The cost of falls

CBS News reported yesterday on new survey findings from the CDC on the prevalence and risk of falls. According the report, 1.8 million report falling in the prior three month period--up from prior numbers of 5.8 million per year. Costs of these non-fatal falls is estimated at $19 billion. The CBS report notes that many senior adults may not take wise precautions because of "embarrassment"--but don't really touch on the fact that many safety modifications do not need to look institutional nor signify frailty.

Watch the news report here:

http://www.cbsnews.com/sections/i_video/main500251.shtml?id=3919186n&channel=/sections/health/videoplayer204.shtml

Personal Design vs Universal Design

One of the things I've observed is that with all the attention on Universal Design there is becoming a certain dogmatic stance in some areas or by some people. Sometimes we seem to forget that UD is a set of seven principles to help guide decision making, not an enforceable code. When you are dealing with residential housing and a person's living space, universality can take a back seat to something tailored to the individual. We aren't talking about public buildings here, rather individual living spaces. Here are a few examples from work we did this summer.

• The aging-in-place bias in redoing a bathroom for a senior would be to expand the shower and make it zero threshold in the event that a wheelchair is in their future. But we had two customers (both smaller women) who really wanted smaller showers--they felt more secure and stable in the small shower, the walls providing an envelope that makes it easier for them to maintain their balance. The new showers will accommodate a small shower chair if needed in the future, so there is that provision for flexibility. But never will a wheelchair be practical in the bathroom (in one of the homes, a wheelchair will never be practical anywhere.) So, while this might not live up to UD principles of equitable use or size and space for approach and use, for these particular homeowners it was the right design for now.

• We like wall ovens over ranges--less bending and lifting, easier to see into. Separate cook tops allow for storing pots and pans where they are needed or even the ability to sit and cook. But for one customer, the wall often was wasted space that was better put to storage. So, the wall oven came out and the oven cavity was fitted with pull-outs. Separate cabinets were modified for a freestanding range. This resulted in an overall more functional design for the customer, even though we had to go with a less UD appliance. Sometimes the practical issue is how and where to apply the UD principles. In remodeling, there are typically trade-offs.

• Split level counters are seen as a good idea to accommodate people of different heights or who need to sit. They find their way into a lot of kitchen designs these days. But for someone with a severe visual impairment, misjudging where one height ends and the other begins can result in spills and broken dishes. A common height counter, or one where the height differences are in distinctly different areas of the workspace, is the better solution for the individual.

Don't get me wrong, the attention on UD is great. Even in these designs, we employed UD principles where we could--lever handles, hand showers on glide bars in the shower, grab bars instead of towel bars that offer no support if grabbed, materials and designs that provide visual cuing, task lighting, storage that minimizes reaching, etc. But let's remember that it is a set of principles to help shape a design, not a set of routine solutions. Often in residential remodeling the design dictates are very personal.

Temporary solutions can help caregivers

When I did my bathroom options post awhile back, I didn't include a practical option for shorter term needs. We frequently get calls from families providing care for a loved one who, realistically, is in the final stages of being in the family residence or nearing the end of their life. A full bathroom remodel may not be needed or would create too much disruption. There are portable and temporary shower units available that can make life easier for a family in this situation or for someone who is recuperating from an injury or illness and needs a shorter term solution.

I've used portable showers out camping, but those aren't a solution in the home. But there are new solutions being designed that can make it practical.

FAWSsit is folding shower with an electric pump that can be set up in a room where there is sufficient space and an available source of heated water and a drain (sink, toilet, floor drain, etc) Laundry rooms and kitchens are obvious options. Since it can easily be folded and stored away, you don't need a dedicated space, making it possible to provide a shower to someone with greater ease and less stress on everyone. www.fawssit.com

Another resource is Shower Anywhere. These are more what I would call temporary rather than permanent shower solutions, so they require some dedicated space, but are an option when remodeling is not practical or in the long term interests of the homeowner.

Neither of these would be a great long term solution--having a home designed to have an accessible bath and bedroom on the ground floor is still the best precaution, but when that is not the case, a solution like these can certainly make life easier.

As we age one thing we can look forward to is more technology and non-traditional solutions like these to help us navigate this journey.