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Archive for the ‘Accessible Design’ Category

Do you need modifications to your home because of injury, illness, or just plain aging and a desire to stay in your home, eliminating obstacles that may exist to doing so, but don’t think you can afford them?

First of all, many modifications may cost far less than you might expect, because they often don’t need to be as extensive or labor-intensive as you might imagine, and can actually be quite simple.

For example, sometimes all that is needed to ensure wheelchair accessibility may be to remove the moldings from around your doors and finish off the opening without them, and maybe either add new doors that fit the enlarged opening better, or in some cases, dispense with them altogether.  This alone can add a couple of inches of width to the doorway that can make all the difference, without getting into major remodeling.

And in places like the bathroom, as long as you can get the chair in there (which the door width may be the only obstacle to), depending on your particular situation, all you might need to be able to shower or bathe on your own might be a transfer bench and grab bars – although of course, you could certainly also opt do a full remodel with a wheel-in shower, step-in tub, and many other helpful aids that can be created in a way that no one else needs to know their purpose if you prefer.

Your best bet to determine what will serve your needs the best in a way that will fit your budget will be to consult a professional with the CAPS (Certified Aging in Place Specialist) designation to find out what’s necessary and possible, and to get a realistic idea of what it will cost.  You can search for an appropriate professional in your area via the National Association of Home Builders CAPS Directory.  CAPS specialists are specifically trained to manage the changes needed in the residential built environment in order for people to age comfortably and safely in their own homes – and that same training applies to both accessible and universal design as well.

If you have an occupational or physical therapist, you might want to involve them in the process as well, even if they have not already done a home visit, so that your needs and the specific obstacles in your home are most appropriately identified from a medical/functional perspective, leaving the design professionals to create a solution that best implements those requirements in the most aesthetically-pleasing way possible within your budget constraints.

Accessible design is created for people with specific, known needs, and universal design is a more general concept that allows people of a range of ages and abilities to function well together in the same space, anticipating potential needs along with addressing actual existing ones.   They overlap with each other, and both overlap with aging-in-place.

If aesthetics is important to you (and it should be, because that greatly impacts your enjoyment of your home), start with an interior designer or architect who is CAPS-certified, and hire a contractor who also holds the designation for the optimal combination of design and construction knowledge.  No one wants to – or needs to – live in a home that looks institutional in order for it to function well for physical needs.

Some contractors, although far from all, may have some training in interior and/or architectural design, so unless you know you only need or want the most basic of changes like functional grab bars and/or stair glides, the best outcomes in any renovation or new construction project will usually come from hiring a team that works together to address not just the technical issues but also the aesthetic ones, and not just the physical house issues, but also furnishings, color, lighting, etc., all of which can also be modified as necessary to address various types of disabilities, including normal age-related vision loss.

Most designers and architects will meet with you initially at no charge to explain their services, find out generally what your needs, budget, and preferences are, and to make a proposal, so don’t be afraid to call one even if you think you can’t afford our services.  If it does turn out to be more than you want to spend to hire one to do the whole project, many, myself included, will also work on an hourly consultation basis to give you advice, review contractors’ plans before the proposed modifications are built, etc.

Finally, when it does come time to do whatever work needs to be done, if you find that you really can’t afford them on your own, you may be able to locate some surprising sources of help in funding the modifications.

While it is beyond the scope of this blog – and indeed the scope of any design or construction trade professional – to offer specific advice about financial assistance, or its appropriateness for any specific situation or type of situation, I would like to share some resources that you can investigate on your own.  Please do consult with your own financial, tax, and legal advisors to determine the impacts and pros and cons of any financial options you may be considering.  In some situations, there might even be tax breaks associated with such modifications that might increase their affordability, but again, please do consult your own advisors for details.

One place to start, certainly, is asking your bank about a loan, and another is to ask your accountant and/or attorney about any sources they may know of.  Likewise, your church, synagogue, or other house of worship might be able to suggest or offer assistance through either that particular facility or through the religion’s local or national agencies and charities.  Fraternal organizations might have options as well, if you belong to one.

The Our Parents blog (which is a wonderful general resource for information about aging in general, and caring for older adults) also has a nice article on where to turn to seek financial aid with an assortment of links that will help you research options in your area, or that apply to your particular circumstances.

Don’t be put off by the name of the blog or references to aging and seniors if you are not of that “certain age”, as many of these agencies might also have programs that could benefit younger people as well if they have significant disabilities, and the blog certainly has information that would be beneficial to people with other disabling conditions.  They also have a nice article with other links about the possible pitfalls of reverse mortgages, which many people think of, and which may or may not be appropriate for a given situation.

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Louis Tenenbaum has written a very nice article  about the basic strategy for aging in place remodeling, discussing the important considerations.  I wrote a short response on his blog, then decided to take a more comprehensive look here on my own.

In addition to the main points inherent specifically with aging in place, Louis has hit on a couple of things I rarely see spoken about, namely the challenges inherent in figuring out what a client wants and needs, as well as their aesthetic preferences, and translating it all into something workable – and the design team’s role in helping the client envision what is coming from a medical point of view.

One thing that really surprises me is how seldom anyone involved in universal design and aging in place ever thinks to include an interior designer on the team.  Most interior designers really have no idea what they are doing with respect to aging in place, etc., but all really good ones certainly know how to figure out a client’s aesthetics at minimum and translate them – and how to work with a team of architect, contractor, and other consultants to create a comprehensive whole.

A few undertake additional training to learn about this specialized area of design, but exceedingly few go the extra mile to obtain the Certified Aging in Place Specialist credential that verifies the designer really understands the needs of this population.

What good interior designers in general do, however (even those without such specialized training), perhaps more than any other party to the design team, is translate all of the needs and desires to a workable daily interface that also meets all of the client’s aesthetic requirements, both interfacing with the structure itself, and in selecting the most appropriate finishes and furnishings, and all other interior elements.  The best designers know how to get past what is not said or is poorly articulated to ferret out the real needs and desires and to translate it all into what is actually wanted and needed, both functionally and aesthetically.

A good interior designer adds far more value to this whole undertaking than most people have a clue about, both in this arena and in working with any other kind of client as well.

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Image from Sparkly Like a Holiday

OK, I admit it.  I’m stealing this topic from Paul Anater, over at Kitchen and Residential Design.  But I’m not going to say the same things.

Yes, I quite agree that chalkboard paint is overdone – and way overdone in several of the images he shows.  It’s old.  It’s boring.  It’s dated.  There are clearly limits to its usefulness, safety, and definitely to its appearance.  Not only can it be toxic when it gets into your food as Paul mentions, but chalk dust can also be a major problem for people who have allergies, asthma, or chemical sensitivities, so it would not foster an accessible design for people who suffer from such afflictions.  It would also violate universal and visitability design principles, as it could create a similar hazard for other users of the space, particularly visitors whose sensitivities might be unknown.  Chalk dust doesn’t do anything for overall air quality, either, so that lowers the green design reusability quotient of the paint, never mind what the VOC content of it might be.

Now that we’ve looked at the potential health hazards, let’s focus more on the visual elements.

Looking at the images Paul posted, the ones that really offend me the most are the refrigerator fully covered in the dreadful green version of the paint, that huge, frightening expanse of black wall and door, and yes, that hideous kitchen. (more…)

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I just saw this amazing inspirational video that I had to share.  Whenever you are down in the dumps, feeling sorry for yourself, thinking you can’t go on, or that you’ve got major problems, watch this video and see if it doesn’t change your perspective.  These two young men are completely amazing, and the friendship between them should be an inspiration to all just by itself.  Our lives would all be so much richer – and the world more peaceful – if we had more people sharing the kind of close friendship and caring for each other that they have.

Outside the Lines/Carry On

And, as somewhat of a side note, and just to make this specifically interior design related, look at the living conditions that Leroy has to deal with – a situation that by itself would stop most people in their tracks.

These kinds problems can be averted by good advance planning and application of universal design techniques while you are still healthy, as well as specifically accessible design planning to help someone with particular, known changes in ability.

For that matter, the very fact that Leroy’s buddy has to carry him various places in public could be changed if we focussed on making all public places as accessible to the disabled/differently abled as possible as well.  Accessible/universal design shouldn’t be limited to the few who know about it, or to the wealthy who can afford to hire a designer; it should be just the way that everything is designed.  It should be the norm in our society to build so that everyone can access public places as well as housing, without being made to feel different, and without calling attention to the measures taken to allow this.

It’s a shame that people who are low income as these two are have to put up with the challenges of inaccessible housing in particular.

Fortunately, there are actually funds available from various sources, as well as tax credits, that can help people modify their homes if necessary, particularly low income people, which could make all the difference in their lives and ability to remain in and continue to enjoy their homes. Ramps, lifts, grab bars, etc. don’t have to necessarily cost a fortune, especially with this kind of assistance. In future blog posts, I’ll go a bit more into these options, and the Centers for Independent Living can help, along with knowledgeable interior designers, but you should consult your tax advisor in any event for the specifics and how they might apply to your particular situation.

I’m really appalled, actually, that the occupational therapists who must have worked with Leroy throughout his recovery didn’t find a way to make these arrangements for him.

And Leroy, if you happen to come across this, contact me and I’ll do my best to help you find the assistance you need to give you these options.

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In his excellent Aging in Place Guide blog, which I have been following for some time because of my strong interest in universal and accessible design and aging in place, Louis Tenenbaum brought up the issue of the “sideways” pressure those of us in this position often feel coming from siblings who may be either more or less involved in the care of the parents. We’re all familiar with the concept of the upwards and downwards pressure of the three generations, but these sideways pressures don’t get much press, if any.

There’s still another aspect to this sideways pressure that Louis didn’t mention. Something that’s never talked about is what happens when the siblings themselves become in need of care, and become as much a part of the issues that we have to deal with as the aging parents, when neither of them are available to help with the care of the other. We expect to eventually have to take care of our parents, to have to worry about where they’ll live as they age, to possibly have to move them into assisted living or new, more accessible homes as they get older and sicker, but how often do we think about those potential needs for our siblings – or even ourselves?

I’ve been shoved headlong into this whole issue within the past two months in a way I never expected to have to face (or at least far younger than I ever dreamed we’d face it) – and of course, none of us do anticipate this sort of thing.

My father is undergoing radiation for cancer in Kansas, and his status is deteriorating, so we are absolutely going to have to do something about his present living arrangements. I’ve always done all the legwork to help him when he’s been sick over the past few years, and frankly resented that my brother didn’t do more – some of the sideways pressure Louis was talking about, only in reverse, but something that people face all the time. One sibling is usually the one doing most of the work while the other is less involved for any of a number of possible reasons, and this often results in tremendous family tensions, anger, guilt, and so on.

On Christmas day of 2008, however, I was suddenly thrust into the position of both having to take care of Dad – and my 50 year old brother, who has become critically ill in Pennsylvania as a result of ongoing complications of some surgery he had last year. He nearly died, and the extent and nature of his present illness and injuries mean that he’s not only facing a very long and difficult recovery, and is completely incapacitated now – but that he will very possibly not be able to return to his own home because it is completely and totally inaccessible.

And I’m here in California, suddenly trying to deal with both of them – with virtually no support from either – and certainly no assistance with the logistics.

Both of them are understandably deeply worried about the other, but neither of them are able to do a darned thing about it – and I’m pulled in three separate directions every day because of course I still have my own life and issues to deal with, as well as those of my partner.

The very fact of a still-young brother being as sick as he is highlights all the more the need for universal design at all stages of life, but particularly as we move into our middle years and on, because absolutely anything could happen – and very likely will at some point. Really, it’s critical to consider at all ages, because you simply never know when disaster may strike, but we do expect more debilitating illnesses and injuries as people age – and we have more people age 40 and up today than we’ve ever had at any time in the history of the world.

I’ve known the odds of something happening for decades, between my former career as a paramedic, and a stint selling life and disability insurance. S*** is going to happen in the majority of people’s lives at some point, end of story, or they are going to be touched by it one way or another. Not one of us is going to escape at least being touched by illness and disability at least in a family member or friend, if not our own selves.

When you come face to face with it actually happening in your own life in a catastrophic way like this, though, that brings it all home in a very different way than seeing the effects on patients or clients, or reading about it in actuarial charts or textbooks or blog posts. It moves from the conceptual into reality in a way that will make your head spin.

There is a chance that my brother will not be able to return home to his present house because of the nature and extent of his injuries, and the potential outcome he may be facing. I’m praying this won’t be the case, and with luck it won’t, but I’m bracing for it because it’s certainly not impossible. We would be able to do some modifications, but others simply won’t be possible without major reworking of the building and additions and/or extensive engineering as well as landscaping because of the size and layout of the house, so it will probably be a waste of time and money to do the little bit in this particular situation. In all likelihood, the best, easiest, and most economical course of action if things go in the direction they very well may in the course of his illness will be for him to move to a new home that would be more accessible to start with.

Can you even begin to imagine how traumatic it would be to be seriously ill, in the hospital and rehab for months, fighting for you life and even limbs – and then not even be able to return home to your own home? To have to go through the trauma of finding a new home, packing and moving, etc., especially when you are at your least physical and emotional ability to cope with the already substantial pressures of buying, selling, and moving that even fully healthy and mobile people go through? To know that you’re going to have to leave it to others to do all the legwork, packing, etc., because you won’t even be able to get to most of your own stuff? To realize that you may simply never be able to access the places you love in a home you are attached to ever again? That you literally can’t ever go home again?

Can you even imagine the pressure that you would face, even as just a family member who has a loved one go through this? Not just the emotional worry about your loved one’s health, but all the myriad of changes and decisions you’ll have to make to help them – learning how to navigate the health care system, as well as find resources to help once they come home, and likely have to figure out how to find a designer, architect, and contractor to help with housing modifications, as well as possibly a realtor, movers, etc.

I at least have the advantage of having both a strong medical background, as well as a strong design background with a particular interest in universal and accessible design, which I’ve been studying for years, and an ocean liner’s worth of resources to draw upon – but let me tell you, I still have a lot to deal with, because it’s a whole different ballgame with the personal involvement.

If you don’t already have this kind of broad background, trust me, you’ll be on a roller coaster ride to a crash course in a whole lot of things you never even thought about before, and never wanted to know about – at a pace you never imagined. And it will be all the harder because you’ll also be dealing with your own emotions and possibly even depression over your concern for your loved ones, exhaustion from their care and advocacy for them, travel, etc., and all the more so if you’ve got your own physical issues to contend with as well, which many of us do. You will absolutely have to have the help of social services people and designers and architects to even begin to be able to navigate the whole thing and filter through all of the endless details and things to consider and attend to in order to get your loved one healthy as possible again, and eventually settled back into a healthy and functional home of their own. No matter how much you know, you cannot navigate a complex situation like this by yourself.

You expect this to face these issues with parents, but not with otherwise strong and healthy younger siblings or other relatives – yet the reality is that the odds of being hit with some disabling condition at some point in life that lasts three months or longer before reaching the age of 65 are as high as 44% – and the chance that these same people will remain disabled for five years or more after the onset of the disability reach almost 60%. Here’s a great chart that shows the disability probabilities by age.

And if it’s not one of your siblings facing disability, in addition to your parents and/or children, it’s going to be you – and the others will be the ones having to deal with all of these issues for you instead. This is really inevitable in life, so we may as well all just plan for it. There’s just no point sticking our heads in the sand and hoping we’ll never have to face these kinds of issues.

A “disability” that may affect your use of your home and ability to care for your own self may be as “simple” as breaking your leg – how many of us go through things like that? Have you ever tried to take a shower with your leg in a cast in your present home? To get food prepared and onto a table while using crutches? To get up and down the stairs, do laundry, grocery shopping, put away the groceries, or clean? It’s hard enough for the couple of months you have to deal with it with a simple fracture – but what if you knew that was how things were going to remain for always? What do you do then?

Disability isn’t necessarily something catastrophic like a major stroke or paraplegia or even blindness, which is about all most people think of when they think of the term “disability”. Even the day-to-day injuries incurred by normally healthy and active people can result in their homes becoming serious barriers to their use, enjoyment, and even safety, even if they are expected to eventually recover from the problem.

And even if we ourselves are healthy and our homes provide no obstacles to us at present, how many of us have friends or relatives who would find barriers in our own homes, and thus be unable to even visit us? Or how many of us would have to move if we suddenly had to take in a disabled or elderly relative?

This is why I make the best efforts I can to incorporate as many universal design principals as possible into every project I design. We absolutely must all take these potential eventualities into consideration when buying a new home, renting a new apartment, and in designing any spaces we occupy. We must demand that builders build for these eventualities, especially since we are at a point in history where more people than ever are reaching the age where disability is more likely than ever.

Believe me, it is far easier to plan in advance, and be sure that your living space is usable for people across all age and ability ranges (or can at least be easily adapted) before a need arises than to have to worry about how to deal with it once a crisis is in your face.

And if you never do need these features? Terrific! They will still enhance your enjoyment of your home in myriad other ways, and can be easily designed by a competent designer so that they won’t even be remotely noticeable as anything unusual. Universal design is just plain good design – period. It makes navigating around the house easier for everyone, even the fully “temporarily able-bodied”. I hope we get to a point where we don’t even need the term any more, because the principles will just become so ingrained in design professionals as just the way things ought to be done, and in the public as just what they ought to have every right to expect everywhere in the built environment.

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