bathroom Tub & Shower issues: Ensure that grab bars do not take up too much room or prevent the person from safely getting in or out of the shower/tub. Roll-in shower/tub cut Install a hand-held shower head Utilize a shower seat Provide a shower caddy hold toiletries within easy reach Remove old shower doors If it is a small shower room, consider making the entire room part of the shower by installing additional floor drainage to catch excess water.

28. Inside the home: Bathroom Toilets: Challenging because some older people have difficulty sitting down and standing up from the toilet due to the toilet being too low or too small. Installing a raised toilet seat can help install toilet arms at the side for people to lift themselves on/off the toilet

29. Inside the home: Kitchen Lower shelves and cabinets to make things easier to reach. Raise dishwashers to make them easier to access for those in wheelchairs. Install Lazy Susans in corner cabinets to make items easier to reach. Replace drawer and cabinet knobs with ‘C’ pull hands, which are easier to grasp.

30. Inside the home: Kitchen Grabbers can help people reach light weight items Use/purchase stoves with knobs in front. Install kitchen sink faucets onside of sink rather than the back If scalding is a concern, install anti-scald devices. Adequate lighting and switches at each entrance to the kitchen