Most of us prefer to live and die at home. To do this, we need a home that we can reasonably live in when illness or injury happens. Here are five tips to make a home easier to live in as we age.
In an ideal world, the kitchen, living area, bedroom, and full bath need to be on the same floor. A simple injury or illness can make climbing stairs difficult or impossible. Think ahead about living in your home without climbing stairs. A small refrigerator, coffee maker, and microwave can serve as a temporary kitchen. A living room or dining room can serve as a bedroom. Access to a full bathroom dictates the living location in many homes, often isolating the person on an upper floor and making it difficult for them to leave the home. Stair lifts are a modestly priced option for a long-term need. Home elevators are rare and expensive.
Forty years ago, a friend of mine built his family “dream home,” a spectacular two-story on a wooded lot with a bridge over a trickling stream in the back yard. Shortly after the housewarming party, he had surgery. When he was released from the hospital, he was ordered not to climb stairs for six weeks. Oops, there was only a powder room on the ground floor. He faced the choice of being helped up the stairs and staying there for six weeks, or not being able to take a shower in his beautiful new home for six weeks (or ignoring his doctor, a choice he regretted).
Think about access to get in and out of the house. On a horse-drawn carriage tour in Savannah, Georgia, the guide pointed out the porch level on most homes was about level with the floor of the carriage or a horse-drawn wagon, which is up a half a dozen steps from the pavement. He explained that the higher entry level made it easier for those arriving by carriage and also kept shoes and skirts from dragging in the horse exhaust on the street. Many older homes and new homes retain this design of the entry being raised 4-6 steps above grade level. Unless you are coming and going by horse-drawn carriage, plan ahead for ramps or a sloped entry.
We need wider doors. While the ADA standard for doors is 32 inches, most walkers will fit through a 26-inch door, and many wheelchairs will fit through a 28-inch door. When selecting a home or remodeling, think about door width. A lot of older homes have doors into bathrooms that are less than 24 inches. A related challenge is doors that swing into a small bathroom. Sometimes these doors can be removed, at least on a temporary basis. If you are building or doing an extensive remodel, consider “pocket doors.” A less costly alternative to a pocket door is a “barn door.” This is a door that slides on overhead tracks on the outside of the wall. A barn door also allows for the removal of the woodwork and drywalling the opening, a minor change that opens up about two more inches of space. We did barn doors on both bathrooms and widened the opening on one bathroom when we remodeled.
There are many ways for “coming clean” in your home. Soaking in a bathtub can be soothing, but most are designed for economy-of-space or appearance without consideration of getting in and out of them. In 2015, I had a period of time when I could not step in and out of the tub in the bathroom attached to my bedroom. Fortunately, we have a second bathroom that had a walk-in shower. When I had my bathroom remodeled, I had the tub removed and a large walk-in shower installed. A neighbor of mine, who has had both knees replaced, went a step beyond and had a roll-in shower installed. A “telephone shower,” aka a handheld shower on the end of flexible hose, is a huge help. This change can be as simple as hand threading onto existing plumbing, or as elaborate as money and imagination will allow. But don’t delay, do this before you need it. Balance or the ability to stand can make showers difficult, a simple answer is a removable plastic shower seat you can order online with free overnight delivery. Transferring from a wheelchair or walker to a removable seat in the tub or a walk-in shower equipped with a handheld shower is all it takes to come and stay clean at home.
Plan ahead and aim for a universal design.
Universal design is a design concept that makes a space easier for everyone to use. The four tips above are based on universal design. Most of us will live and die without needing the extreme design modifications of accessible design, changes like roll-under sinks and cooktops- but you should still consider them as you plan ahead. Injury and illness often happen without warning, in-patient health care stays are short and limited, and when you are ready to be discharged, you need to have a home ready to return to. You will not have time to wait for a door to be widened or a ramp built.