Key Words
home adaptation, home modification, home safety
Glossary
Activities of daily living (ADLs): Skills that a person must be able to perform in order to live
independently.
Instrumental Activities of Daily living (IADLs): Important but not essential skills for someone living
independently since services such as home care can provide the required support.
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.
Specialists 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 him. 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 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
