How To Care: Home Modifications: Print It Summary
How to Care: 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.
How to Care: 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 and appliances
- 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 exterior 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 mats or adhesive strips in bathtubs
- 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 stairways
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 an 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 bed rail 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 numerals
- Buy telephones with large buttons
How to Care:
Home adaptations to accommodate specific behaviours, deficits and requirements of people
with dementia
Wandering
- install a home alarm system
- install bells or buzzers on exit doors
- add dead-bolts and chain locks to exit doors
- install locks that take two or more steps to operate
- place locks higher than usual, near top of the door
- install invisible door locks
- install alarms on bedroom doors
- install a portable motion detector in the bedroom or near exits
- keep yards fenced and locked
- keep outside lights off at night
- disguise exit doors with curtains or posters
Disorientation
- simplify the environment — remove distracting objects
- mark doors to reduce confusion
- post signs, symbols, and pictures on doors to identify the purpose of rooms
- mark a clear path from the bedroom to the bathroom
- use a contrasting coloured toilet seat
- place coloured tape around the edge of the toilet and tub
- place a commode or urinal in the bedroom
- remove from sight open containers that may be mistaken for toilets
- leave a night light on in the bathroom
- install bright, even lighting throughout the home
- create turning points in dead-end hallways
Pacing
- create a track or path for safe pacing
- push furniture against walls
- remove low pieces of furniture and standing objects
Agitation
- remove or cover mirrors
- keep curtains drawn at night
Perceptual problems
- remove glass tables
- place decals on glass sliding doors and windows
- outline steps with brightly coloured paint or non-skid tape
Safety
- limit access to one or more rooms
- limit access to basements
- install a gate in front of stairs
- remove clutter from rooms and hallways
- secure cords and wires
- remove sharp objects
- put plastic plugs in unused electrical outlets
- attach thermostat covers
- remove or lock away hazardous materials
- close off fireplaces
- remove small kitchen appliances from countertops
- install a separate power switch for the stove
- install a child-proof lock out of sight at the top of the refrigerator
- remove control knobs from stove, oven and inside the refrigerator
- remove locks from bathroom door
- remove medicines from the bathroom
- store medications in a locked or out-of-reach cabinet
- remove sink stoppers
Questions to Ask
- What disabilities does the individual have?
- Are the disabilities temporary, permanent, progressive?
- Is the individual having difficulty in any of these areas:
- getting in and out of the home?
- using the stairs?
- moving from one room to another?
- moving about in individual rooms
- using the kitchen?
- preparing meals?
- using the bathtub or shower?
- using the toilet?
- getting in and out of bed, chairs, sofas?
- getting dressed?
- reaching items in closets and cabinets?
- doing laundry?
- cleaning?
- using the telephone?
- answering the door?
- emptying the mailbox?
- opening, closing or locking windows and doors?
- operating light switches, faucets, kitchen appliances, laundry appliances?
- What are the problem areas in the home?
- Does the home provide adequate:
- lighting?
- safety?
- support?
- accessibility?
- What kinds of home modifications would make it easier for the individual to continue living at home?
- How much will the home modifications cost?
- Can the individual continue living at home?
- If not, what housing options exist?
- What health care, community or commercial resources are available to assist with home modification,
alternative housing or relocation?
- Assess the individual's ability to function (ADL's) in the home:
- note activities that are difficult to perform
- note obstacles that prevent the individual from performing each activity
- Determine which types of home modification would be most useful
- Discover at-home coping strategies for home modification
- Learn about helpful products and devices for home modification
- Develop a plan to implement the home modifications:
- how much work is needed
- who will do the work
- what types of materials are needed
- how much the materials and labour will cost
- Discuss the home modification plan with the individual and any health professionals, as necessary.
out if financial assistance is available, if needed
- Carry out or make arrangements for the required home modifications
- Investigate alternative housing or relocation options, if necessary
- Contact associations and organizations that offer information and
advice on home modification
- Once changes have been implemented, monitor the situation and arrange for additional care services, if necessary