Home modification involves adapting a home so that a person with disabilities can perform the activities of daily living as safely and comfortably as possible, while maintaining some degree of independence.
The modification can be simple — removing scatter rugs to prevent slips and falls — or complex — installing a stair lift or elevator to improve accessibility. The type of modification required will depend on the nature of the individual’s disabilities and the physical set-up of the home. An investment in home modification may eliminate or possibly delay the need for institutional care.
Home modification:
- helps people with disabilities retain their independence and continue living at home for as long as possible
- is suited to people who have some degree of mobility and do not need intensive medical care
- can be a relatively inexpensive alternative to institutional care
- can include home adaptations for people with dementia
You may hear or read about ADL’s. Specialitsts in gerontology evaluate seniors’ abilities using 2 lists; the first is Activities of Daily Living or ADLS. If your parent has problems with any of the following, the need for outside help or other intervention is obvious and critical:
- Maintaining continence
- Eating
- Getting in and out of bed
- Using the toilet
- Bathing
- Dressing
The second list is Instrumental or Intermediate Activities of Daily Living or IADLs. It is more difficult to know if an individual has problems with any of these unless you live with them. This is where your observation on visits can be critical.
- Using the telephone
- Shopping
- Preparing meals
- Housekeeping
- Doing laundry
- Using transportation
- Managing medications
- Managing finances
Even though help may needed in one or more of the above IADLs, a senior can still remain independent.
Things You Should Know
Seniors, housing and safety
- 93% of Canadian seniors live at home — with a spouse or family member
- 82% of seniors living at home have at least one chronic health condition
- Over 45% of Canadians over 65 have difficulty with one or more activities of daily living
- Most seniors with Alzheimer disease or other dementia live in health-related institutions
- The overwhelming majority of seniors wish to continue living at home for as long as possible
- 60% of all injuries reported by Canadian seniors occur in the home and surrounding area
- Financial assistance may be available for home modifications relating to age-related and physical disabilities
Source: Statistics Canada, Health Canada
Key problem areas in the home
- stairs and steps
- bathrooms
- kitchens
- basements
- exteriors: exits, walkways, driveways, garages
- security
Things to Look For
Risk factors for difficulty with activities of daily living
- poor vision
- problems with depth perception
- hearing problems
- diminished sense of smell
- diminished sense of touch
- decrease in sensitivity to heat, pain, pressure
- incontinence
- height extremes — very short, very tall
- obesity
- physical weakness
- reduced mobility
- poor balance, gait
- use of cane, walker, wheelchair
- poor grip
- lack of coordination
- limited reach
- cognitive impairment
- chronic illness
- polypharmacy
- a fall history
Note: More accidents happen in the home than anywhere else. Fall prevention is a critical issue for the elderly. In Ontario alone, falls cause over 600 deaths annually for those over 65. (Ontario Medical Review 1992.) A broken hip can mean immediate loss of independence. Many of the guidelines below will help decrease the risk of falls in the home. If necessary look for a fall prevention program in your area.
General Home Modification Options
To improve lighting and visibility
- place light switches close to room entrances
- install light switches at the top and bottom of stairs.
- install lighted switch plates
- use high-watt light bulbs in stairways and other hazardous areas
- provide sufficient, even lighting throughout the home
- install additional lighting, if necessary
- install a voice or sound activated adapter to turn on lights an dappliances
- install under-the-cabinet lights in the kitchen
- place a night light in the path between the bedroom and bathroom
- install cordless battery-operated lights inside closets and cabinets
- install motion-sensitive experior lighting
- use bright colours
- use contrasting colours
To enhance safety and support
- remove loose rugs
- secure mats with non-skid backing or double-sided carpet tape
- secure telephone and electrical cords
- install non-slip flooring, especially in kitchens and bathrooms
- use non-skid flooring, especially in kitchens and bathrooms
- remove thresholds
- rearrange furniture to move it out of paths and walkways
- place barriers at dangerous locations
- edge stairs with bright non-skid tape to highlight changes in floor levels
- install rubber treads on uncarpeted indoor and outdoor stairs
- install handrails and grab bars, particularly in stirways and bathrooms
- clamp adjustable safety rail onto edge of bathtub
- install anti-scald devices on faucets and shower heads
- install smoke detectors near kitchens and bedrooms
- install plug-in carbon monoxide detectors
- install a portable security intercom
- install emergency response system
To improve accessibility, ease of use and convenience
- install a wheelchair ramp
- arrange furniture to leave wide corridors for wheelchairs or walkers
- ensure chairs have arms and seats that are high enough to allow for easy sitting down/getting up
- widen doorways by removing mouldings and replacing hinges
- install revolving shelves
- convert a ground-floor room into a bedroom
- install a bedrail and/or handrails
- install a commode (portable toilet) in the bedroom
- lower closet shelving and cabinets
- install slide-out shelving, adjustable rods, baskets and other closet organizers
- replace round doorknobs with lever handles
- attach lever adapters to round doorknobs
- install lever-handle faucets in kitchens and bathrooms
- replace fixed shower heads with flexible hand-held shower heads
- install a raised toilet seat
- install a shower or tub chair
- install crank-operated windows
- buy clocks with large numbers
- buy telephones with large buttons