A trained eye knows what to look for in a home to keep the people who live there safe, less likely to fall or sustain an injury. Home inspectors are known for pointing out flaws, defects and features that can be improved in homes.
As home inspectors structure the focus of their business, they could specialize in accessibility by inspecting homes for factors related to aging in place. Older adults, as well as their grown children, are interested in hiring professionals who can evaluate their existing homes as well as homes they are considering for purchase. This trend can enhance business opportunities by expanding the market and providing income at times of the year when home inspection demand from real estate agents is low.
Aging in Place
The US Centers for Disease Control and Prevention defines “aging in place” as “the ability to live in one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level” (https://www.cdc.gov/healthyplaces/terminology.htm). A home must be built or remodeled to ensure that every facet of life is considered. Oversights can lead to accidents and falls, with resultant injuries, sickness and potentially avoidable fatalities.
People want to stay in their homes for a long time. According to an AARP study, 90 percent of people age 65 and older would prefer to stay in their own homes as they get age—and not go to a nursing home or an assisted living facility (https://www.aarp.org/money/budgeting-saving/info-2017/costs-of-aging-in-place.html). People expect “home” to provide independence, accessibility, safety and peace of mind—regardless of disabilities, limitations or health challenges.
Health Issues Requiring Home Modifications
This movement isn’t restricted to people who are aging. It applies also to patients with sudden health changes, due to accidents, stroke or spinal cord injury, for example, as well as to people with degenerative conditions such as arthritis, amyotrophic laterals sclerosis (ALS), dementia, muscular dystrophy, multiple sclerosis or Parkinson’s disease.
Making simple modifications to a home is not surrendering to the aging process. Home modifications can prevent a fall that could lead to serious health consequences. Prevention of falls should be a top consideration when designing a home and evaluating an existing home. When assessing a home, inspectors could note potential trouble spots. Also, it could be helpful to take note of how steady the people who do or will live in the home are on their feet. Inspectors could note areas that might be difficult for them to navigate or could pose obstacles to daily living. Falls can lead to a serious injury that can change a person’s life in an instant. I know from personal experience.
A Firsthand Understanding
On June 13, 1998, my husband, Mark, and I went for a bicycle ride on a rural wooded trail in Granville, Ohio. After riding for a few minutes, Mark thought he heard a gunshot and slowed down to investigate. As he scanned the scene, he saw a large tree falling. He shouted to me, “Stop!” But the warning was too late. I was crushed by a 7,000-pound tree and paralyzed from the waist down.
Coming home from the hospital in a manual wheelchair after my spinal cord injury, I realized how the design of my two-story home intensified my disability. Mark and I knew that we had to sell our home and find something more suitable.
In September 2004, we hired an architect to draw up plans for our new home in Columbus, Ohio. We faced a steep learning curve as we prepared to build our home. We assembled a team of interior designers and more than 200 corporate contributors to assist us. Serving as the general contractors, my husband and I spent 32 months building our home.
This home, named the “Universal Design Living Laboratory,” is the top-rated universal design home in North America. It has earned three national universal design certifications (view our home at www.UDLL.com).
Since the 1980s, architects, interior designers, and other design and building professionals have embraced the concept of universal design, which is a framework for creating living and working spaces and products to benefit the widest range of people in the widest range of situations without special or separate design. Universal design is human-centered, accommodating people of all sizes, ages and abilities.
Living in the Universal Design Living Laboratory for the past six years has given me a unique perspective. As a person who uses a wheelchair, I have learned the importance of space planning, and that small differences in the width of a door, the height of a threshold or the slope of a ramp can impact a person’s independence. I have experienced the joy of rolling on hardwood and tile flooring. No longer do I have sore shoulders, as I did when I had to roll on the carpet in my previous home. Safety features like grab bars in the toileting area and shower have kept me from falling, and they make transfers easier.
Inspection Tips—Doors and Grab Bars
Life is easier when a home includes universal design features and products. Here are some guidelines about universal design that could help you educate your clients during home inspections.
Subtle home features related to doors can make a difference. Consider these examples:
- the width of a door
- the height of a threshold
- design of the door handle hardware
- the direction the door swings into or out of a room
- whether the door stays in place when it is open rather than drifting closed
A whack on the head due to walking into a door hurts. This can lead to a stumble, a fall, a trip to the hospital, broken bones and a lack of consciousness.
A sobering example is of a man who was inside a small bathroom when he had a stroke and passed out on the floor next to the closed door. When the paramedics arrived, they couldn’t get inside to save him because the bathroom door swung inside the bathroom and the man was blocking the door. Bathroom doors need to swing out from the room.
Lever door hardware is easier to use than door knobs. When a person has paralysis, weakness or pain in the hands due to arthritis, a lever door handle may be more comfortable for the person to operate. Lever handles also allow people to use their elbow to open a door.
To enable access for people who use wheelchairs and walkers, all exterior and interior doors should be at least 36 inches wide. Depending on the width of the mobility device that the occupant of the home uses, doors may need to be wider than this guideline.
Narrow doorways can be a real handicap for someone who uses a wheelchair or a walker. If the door is narrow, a set of swing–away or swing–clear offset door hinges could be installed to replace existing 1½-inch x 3½-inch hinges. These special hinges are designed to swing the door clear of the opening, which adds about 2 inches of clearance for wheelchairs and walkers.
Pocket doors take up less square footage in a room. Those with the proper track hardware will operate smoothly with little effort. The door’s hardware should be easy to access and to grab.
Door thresholds should be no higher than ½ inch. This allows people who use wheelchairs and walkers to have an easier roll, and is less likely to be a tripping hazard for those who are walking.
Front–door peepholes should be at various heights to be more convenient for all people to use them. An alternative is to have a glass sidelight panel next to the front door.
It is recommended that grab bars be installed in bathing, showering and toileting areas. If grab bars already are installed, inspectors could note how they might function to hold a person who needs support. The bar should be attached firmly with supports in the wall, attached to wood blocking behind the wall or both. Inspectors can help educate homeowners that they may want to consider replacing a towel bar that was not designed to be a grab bar. The placement of grab bars is often a personal choice, associated with the height of the person who needs to use the bar.
Supporting Independence with Universal Design Features
As people plan to remodel, move or build a new home, independence, accessibility, safety, convenience and usability features need to be a top priority of the design phase. The following suggested guidelines, features and products can help create homes that make life easier, especially for those who use a wheelchair.
Throughout The Home
- Door thresholds should be ½ inch or less, and exterior and interior doors should be 36 inches wide.
- Elevators or stair lifts may be necessary for multiple-story homes.
- Hardwood, tile, composite materials and linoleum are easier to traverse when using wheelchairs or walkers.
- Abundant natural and artificial lighting increases safety for all.
- Electrical outlets and light switches should be located where a seated person can reach them.
In The Kitchen
Universal design features in the kitchen include the overall design of the circulation pattern, cabinet design, countertop height and appliance selection.
- A minimum 5-foot turning radius throughout the kitchen allows a person who uses a wheelchair the ability to do a 360-degree turnaround. Power wheelchairs and scooters may need additional space.
- Side-hinged ovens are preferable to those hinged at the bottom, installed at a height that is easy to reach from a wheelchair.
- Cooktop controls and ventilation control panel at the front and at waist height make them accessible by all.
- Multiple countertop heights, such as 40, 34 and 30 inches, accommodate a diverse population. A 30-inch countertop with knee space underneath works well for someone who remains seated during meal preparation.
- At least half of the storage space should be accessible from a seated position, including drawers and cabinet shelves.
- Cooktops and sinks with knee space beneath make for user-friendly work areas. This space can be hidden by removable or retractable doors.
- A dishwasher raised 16 inches off the floor eliminates the need to bend down low.
- Side-by-side refrigerator-freezers provide easier access from a seated position.
In The Bathroom
- Accessible bathrooms meet needs for convenience, safety, privacy and independence.
- Curbless showers with channel drains are a must-have feature.
- Showers must be large enough to transfer a person and allow for an assistant when needed.
- Shower chairs or benches can be mounted on the wall or used in the portable form.
- Handheld shower nozzles and an adjustable height vertical bar make showering easier.
- Grab bars need to be accessible to toilets and showers.
- Toilets seats should be 17 inches off the floor.
In The Laundry Room
- Space to accommodate a 5-foot turning radius makes navigation easier.
- Front-loading washers and dryers on pedestal drawers position these appliances to be accessible for a standing or a seated person.
- A sink with knee space underneath allows all users to wash clothes by hand.
Where to Get Additional Training
Certified Living In Place ProfessionalTM (CLIPPTM) Training is a two-day professional course that is approved for 16 ASHI® continuing education units. It is offered in locations throughout the United States, as well as by taking a live, interactive virtual class in which participants can sit in the comfort of their office or home and attend the class by viewing sessions on their computer. This course is focused on making all homes accessible, comfortable and safe for everyone, regardless of their age or needs.
CLIPP Training graduates have subscription-based access to the “Home Accessibility and Safety Assessment Checklist.” This electronic checklist creates a report, complete with photos, notes and recommendations for improving accessibility, comfort and safety in every home. CLIPP certification is offered through the Living In Place™ Institute (http://livinginplaceinstitute.org).
Age Safe America offers an online, self-paced course that takes approximately six hours to complete. Participants can take breaks as needed between the 17 modules. This course is approved for four ASHI® continuing education units. It empowers professionals with actionable ways to better help educate clients, older adults and their family members on the serious issues of home safety, fall prevention, financial exploitation and personal safety. Upon successful completion, the participant will be certified as a Senior Home Safety Specialist™. (For more information, visit https://agesafeamerica.com/)
Improved Quality of Life Beyond Independence
A home that incorporates universal design guidelines provides an improved quality of life for all occupants, not only those with disabilities. In addition to occupants having more freedom in a home with universal design concepts, they also may have improved convenience and safety, restored human dignity and peace of mind.
Rosemarie Rossetti, Ph.D., is a speaker, consultant and author (RosemarieSpeaks.com). She earned her doctorate, master’s and bachelor’s degrees from Ohio State University. Rossetti’s newest resource, Universal Design Toolkit: Time-saving Ideas, Resources, Solutions, and Guidance for Making Homes Accessible, is an illustrated 200-page book with online videos and webinars. Visit www.udll.com for a free chapter, ordering information and virtual tours, videos and articles about the Universal Design Living Laboratory. Rosemarie can be contacted via Rosemarie@RosemarieSpeaks.com or 614-471-6100.