Expert Interview: Making Your Home Safer as You Age

Nearly 90 percent of adults over the age of 65 say they want to stay in their home as long as they can, and 80 percent believe they will always live in their current home, according to a survey by AARP.

But the fact is that as our needs and abilities change as we grow older, aging in place can be a risky proposition. According to the CDC, one out of three adults over the age of 65 falls each year; and falls are the leading cause of injury and death among seniors. For older Americans who want to age in place, it’s critical that safety precautions and modifications be made in their homes in order to reduce the likelihood of falls and other injuries. That’s where licensed physical therapist Karen Frank and occupational therapist Gregg Frank come in. The pair founded Back Home Safely, through which they inspect homes and work environments for safety and offer modification services for seniors and families with special needs. Their goal is to help people live in their homes despite medical challenges. Here, Karen and Gregg discuss their mission and the dangers facing older adults who want to live independently, and also offer advice on how to make your home safer as you near retirement. Read on: Can you tell us about your professional background? We both have worked as therapists in acute care hospitals, outpatient clinics and long-term care facilities. Gregg has specialized in hand therapy. Karen has also worked in rehabilitation hospitals and home care. Eight and a half years ago, we developed a company called Back Home Safely whose mission is to allow people to live in the homes they love – no matter what medical challenges they are facing. Since then, we have been evaluating homes for any safety or accessibility issues. We make recommendations and if a client decides to pursue any of these projects, we have carpenters and installers who can perform the work. Our company installs grabbars, stairlifts, vertical platform lifts, stair rails and ramps; and also performs door widening for wheelchair accessibility and creates barrier-free showers. Our motto is “Live Home Despite All Obstacles.” We work with a lot of people who are in rehabilitation facilities and who need to return home following a medical compromise. We also work with people who are aging in place, but are becoming weaker and losing their balance and require some modifications to keep them safe in their home. We especially enjoy working with people who are being proactive and call us in prior to a fall to install grabbars or other safety measures to reduce their fall risk. How did you become interested in home safety? Being therapists, we both recommended home modifications for many of our patients who were no longer safe in their homes, or their homes were no longer accessible due to a new medical condition. For example, we would recommend a grabbar, stairlift, ramp, etc. They would say, “Who do I call to do these installations?” We would put up our hands and say, “I don’t know, I guess you need to call a handyman for the grabbar, a stairlift company for the stairlift, and a ramp company for the ramp.” A lot of those people didn’t necessarily understand disabilities. We realized the need for someone who understands disabilities to be able to go in and evaluate the home, make the recommendations, and be involved with the construction to make the optimal modifications. For example, some people may have suffered a stroke. With most strokes, people sometimes have one-sided weakness. Putting a grabbar on the right wall of the shower when a person doesn’t have use of his right arm would not be beneficial. These are things a therapist would look at that may be overlooked by the typical handyman. What do you think surprises people the most about the challenges of living independently as they age? They do not realize the challenge of stairs in a multilevel home. They do not realize how a bathtub can become a large obstacle when accessing the shower. Also, with reduced strength when aging, it can be difficult to rise off a toilet. It also surprises people that at a certain age, it is OK to ask for help (many aging individuals wait too long to get a caregiver to assist them). People also are stubborn about using assistive devices (canes, walkers, etc.) that are recommended to them that normally would reduce their fall risks. It becomes an immense challenge when they stop driving and need to figure out rides to doctors appointments, grocery stores, shopping, etc. From a therapist’s perspective, the more people sit and do not move, the weaker they become. The weaker they become, the more they lose their balance, which contributes to more falls. It’s so important to remain active as you age. What are the most important modifications homeowners nearing retirement should consider making to their homes?

• “No threshold” showers
• Grabbars
• Additional stair rails
• Right-height toilets
• Non-slippery floors
• Pullout pantries and cabinets for easy access to items
• Smooth door thresholds

For any new construction, consider Universal Design, which allows for wheelchair accessibility. For retirees looking to downsize, what would you recommend they look for in a new home? Stairs are one of the biggest challenges. Purchasing a home with minimal steps to enter and reach the master bath and bedroom on the first floor is recommended. An entrance into a home from a garage is a lot easier to transition in and out of a home without exposure to the weather. Large doorways that would be able to accommodate a wheelchair if need be are recommended, as well as a home that is in close proximity to grocery shopping and healthcare. Look at the landscape near the entry of the home. A steep landscape as one approaches a home will require more ramp material if a ramp is needed on the front entrance stairs. What are the most common causes of injury or death for seniors at home? Falling down stairs, and falls in the bathroom that lead to hospitalizations and further complications resulting in infections (and death). What rooms or areas of the house are the most hazardous for seniors? Bathrooms are the most hazardous for seniors. How can they be made safer?

• Installing well-placed grabbars
• Avoiding using towel bars and glass shower doors as hand holds
• Putting in non-slip walking surfaces
• Ensuring adequate lighting
• Removing the bathtub to create a barrier-free shower
• Purchasing shower product dispensers to avoid retrieving fallen bottles

What advice do you find yourself repeating to your clients over and over again? The benefits of grabbars. Lighting is so important. Railings are important. If a person becomes disabled and has difficulty with stairs, try to get the loved one to have access to their bedroom even if it involves a installing a Stairlift. Make sure people are using proper footwear that stays on their feet. Make sure their medications are under control, since many combinations of medications can cause issues with balance. Ensure that seniors use glasses if needed and that they keep the glasses clean. Can you offer a checklist of areas of the home we should inspect with safety in mind?

• Front walkway – look for even, smooth surface. Watch out for loose pavers or broken up walkways. Moss can create a fall hazard.
• Stairs to enter home – we would recommend iron or aluminum stair rails (many homes do not have railings to enter the home).
• Door thresholds throughout the home – large marble saddles can be a tripping hazard.
• Stairs within the home should all have stair rails. Stair rails should start right at the bottom step and go all the way up the stairs so you do not need to ditch the rail as you ascend the last step, Rails should return into the wall at top and bottom to avoid pocketbooks and oxygen tubes from getting caught on railing.
• Carpeting – buckled carpeting or torn carpeting is a tripping hazard.
• Electrical cords are a tripping hazard.
• Area rugs that are not secured at the edges are a tripping hazard.
• Lighting – easily accessible lights or motion sensor lighting is recommended.

• Bathroom – grabbar to enter shower and grabbar on far wall, comfort-height toilet, remove towel bars that someone would use as a hand hold, glass shower doors can be an obstacle if one requires a caregiver to help transfer them into the shower (removal of the glass door and installation of a shower curtain can solve this problem). Check for slippery tile on floors.
• Living area – reduce clutter to reduce tripping hazards.

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