Aging-in-Place With Universal and Adaptable Design

Homes That Grow Gracefully With You

As we enter into retirement, we begin to face some very difficult questions about the future of our families and our ability to maintain our independence through the retirement years. We have a strong desire to retain our autonomy as long as possible and not rely on family members for assistance with daily living. Universal and adaptable design concepts optimize space in our homes to accommodate a wide range of individuals with varying physical abilities, allow people to stay in their homes longer, and keep families together.

What is Aging-in-Place?

Aging-in-place means living in your home safely, comfortably, and independently, regardless of age or ability level. It allows you to continue living in a familiar environment throughout your maturing years. Aging-in-place is the ability to remain in your home for a lifetime.

Quick Facts...

One-quarter of the U.S. population is over age 50.

From 2000 to 2030 the over 65 population will double.

By 2030, the population of older people will likely increase to over 69 million persons.

By 2050, the U.S. will account for 79 million people over age 65.

The net worth of seniors is five times greater than the average net worth of all U.S. citizens.

What is universal and adaptable design?

Ron Mace, founder and program director of the Center for Universal Design, defines universal design as "the design of products and environments to be useable by all people, to the greatest extent possible, without the need for adaptation or specialized design". For our purposes, we will limit the term "universal design" as it applies to home design and related products.

Adaptable design, on the other hand, allows the easy modification of a space to accommodate a specific need. Where universal design benefits everyone regardless of ability, adaptable design provides access to spaces or products through alteration or the addition of an assistive device that bridges an existing barrier to its use. Adaptable design is defined by ANSI A117.1 (American National Standards Institute) as, "the ability of certain building elements, such as kitchen counters, sinks, and grab bars, to be added to, raised, lowered, or otherwise altered so as to accommodate the needs of either persons with or without disabilities, or to accommodate the needs of persons with different types or degrees of disability".

The differences between universal and adaptable design may be obscure at times. One could consider the installation of grab bars in a shower to be universal as anyone can use the bar for balance or safety. But the installation of the backing (structural support) for grab bars may be considered adaptable if the intent is to install the bars at a future time when needed to provide access to the use of the shower by a person with a disability. It is this obscurity that points to the fact that universal and adaptable design is not a matter of listing items as features; rather, it is a philosophy of design. The philosophy of universal design is summarized by the Principles of Universal Design developed by the Center for Universal Design (see Sidebar).

THE PRINCIPLES OF UNIVERSAL DESIGN

Copywrite 1997 NC State University, The Center for Universal Design

PRINCIPLE ONE: Equitable Use
The design is useful and marketable to people with diverse abilities.

PRINCIPLE TWO: Flexibility in Use
The design accommodates a wide range of individual preferences and abilities.

PRINCIPLE THREE: Simple and Intuitive Use
Use of the design is easy to understand, regardless of the user's experience, knowledge, language skills, or current concentration level.

PRINCIPLE FOUR: Perceptible Information
The design communicates necessary information effectively to the user, regardless of ambient conditions or the user's sensory abilities.

PRINCIPLE FIVE: Tolerance for Error
The design minimizes hazards and the adverse consequences of accidental or unintended actions.

PRINCIPLE SIX: Low Physical Effort
The design can be used efficiently and comfortably and with a minimum of fatigue.

PRINCIPLE SEVEN: Size and Space for Approach and Use
Appropriate size and space is provided for approach, reach, manipulation, and use regardless of user's body size, posture, or mobility.

"The Principles of Universal Design were conceived and developed by The Center for Universal Design at North Carolina State University. Use or application of the Principles in any form by an individual or organization is separate and distinct from the Principles and does not constitute or imply acceptance or endorsement by The Center for Universal Design of the use or application."

What are some applications of universal and adaptable design?

Universal design encompasses a wide scope of home design and modification extending from landscaping and low maintenance exterior and interior finishes to specific features that enhance the use and safety of bathrooms and kitchens. The use of energy efficient building materials and solar design, for example, may be considered universal design criteria because it benefits everyone who uses it.

Some of the major areas we look at, from the perspective of universal design, are entrances and pathways leading to entrances, overall interior accessible features, kitchens, bathrooms, and sleeping areas. Let's take each of these individually and look at ways that we can improve the usability of each.

Entrances and pathways

One of the first things to consider in universal design is how to eliminate barriers to access from a vehicle drop-off point to an accessible entrance. To make a pathway usable for a person using a wheelchair or other assistive device, we need to limit the slope of the walkway to a maximum change of 1 foot for every 20 feet up or down to the entry. We prefer to use earth berms, bridges or retaining walls instead of front ramps that may suggest a vulnerable resident. Anyone moving heavy furniture in or out of the home will love this feature!

The entry itself has many facets to look at in terms of accessibility. These items include providing weather shelter, a no-step entry with a threshold less than ½" high, maneuvering space on both sides of the door, sidelights or "peepholes" to view visitors, and adequate lighting to operate locks and provide security.

Overall features of the home

Here, we are going to explore some universal design features that aren't specific to any one room, but should be considered as general applications.

Whether the home is designed for aging-in-place or simply for visitability, we want to create easy access to the main living areas and facilities. This can be accomplished by providing a minimum clear opening of 32" on all doors to accessible areas and a 40" minimum clear circulation route through rooms and hallways. We also want to provide a minimum of 18" beside the door latch for easy operation for people using assistive devices. Lever handles allow use with an elbow, forearm or wrist for people who have difficulty gripping or twisting a doorknob.

Another consideration would be the placement of electrical outlets, switches and other operable controls. Raised outlets between 18" and 22" above the floor falls within the range of use for a person in a seated position and also aids people who have problems stooping over. Placing light switches and other controls a maximum of 48" above the floor allows their use from a seated position. Children also have an easier time using these switches.

Safety in the home is another big consideration addressed through universal design. Non-slip floor surfaces will help avoid falls and aid in the use of walkers and wheelchairs. Telephones installed in strategic locations, such as bedrooms and bathrooms, will help summon assistance if needed. Also, lowered window sill heights to a maximum of 36" high will enhance the use of windows for egress in case of fire or other emergency.

Kitchens

Kitchens are notorious in excluding their use for a variety of people and there are many universal design "standards" that apply to this area of the home. Even though the application of universal criteria to the kitchen is typically design specific, we will cover some of the more critical design choices.

We first want to be sure we have proper floor space that is suitable for all users, including people who use wheelchairs. Optimally, we would like to see a 5' clear turning radius in the kitchen, but, as a minimum, we want to provide a 30" x 48" approach in front of all appliances. We also want to provide knee space under the sink and cooktop, as well as a lowered counter (also with knee space) at a work area for a person in a seated position. Some adaptable criteria may come into play here with removable base cabinets or doors that swing out for roll-under access.

Continuous counters between work areas may be a universal design consideration. An example would be having a sink and cooktop on the same run of counter so that a heavy object could slide between the two without having to pick it up. Another idea might be to have a sprayer or faucet located to fill coffee makers or pots without lifting.

The selection and placement of appliances need to be considered for ease of use. Controls need to be placed within the range of reach for persons in a seated position. The maximum reach height of 48" for all kitchen controls apply here. Forward reach over obstructions should also be considered, but this is client specific and mathematical formulas are used to determine forward reach ranges. Front mounted controls are easy to use for everyone, but consideration needs to be taken in terms of access to small children. Side-by-side refrigerators are also accessible to everyone.

A raised dishwasher, as well as raised washer / dryer in the laundry room, improves its use for both people using wheelchairs and those having problems stooping over to load the machine. There is also a long list of cabinet features that improve access, such as pull-out shelves, lazy susans, and roll out waste containers. Adequate task lighting is also a major consideration in the kitchen.

Bathrooms

Safety is the number one priority in the bathroom as it is the room with the highest number of accidents in the home. Non-slip surfaces are essential both inside and outside the tub / shower area. As mentioned earlier, grab bars enhance the safety for everyone, but are especially important to people who have an increased risk of falling. They are also very important for people who use wheelchairs to enable transfer to shower seats and toilets. Pressure balanced / anti-scald valves are another safety feature that benefits everyone.

Access for people using assistive devices is critical in the bathroom. Curb-less showers allow people to roll-in or avoid tripping over a curb at the shower pan. (This feature has also spurred some very beautiful bathroom designs!) Dimensions around toilets are critical for access and 30" x 48" minimum approach area in front of all bathroom fixtures is needed. (These clearances can overlap.)

There are many accessories available for shower / tub modifications that improve safety and convenience. Recessed soap and shampoo ledges, various seats and benches, and adjustable height / hand-held shower with slide bars, just to name a few.

Bedrooms

One of the important features we want to look for in the bedroom is that there is adequate clearance for maneuvering around the bed and proper clearances for emergency egress, either at a door or a window with a lowered sill. Proper clearance should be considered for adaptable devices, such as a Med-Pole (a stainless steel assistive device) or Hoya lift. The doorways to accessible areas, like the bathroom and closet, need to be a minimum of 32" wide as mentioned earlier. Adjustable shelves and clothes rods in the closet are very helpful to accommodate a wide range of reach.

Summary

Aging-in-Place means maintaining independence and control of your life. Your environment plays a key role in achieving that goal and steps should be taken to improve the usability, safety and comfort of your home.

This begins with a comprehensive personal assessment and home audit for independence that may be performed by a medical professional or a trained aging-in-place specialist. With this information, solutions for home modification can be developed. Some of these modifications may be done yourself, such as using brighter lighting and slip-free mats. Other modifications will require a trained professional for widening doors and various remodel projects in bathrooms and kitchens.

Whether you are considering remodeling or designing a new home, look for professionals who have the experience to accurately assess your needs and find the solutions that will make your house a home for a lifetime. One resource for finding qualified professionals is the National Association of Home Builders (NAHB). They have created the Certified Aging-in-Place Specialist (CAPS) program to help you identify industry professionals with the skills and knowledge specific to home modifications for aging-in-place.