Universal Design: The Beating Heart of Aging in Place

Most of our clients are familiar with the term "aging in place" and know that it represents the idea that remaining in one's house and community can be a highly satisfying and financially smart choice...especially when combined with improvements tailored to increase home safety, convenience and accessibility. But what many don't know is that while aging in place is a robust descriptive label, the real power behind it is a concept called Universal Design.

Universal Design is the simple concept that all the things we make; structures, furnishings, appliances, vehicles, all our products, and environments, should be easily usable by all people without the need for adaptation or specialized design. It's based on a set of seven core principles, such as flexibility and simplicity that are applied in ways that result in maximum safety and access for everyone. Young, old, disabled, or healthy, the design mechanism is meant to support all ages and abilities in ways that enable everyone to live together in the same place.

The seven principles of Universal Design are:

PRINCIPLE ONE: Equitable Use

PRINCIPLE TWO: Flexibility in Use

PRINCIPLE THREE: Simple and Intuitive Use

PRINCIPLE FOUR: Perceptible Information

PRINCIPLE FIVE: Tolerance for Error

PRINCIPLE SIX: Low Physical Effort

PRINCIPLE SEVEN: Size and Space for Approach and Use

One of our favorite examples of universal design is the story of the old-fashioned vegetable peeler, a clunky appliance that felt uncomfortable and was challenging to use. One day, a guy named Sam Farber was watching his wife, who has arthritis, struggle while peeling apples, complaining about how the device hurt her hands. He thought there had to be a better way, and together with a team of enlightened designers produced a new line of kitchen hand appliances called Good Grips. His idea was basic and straightforward; attach thick rubbery handles to existing kitchen tools, and suddenly what was difficult for folks with arthritis to suddenly became a much better tool for everyone to use. Sam had designed a handle that could be used for all sorts of applications, pushing, pulling, using like a paintbrush. He made it bigger, shaped it better to fit in hand, and gave it a unique rubber material for improved grip. We know now the brand as OXO Good Grips, with a vast line of kitchen tools used by everyone. This improved utensil is the underlying concept of Universal Design: create a product that erases the distinctions among its users and brings ease of access to everyone.

 So, how does this all apply to home environments for our aging in place or mobility clients? Well, as we've said in past blog posts, we take a "whole house" view of aging in place and try to design and build spaces that work for everyone in the household. When we create no-step entrance ways, we aren't just thinking about improved access for wheelchair users; no step entrances are just a better way to get in and out of homes. The same is true of storage and shelving projects. Easy reach designs make sense for everyone, not only those with limited movement or flexibility.

Universal design is the shining beacon that guides all our planning, design, and construction work. We help clients in a variety of situations, design and consulting to age in place, or an improved space to accommodate a physical disability, or just a cost-effective remodel. As always, we're glad to share our knowledge with you; please don't hesitate to give us a call. 

Thinking About Safe Flooring

The statistics are telling: This year, over 60% of older Americans will slip and fall in or around their homes. Many of these falls will cause severe injury and expensive hospitalizations. In some cases, the outcomes can be life-changing, but, with careful planning, can be avoided.

So, when you sit down to begin considering Aging-in-Place modifications, floor safety should be top of mind. In this post, we want to pass on some of the issues we think about when designing and constructing aging in place environments for our clients. Our perspective is always to maximize client safety without compromising great design and appearance. Given that overall framework, here are some of the items we consider.

NO-SLIP. Perhaps the most crucial consideration is the "slipperiness" factor. Put another way, how slip-resistant is the floor. Ceramic tiles, highly waxed wood floors are a few of the culprits. This factor is especially important in kitchens and bathrooms, where the moisture increases the slip factor.

WALKABILITY. What's the best floor surface for mobility, either walking or navigating a wheelchair, cane, or walker? The answer involves paying attention to ultra-soft or "snaggy" surfaces as well as a reduction of seams and joints. Remove or stretch out the old wall to wall carpet, or, better yet, replace it with a solid surface.

CUSHIONING. Hardwood flooring, stone, or something more forgiving, like carpeting or soft tile. You don't want to fall on a hard surface, but you also don't want to trip on high-pile rug surfaces, so find the balance that's right for you.

KEEPING IT CLEAN. We pay attention to how easy is it to keep a floor clean. Dirt and soil add to the slipperiness factor, particularly on harder surfaces.

FEELS GOOD. If you don't feel comfortable in your home, then we have failed in our planning. You need to enjoy your home design.

AREA RUGS. In general, area rugs and floor mats can present significant problems. While they can look great, by adding color or texture to the room decor, they can present tripping hazards. Small area rugs and mats can slide easily and create uneven surfaces. Older adults tend not to lift their feet as high when walking and can trip if they catch on one of these floor coverings. Maneuvering walkers and wheelchairs around area rugs can difficult. However, if you must have an area rug, make sure it has a grippy undersurface that won't slide and that corners are secured down and that the carpet is not too thick.

SINGLE FLOOR SURFACE. It's best to use a single floor surface throughout the space to reduce the seams or thresholds that can create tripping hazards. Again the danger is the tendency of older adults to drag their feet, and it's easier for a walker or wheelchair to navigate over one surface.

LIGHTING. Make sure that there is proper lighting in hallways, stairs, kitchens, and bathrooms. Nothing reduces fall rates more than adequate illumination.

There's a wide variety of flooring products in the marketplace designed to ensure that the flooring you install is safe and attractive. It's a pleasure to share our knowledge of flooring and help you make choices as you begin planning your aging in place solutions.

Healthy Home Construction

Spring is right around the corner; which for many means the start of allergies again, along with the sneezing, running noses, red eyes, and headaches. The side effects of allergies can be similar to those when you have construction going on in your home. The fumes of paint and flooring finishes can induce headaches, the excessive dust created from demolishing walls or sanding floors can cause sneezing and coughing as harmful pollutants are released into the air, and the influx of different people performing work in your home can introduce germs and spread illness, especially during the winter months when the flu season is in full swing. These common issues during remodeling and construction jobs can be more complicated for our senior population undergoing renovations to help them “age," or "live in place", especially since so many of them will be remaining in their home while the renovations are taking place. 

Here are some strategies to discuss with your contractor before beginning work in your home to help prevent and reduce the most common health issues during renovations.  It’s important when selecting your contractor, to discuss and understand how they handle dust and related health risks to ensure they are kept to a minimum. Contractors that use some of the equipment referred to, may also come in with higher bids, so balancing the cost and benefits during the contractor selection process should be performed. 

1. Forbid the Fumes: 
Most paints and floor finishing products contain chemicals that evaporate in the air. As with any chemical, the likelihood of a reaction and the extent and type of health effects will depend on many factors. These factors include the number of compounds in the indoor air, the length of time a person is exposed, and a person’s age. Eye, throat or lung irritation, headaches, dizziness, and vision problems are among the immediate symptoms that some people can experience soon after exposure. When picking paint for your home interior, make sure you select one that is for indoor use only.  There are two categories of interior paints:

• Water-based: referred to as “latex” paints

• Oil-based: referred to as “alkyd” paints

In general, water-based paints will emit fewer chemicals and lower levels of chemical vapors. Select primers and paints with low-volatile organic compounds (VOC) as these products release fewer fumes. Low-VOC materials are applied the same way as conventional paints and primers and cost about the same as most manufacturers' top-of-the-line paints. They can also be cleaned and disposed of easily without the use of active solvents; which is always a plus! As paint dries, harmful VOCs are released into the air at high levels, so this would be an essential time for seniors to open all windows, place fans around the house to direct the fumes outside, or better yet, get out of the house for a few hours or overnight. 

Another paint or finish option is to look for products that carry the “Green Seal.”  These products are guaranteed to meet precise environmental standards and contain VOC levels even below those of already low VOC products. Green Seal products are forbidden from using a long list of toxic chemical compounds and must meet specific performance requirements; so ask your contractor about selecting products with this certification, and to understand how best to incorporate these products in your project.

2. Defeat the Dust
Dust is everywhere on construction sites and will always exist. From cutting and sanding materials to excavation, drilling, and demolition, it’s an impossible substance to avoid. However, dust is an unnecessary health risk that can be efficiently managed on every construction site. 

The two most common and effective ways to reduce the risk of dust when performing standard tasks on construction sites are:

• Water dampening

• Extraction and filtration

Water dampening is an effective method,  but can be challenging to manage. It requires the site to be thoroughly soaked before the work starts and a constant flow of water to be maintained during the task to prevent dust particles becoming airborne. A  sufficient supply of water and access to it are crucial elements. The second method is using specialist extraction and filtration units. Power tools and air scrubbers use dust extractors and collect dust as the work is performed and can reduce the dust that is emitted into the air by almost 90%.  Air scrubbers capture dirt before it circulates through your home.

Additional tips to reduce dust and dirt in your home include:

• Place plastic dust barriers with zipper openings at all entry points to a room or space under construction and seal them tightly.

• Review how debris will be eliminated from the home. Will it be brought in and out through the central space, or can it be removed directly from the room in which it was created?

• Contractors should only walk through areas of the home where work is occurring.

• Place sticky mats outside the doorway to pull the dust off shoes, and place floor paper from the construction area to the exit door to capture additional dust.

• Dust generating tasks should take place outside.

• Adequate clean-up at the end of the workday including vacuums and sponge mops should be used to gather dust that has settled in.

During the work, vents should be blocked off with plastic, and if there is a return vent in the room in which work is performed, that’s a bit trickier, so it may be easier to schedule the task at a time when the unit can be turned off.  Once the work has is completed, clean the HVAC system and air vents to ensure that you aren’t continuing to breathe in the dust. With the right dust extraction and filtration systems in place, along with barriers and enclosures, construction dust can be efficiently managed and contained.

3. Get Rid of the Germs

With contractors and others in and out of your home during a renovation, the post clean-up is another critical component to remaining healthy. For those aging in place, we would recommend hiring a professional to get rid of all the germs (and dust!)  living in your home. So after any renovations be sure to:

• clean your walls (including all moldings).

• vacuum all floors (if carpeted go over them a few times, and if they're wood, tile, or linoleum, follow your vacuuming with a quick mopping).

• vacuum all upholstered furniture (couches, chairs, and even mattresses).

• take down and clean all light fixtures and window treatments.

• unscrew and clean your vents.

• check and change all air filters.

• Use disinfecting products to wipe down all surfaces (countertops, hand railings, toilets, vanities).

It's important when planning a home renovation project to review health and safety concerns, and build these strategies into the project before the work begins to remain healthy, happy and ready to enjoy your new home!

Aging in Place Row Home Style

Our job is to help our clients understand the benefits and challenges associated with making home improvements to “age in place”.  Often, we are called in to perform Home Safety Reviews, to evaluate the issues and offer solutions to help someone remain safe and live independently in their home for as long as possible. We encounter many different types of homes; ranging from single family homes, to apartments, to town homes, as well as city row homes. Each home comes with different design limitations, cost implications, as well as overall neighborhood concerns. The topic of this story relates not only to our ability to help our client create a beautiful and safe environment in her row home at a price that she can afford, but how to best help her address the overall safety in a neighborhood that has changed.

We recently met our client at one of our workshops, “Designing for Home Safety”, where we educate seniors, care providers and loved ones on how to keep a home safe.  The presentation focuses on fall prevention, as falls are one of the leading causes of hospitalizations for seniors, and eventual health decline. She approached us after the presentation and asked if we would help her not only freshen up the interior design of her home, but to provide recommendations and solutions to to help her safely remain in her home.

We were happy to help, and quickly scheduled an appointment. As we drove into the neighborhood, we noticed many homes in disrepair and many stairs to get to the front door. As we walked through the front door it was like taking a time machine back into the 70’s; the layout, decor, and overall feel was one that has been lived in and loved. For those of you who have never stepped foot in a row home, they are typically extremely narrow with few rooms per floor, very steep slender steps, little natural sunlight, and few, if any first floor bathrooms. 

Some significant home safety issues that we discovered on our tour of the home:

Exterior Steps : There are two sets of stairs leading to the front door, the concrete paving is uneven, cracked and in need of repair. We would recommend repairing the paving, installing rails on both sides of the steps, and installing motion detected security lighting.

Master Bedroom and Bathroom: Both located on the second floor, up very steep narrow steps. Although there is a double railing on the stairs, it’s so narrow that putting a chair lift in may be problematic when she is no longer able to walk up the steps. We typically recommend a first floor bedroom and full bathroom to avoid the safety issues surrounding steps, but due to space constraints, this may not be possible. 

Laundry Room in Basement:  Remaining independent involves performing your daily activities, including doing your laundry. Here, the laundry room is down poorly lit, steep stairs with no rails. We would recommend reconfiguring the kitchen and installing a small stackable washer/dryer to eliminate the need to use these stairs. 

Elevators and platform lifts are now a more affordable option, can add to a home’s equity, and can be one of the best investments homeowners can make, especially for seniors planning to age in place and remain in their home for several years. Since our client's home is so narrow, this  solution would take up a significant corner of a room on each floor and may not be an acceptable design solution. 

These are only a few of the issues and safety solutions we noted inside the home. In addition to the safety problems inside her home, we noticed that the neighborhood had changed. Once a vibrant and convenient neighborhood to both Center City and the Suburbs, it has become more transient, and she no longer has the long standing relationships in her neighborhood that could offer support and oversight in the case of a home emergency. 

Our client story is a common one; she has lived in her home for almost 50 years, raised her family there, and has been living alone for a number of years, since her husband's  passing. She remains independent and active in the community by volunteering and attending classes at a senior community center, and has family and friends in the local area. She can’t imagine living anywhere else at this point in time, but may not be able to afford either making the needed home improvements or moving to a new living situation, even if her home no longer supports her, a reality many seniors face. 

We work with our clients to help evaluate the cost and benefits of making these much needed home modifications, and also provide a much needed connection to other resources to help evaluate other living situations that may better support your age and lifestyle.  

Making a Difference

This past Saturday was national Make a Difference Day, where millions of Americans participate in many acts of kindness. Whether it was community cleanups, neighborhood painting or even acts as small as buying someones coffee or giving a stranger a compliment; what matters the most is that people participate in making a difference in someone else’s life. Sometimes, you don’t have to leave the comfort of your own home to make a difference in someone else’s life. 

In the work that we do, we try to make a difference everyday, and making a difference can come in all forms. Whether we are suggesting a bathroom or kitchen remodel to support the changing needs of our clients, a home safety inspection along with some easy to implement home modifications, or helping a client celebrate their birthday with a cupcake and candles, we know how interior design with a focus on accessibility and safety can make a difference by providing safety and peace of mind.  One of our clients shared a personal story that encompassed compassion, support, and an eager willingness to help someone she loves. 

The conversation with our client began by her explaining her interior design goals for the project. She had recently moved and downsized, but with a busy career she had not been able to prioritize herself, and create the home environment she desired and that made her feel happy to come home to at the end of the day. The conversation then took a turn and she explained that her 88 year old mother was living with her. She shared the struggle her mother had when facing the reality that she wasn't able to live on her own any longer. Her mom was persistent that she didn't need assistance, and she didn't want to live her days in the nursing home. With few siblings in the picture, our client was the only one to step up to the plate and volunteer to have her mom move in with her family. This selfless act can be a difficult one. 

Our discussion quickly shifted to talking about not only what our client’s needs were, but to discuss how our design suggestions would be modified to best accommodate the needs of her mother as well. In addition to caring for her mother, she also mentioned that she is the “one” in her family to entertain and hold the family gatherings, and that many of her family members were elderly.  Allowing for her mother to “age in place” at her home will mean adjusting her own home lifestyle and environment to best support not only her mother, but the family, as well as all visitors. We finished the conversation talking about her goals for her personal space, but ensuring that the proper living conditions were in order for her mother. Such as completing a home safety evaluation, creating a first-floor bedroom, securing all rugs, and installing proper lighting throughout the house. This eye-opening experience has educated her on the importance of maintaining a safe home, not only for her mother but for the rest of her own family too. Her simple act of kindness by creating a safe home for her mother and her family will really make a difference. 

This story is just one of many acts of kindness that happen daily.  It doesn’t need to be a national day to help someone in need. So although this day has passed, take some time to make a change in your neighborhood or in your family; big or small! We like to think we make a difference everyday, by helping others live safely and comfortably in their homes!