All About Home Safety Assessments

Who Needs a Home Safety Assessment?

- Anyone!

- People of any age that are differently-abled

- People of any age that are diagnosed with a chronic disease

- People of any age that would like their home setup to be easier

- People of any age with an acute diagnosis and are discharged home

seniors 65+

1.Memory loss, confusion, difficulties with thinking and problem solving

2.Falls are the leading cause of injury, hospital admissions, and injury-related deaths among seniors

3.1 in 4 adults over age 65 report falling each year

4.Bones become brittle

5.Muscles and joints become weaker

6.Decreased coordination/balance

7.Increased constipation, weaker bladder

8.Decline in eye and ear health

9.After age 60, you begin to process medications differently

market research

demand is high and supply is low. Most people will have limited options if they need accessible housing, no matter their age.

aging in place

staying in your own home as you get older

- This requires careful consideration and planning!

What is done to age in place?

- Adapt your home: Adjusting items in your home or change existing routines to improve function

- Modify your home: Adding or replacing items in your home to improve safety and/or usage

- Remodel your home: Higher cost renovations that alter structures in your home

universal design

(UD) is a design concept. The goal is to design a space so that it can be accessed, understood and used by all people regardless of their age, size, or ability. It is just good design.

principles of UD

1. Equitable Use

2. Flexibility in Use

3. Simplicity and Intuitive Use

4. Perceptible Information

5. Tolerance for Error

6. Low Physical Effort

7. Size and Space for Approach and Use

ADA

(American with Disabilities Act) is a federal law that protects people with disabilities from discrimination.

The ADA Standards for Accessible Design

known as "ADA codes" are mandatory construction/remodeling requirements used on new designs to accommodate the disabled population.

- THE CATCH: This applies to construction with public access, not residential homes.

ADA Requirement Examples: Accessible Routes

continuous unobstructed paths, width of at least 36 in.

ADA Requirement Examples: Doors & Doorways

width of 34 in., thresholds less than ½ in. high, lever or U-shaped hardware

ADA Requirement Examples: Ramps

slope of 1 in. rise : 12 in. run, 5 ft. long landings and width or ramp

ADA Requirement Examples: Restrooms

turning space of 5 ft. x 5 ft., grab bars 33 in.-36 in above floor

ADA Requirement Examples: Handrails

34 in.-38 in. height, extensions 12 in. beyond top riser, edges must be rounded

ADA Requirement Examples: Kitchen/Sinks

clear floor space of 30 in. x 48 in., toe clearance of 9 in. minimum height

Occupational therapists who are certified as an aging in place specialist are trained to assess

the whole person and how they interact with their environment.

- medical history

- family involvement

- finances

- personal preferences

- pets

- home layout

- home ownership vs. rental community

- cognition current

- future abilities

Research has shown there to be a significant reduction in falls after

a home safety assessment + intervention from an occupational therapist.

HOME SAFETY ASSESMENT - SETUP

•Treat every client as a Unique Individual

•Client Summary / Story (Occupational Profile)

•Room by Room

•Appropriate Measurements

•Taking Notes

•Possible Recommendations

•Asking Lots of Friendly Questions

•Take Lots of Pictures (with permission)

•Use all 5 Senses

•Better to Recommend More than Less

USING ALL 5 SENSES

1.EYES - Look for hazards everywhere

2.EARS - Listen for clues

3.SMELL- Odors are telling

4.TOUCH - Test structures

5.VESTIBULAR - Any challenges?

6.(Don't TASTE Anything)

The ultimate goal: preventing falls

Falls are the leading cause of injury, hospital admissions, and injury-related deaths among adults ages 65 and older

entrance: low vision

add brighter bulbs, motion-sensor lighting, lights on a timer, nightlights

entrance: impaired upper body

Levered handle, code lock, auto door lock, table surface

entrance: impaired mobility

add colored/textured strips on edge of stairs, level thresholds, add ramp, railings, platform lift, stair lift

hallways: low vision

add brighter bulbs, motion-sensor lighting, nightlights

hallway: cognitive impairments

smart camera installation

hallway: impaired mobility

remove throw rugs, level thresholds, add 1-2 hand railing(s)

bathroom: impaired upper body

handheld showerhead, motion-sensor faucet, sliding shelving

bathroom: impaired mobility

add non-skid mats, personalized grab bars, shower seat/bench, electric bath chair

bathroom: impaired hygiene

bidet installation, combo bath chair-commode

bathroom: seated level

roll-under sink with tilt mirror, roll-in shower with curtain

bedroom: low vision

night lights, smart mats with lights

bedroom: impaired upper body

accessible hangers, open shelving, clear surface

bedroom: impaired mobility

bed rail, lower (remove box spring) or raise bed

bedroom: seated level

mechanical lift, accessible closet

kitchen: low vision

under cabinet or floor lighting, motion-sensor lighting

kitchen: cognitive impairment

magnetic cabinet locks, open shelving, automatic pet feeder

kitchen: impaired upper body

universal pulls, pull-down cabinets, sliding shelves, motion sensor faucet

kitchen: seated level

bi-level countertop, roll-under sink, durable dishware

living area: low vision

cordless flexible standing lights, Smart speaker (Echo, Alexa, etc.)

living area: cognitive impairment

TV timer, smart camera, remote fans/lights (timer)

living area: impaired mobility

remove slippery or damaged throw rugs, remove rocking chairs, clear wide pathways (3 ft.), protect corners, furniture protection, furniture risers, ensure stable furniture

outdoors: low vision

motion-sensor lighting, contrasting colors for surface changes

outdoors: impaired cognition

smart watch, 3-step door locks, fenced-in yard

outdoors: impaired mobility

walking poles, rollator, power chair / scooter

Don't Forget emergency preparedness

•Electrical cords are in good condition and not frayed, cracked, or spliced

•Electrical cords are kept away from water

•Extension cords are used appropriately and not placed in locations where they would pose a tripping hazard

•Wall outlets and switches have cover plates

•The main electrical fuse box or circuit breaker is easily accessible and clearly labeled

•If portable space heaters are used, they are kept away from flammable items

•Ensure that there are properly working smoke and carbon monoxide detectors and fire extinguishers (or fire blankets) and that the patient/family know their location within the home

•Ensure smoking does NOT occur in bed or around oxygen tanks

•Identify an evacuation plan and meeting place in case of fire or other emergency

Complicating factor: Clutter

- Untidy, Crowded, Disorganized, Accumulation, Messy, Temporary

- Decluttering and reducing hazards had the most benefit for older people, who are at risk of falls.

- "Taking measures to reduce fall hazards around the home lowers the overall rate of falls by 26%. This typically includes an assessment of fall hazards in and around the home and recommendations for lowering the risks".

polypharmacy

- five or more prescription drugs regularly.

- Older adults over the age of 60 process medications differently compared to younger adults.

Complicating Factor: multiple medications (Polypharmacy)

•Oversedation or Reduced Alertness, Slow Reaction Time

•Dizziness, Loss of Balance

•Confusion, Cognitive Impairment

•Falls

•Weakness or Loss of Appetite

•GI problems such as Diarrhea, Constipation or Incontinence

•Mood Changes: Depression, Anxiety, Excitability

sedentary lifestyle

6 or more waking hours sitting or lying down = Americans

Complicating factor: sedentary lifestyle

- We spend 55% (7.7 hours) awake time being sedentary

- Health Risks: Obesity, Coronary Artery Disease, Heart Attack, High Blood Pressure, High Cholesterol, Stroke, Diabetes Type II, Colon Cancer, Breast Cancer, Uterine Cancer, Osteoporosis, Falls, Depression, Anxiety

- World Health Organization's guidelines for staying active: 20 to 40 minutes of moderate-intensity aerobic activity per day + two days of strength training

WHAT'S UNSAFE IN THIS ROOM?

1.Diabetes with neuropathy: changing the texture of where the stairs begin in contrast to the rest of the room; remove carpet

2.Aging with visual deficits: change colors of the room so it's easier to see room/level changes; change lighting; adding an accessible switch

3.Chronic diagnosis of Parkinson's Disease: add things for them to hold onto (railings); extend the railing of the stairs; entrance way to the couch and piano are narrow (lose piano, extend wall, add a gate)

4.Recent knee replacement: moving the large couch; add a rail near step downs