Aging In Place

In the recent past, there has been a shift back towards what is commonly called “aging in place.”  Rather than move to a assisted living facility or even a continuing care retirement community (CCRC), seniors have shown a clear trend to prefer to stay in their homes as long as possible.  “Their home” may change from one structure to another as they move to a southern state where the winter temperatures are less deadly, but there is an increasing preference for staying at home and not moving to assisted living or other communities.  A house can be full of memories and hold more furniture and mementos that hold even more memories. It is, to put it bluntly, home.  Change away from those memories can be hard.

Aging in place may be possible. Staying in your home may be extended with modifications to parts of the home.  What is required is a fresh look at new access needs, safety and security.

Here are a few specific areas and ideas to consider to help you age in place:

Entry: The entryway to a home is a point of danger for seniors.  There are typically at least two steps, often more, and there is always a door threshold raised up from the floor level.  The front door is an area to greet people and the point of entry upon returning home.  But look at more than just the front door.  Focus on every entry because entries are points of certain daily passage – to get the newspaper, take out the garbage, walk the dog, or to greet family and friends.  Designs that were preferred for beauty may become tripping points. 

Many entries can be improved for safety and access with relative ease and minimal expense.  A ramp up to a step may be needed, a grab bar at an entry point might be helpful, a place to sit outside a door may be useful for a moment’s rest or to set packages down without bending to the ground level, and improved lighting may increase the safety of an entry point. Getting in and out of your home is essential to aging in place well.

Stairs/Lifts/Elevators:  This is the most obvious and often the most expensive alteration necessary.   Aging typically means a loss of mobility and as a result, stairs become a place of increasing risk of fall. Stairs and entries with multiple steps inevitably will present an increasing challenge.  Each year almost 3 million seniors are treated for fall-related injuries in hospital emergency rooms.  The actual number of injuries is certainly higher because most seniors do not report a fall if the injury is only a bruise or a sprain.  Over 300,000 American seniors are hospitalized annually for hip fractures, most resulting from a fall.  Over 27,000 seniors die annually from falls and fall-related injuries.

Recognizing the risk of stairs also gives us opportunities to work towards accident avoidance.  Exercises to strengthen legs and balance, improving stair rails, improved stairway lighting, vision checks, moving to and using only the ground floor, and adding an elevator or mechanical stair lifts are some of the means to allow safe aging in place. 

Bathrooms: Bathrooms are the highest risk area in the home for falls and accidents.  Many bathroom dangers can be eliminated once those risks are recognized. Bathtubs have three areas of risk: access (having to step over the lip of the tub), slipperiness (especially when soapy), and lack of seating.  These are almost universal problems.  Consider all of these: a replacement tub with an entry door, removing the tub and replacing it just with a shower, adding a portable seat in the shower or tub, non-stick tub appliques or a tub mat, grab bars, improved lighting and removing that attractive throw rug on the bathroom floor that may slip or trip someone.

Learn more by reviewing A Bathroom and Shower Safety Guide for Seniors, a resource of Safety.com. The article offers several ideas to help improve bathroom safety, and several of those ideas also translate to safety in other areas of the home, especially your kitchen and closets.

Kitchen: Kitchens have become spacious over the past 20 years.  But many seniors live in older homes with kitchens that were designed for use by younger and more agile and flexible people.  Seniors have a 2 and 1/2 times greater risk of dying in a kitchen fire than the population as a whole.  If you want to age in place, the kitchen is critically important. There are three areas to focus on: fire prevention, access and convenience, and food safety. 

Fire Prevention: There are many varied ideas for consideration.  The primary cause of fires is leaving food unattended on the stove or in the over.  All kitchen towels and potholders should be far away from the stove top.  Do not wear loose clothing while cooking.  Never leave the house if food is being heated or cooked.  Investigate available automatic shut-off kitchen appliances.  Only use pots and pans with two handles.  Use an individual cup coffee brewer and never set a coffee maker to automatically brew.  Clean the stove top immediately after each meal.  Oil, fat and grease are all significant fire and burn risks.

Access, Convenience and Fall Prevention: Here there are also a multitude of different ideas to consider. Many meals are cooked before sunrise or after sunset, so check the lighting at night.  Check the refrigerator for leaks.  Stop using hard-to-reach shelves and cabinets, both low and high shelves.  Replace glass cookware and items with unbreakable ones.  Store heavy objects at waist level.  Stop using the highest cabinets that might require a stepladder.  Install Lazy Susans in corner cabinets and on corner countertops. Install, or have installed, pull out shelves to reduce the need to kneel, bend and reach.

Food Safety: The universal first rule is, “When in doubt, throw it out.”  After that, there are also many additional ideas.  Date storage containers so the age of stored food is readily visible.  Check the refrigerator temperature routinely.  Don’t assume food is safe just because it doesn’t have a smell or bad appearance; foodborne bacteria cannot be seen, smelled or tasted.  Store meats and vegetables in sealed containers.  Use different cutting boards for meat and other food items; many stores now sell colored cutting boards.  Replace cutting board frequently as damaged surfaces are common sources of contamination. Replaces sponges even more often; they are a common source of contamination. Return leftovers to the refrigerator immediately after a meal.  When reheating food, make certain that the temperature reaches 165-degrees.

The Master Bedroom: You spend many hours here, so aging in place starts in the master bedroom. Getting into and out of a bed can become a major safety issue.  Safety rails can inexpensively be added to most bed frames.  Bedroom and especially closet lighting is often a risk.  The universal home design has the bedroom light switch by the door; walking in the dark is unavoidable.  Add a remote control light switch so that walking in the dark is never necessary.  If possible, make it a dimmable light so the path to the bath at night can be lit bright enough to see the path and avoid obstacles but not so bright as to completely wake you up.  Furniture may need to be rearranged, moved or replaced to address access issues. 

Laundry Rooms: Laundry rooms are often poorly designed areas that are cramped, mere after-thoughts put in spare areas.  Access is often difficult because laundry rooms are designed for the young, not for seniors.  Storage is almost always above the washing machine and dryer, often hard to reach, sometimes requiring a step ladder, something that is always a point of danger.  Consider making certain there is room for a walker or wheelchair.  Switch to a front loading washer and dryer.  Stop using the hard (or impossible) to reach top cabinet shelves.   Consider adding a fold-down shelf for folding clothes.  As always, check the lighting.  Make sure the floor is not slippery when wet.  Consider adding a rolling cart to make the movement of clean clothes to closets and drawers easier. 

Medical Alert Systems:  Falls remain a major risk.  A fall that leaves a senior unable to reach a phone creates a risk of a long and painful wait for help.  Consider a medical alert system with a wrist or neck call button.  There are less expensive systems that work only in or near the home and there are more advanced systems using cell technology that allow alert calls to be made anywhere that there is cell coverage.  They also should include a GPS locator system so emergency responders can locate a lost and injured senior.

Your time in your own home can be extended – a lot.  Aging in place is possible if that is what you want. Careful thought, attention to detail, objective observation, as well as help from your family and friends can add years to your independence.  For the rest of the blessing, call us at The Idlewild Foundation, we would like to help.

About the Author

John Campbell

John Campbell has retired from a 40-year legal practice as a trial attorney in Tampa. He has served in multiple volunteer roles at Idlewild Baptist Church in Lutz, Florida, where he met Jesus.  He began serving as the Executive Director of the Idlewild Foundation in 2016.  He has been married to the love of his life, Mona Puckett Campbell, since 1972.