Aging in Place and Home Modifications

Ch. 12

Aging in Place WHO definition

Creating environments that are truly age-friendly requires action in many sectors: health, long-term care, transport, housing, labour, social protection, information, and communication and by many actors—government, service providers, civil society, older people and their organizations, families and friends

Aging in Place CDC definition

The ability to live in one’s own home and community safely, independently, and
comfortably, regardless of age, income, or ability level

Aging in Place Definition: National Aging in Place Council

Living in a familiar environment and being able to participate in family and other community activities

Community Living Options for Older Adults

55+ communities

Assisted Living Residences

Cohousing

Continuing Care Retirement Communities

Independent Living Communities

Naturally Occurring Retirement Communities

Livable Communities

Community Mobility

Ability to get around community

Employment and volunteer opportunities

Allows for productive aging by access to employment or volunteerism

Exercise and recreation

Both prevent falls and promote aging in place

Stores and Restaurants

Enhanced accessibility and senior discounts

Americans with Disabilities Act

Civil rights law enacted in 1990 with amendments added in 2009; prohibits
discrimination against individuals with disabilities in all areas of public life.
• Examples
o Curb cuts
o Wider doorways
o Ramps or vertical lifts at building entrances
o Modified public bathrooms

ADA service examples

• provides access to transportation

• Curb-to-curb dial-a-ride service with discounted cabs
  o Door-to-door transport
  o Assisted transportation for individuals who require an escort to provide assistance between the car and the door or to stay throughout the trip

Home modification specialties certifications

Certified Aging in Place Specialists (CAPS)

USC’s Executive Certificate in Home Modifications

Home Safety Assessments

In Home Occupational Performance Evaluation

Safety Assessment of Function and the Environment for Rehabilitation: Health Outcome Measurement and Evaluation (SAFER-HOME)

Home Falls and Accidents Screening Tool

Westmead Home Safety Assessment

In Home Occupational Performance Evaluation

Consists of a card-sorting activity targeting 44 activities that are essential for aging in place

Safety Assessment of Function and the Environment for Rehabilitation—Health Outcome Measurement and Evaluation SAFER-HOME

Assesses the environment and the individual’s ability to safely carry out functional activities in the home

Home Falls and Accidents Screening Tool

Designed to identify individuals at risk of falling due to hazards within their home environment

Westmead Home Safety Assessment

A short form used to identify fall hazards in a home

Home Modifications

Alterations to the home environment in order to make living functional and safe while promoting independence
o Ramps or vertical lifts for entry and exit to the home
o Stair lifts for access to the second floor or basement
o Grab bars throughout the house for support and safety

OT Process for Home Modifications

Assess client needs → identity solutions → evaluate outcome

Funding Home Modification

Most homeowners pay for home modifications—little reimbursement exists.
• Reverse mortgage tax-free money can be used to pay for home health care, monthly bills, the self-funding of long-term care policies, and home modifications (e.g., ramps, kitchen or bathroom remodels)
• Nonprofit organization support
• Veterans Administration

Building Codes and Guidelines

Accessible and Useable Building and Facilities

Uniform Federal Accessibility Standards

Fair Housing Accessibility Guidelines

Interprofessional Collaboration

The OT practitioner will need to work as part of a team
o Homeowner and family
o Builders
o Handymen
o Remodelers
o Designers
o Architects
o Contractors

Accessible and Usable Building and Facilities

Standard and current model for most accessibility laws and codes. Minimum design
requirements for persons with physical disabilities and serves as the foremost industry standard and valuable guideline for non regulated residential
construction and modifications

Uniform Federal Accessibility Standards

Commercial standards are useful for dimensions, standards of
construction, clearances, and construction details

Fair Housing Accessibility Guidelines

Non mandatory guidelines for state and local agencies help to
properly implement the requirements of the Fair Housing Act.
• State and Local Codes
• Universal Design