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Posts Tagged ‘Certified Aging in Place Specialist’

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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My friend Nicolette writes quite a bit about aging in place, disabilities, and interior design, and her posts usually get me thinking quite a lot, especially her one on strategies to deal with loss and aging.

It’s a topic that’s near and dear to my own heart as well, along with the related issues of universal and accessible design, all of which are really tied together and inseparable. There’s a lot of overlap among the concepts of aging-in-place and universal design in particular, but also with accessible design. These are issues that we all eventually face one way or another; it just happens to be the turn of my generation to learn how to age well.

Disability, of course, can and does strike at any age. In my own family, my brother has been dealing with an illness and injuries that will leave him disabled and mobility-impaired for life, and he’s only 50. At the same time, both my father and his partner are ill, as is my aunt. My now-former partner is facing serious medical problems in his own family as well, so we were both stressed out by these issues. I myself cope with several disabilities, and have found my mobility impaired by injuries, and even my ability to dress myself and take care of my own hair is greatly diminished at times. Age is taking its toll on us all in various ways – and these kinds of stressors impact all relationships.

Having the tragedy of my brother’s situation occur so suddenly, on top of trying to look after my father at a particularly difficult period in his own life, really brought these issues home for me in ways that even a decade as a paramedic, a stint selling life and disability insurance, and even my own travails never did, and is the reason why I finally completed the coursework I needed to obtain my credentials as a Certified Aging in Place Specialist (CAPS designation) a couple of years ago. I will discuss what CAPS is more extensively in another post.

There are many, many things that can be done in a home or office to assist people in dealing with the physical challenges of disabilities and aging. Hundreds of websites and resources exist; there’s no shortage of information out there. I’ll be writing more about these topics as time goes by, but for the moment, let’s just take this as a given.

In reality, the physical changes required for designing a home that supports aging in place or dealing with a wide range of disabilities well are the easy part. The technology exists, and with enough ingenuity (and sometimes cash, admittedly), anything is possible.

Even if a major remodel is not possible, there are usually at least small modifications that can help improve the functionality of the physical space immensely, especially for people who do not require major changes for wheelchair access. Not long ago, for example, I consulted with a lovely, vibrant woman in her 70s who is feeling the losses associated with arthritis on how she can modify her draperies so that they are easier to draw, and don’t hurt her shoulders. She’s on an extremely tight budget, so a lot of the products I normally work with are out of the question, but even in a brief discussion, I identified at least four different ways she could modify things with cheap, readily available materials just from the hardware store that would still preserve the open, airy, minimalist kind of look she prefers, and we are looking now at more specific products. She’s got cafe curtains hung with a rod pocket, which take some pushing even for able-bodied people to move, so just changing to a style with rings or grommets will allow them to glide effortlessly on the rod. She won’t have to reach up any more, either.

This small change alone will allow her to deal with something she has to handle daily with much less wear and tear on her shoulders, and bring a measure of ease to her life that she never even thought she could have, especially without spending a fortune. When you are in pain, and your joints are deteriorating like this, even eliminating one or two aggravating movements a day can make a very big difference in your comfort level – and your ability to enjoy your home. An accumulation of several or many such minor modifications can really add up over time.

Willingness and ability to think outside the box to adapt common materials to the task at hand are critical skills for designers, especially those of us who work with people with physical limitations or tight budgets. A good interior designer is invaluable to this process – and to making changes that integrate well, still look beautiful, employ the same kind of quality materials of any other good design – and which don’t scream “disability” or “old people”.

People often don’t even know there’s anything that can be done to help some of the difficulties they have, so a sensitive, perceptive, and creative designer who knows how to ask the right questions and to observe well can open a lot of doors, and create solutions for problems that a client never even knew were possible and thus may have never even thought to ask about or request.

I was very gratified to see the face of the lady I consulted with just open up with amazement and hope upon hearing the range of possibilities I was able to come up with; that’s the kind of response that drives me to do what I do. And I didn’t even realize just how automatic it is for me to think this way until she herself commented on how natural it is to me. She’s been incredibly frustrated because she hasn’t been able to find a new kind of wand that would be more functional – but that isn’t where the best solution actually lies.

But what most stops people, especially from doing anything about modifying their environments before they absolutely have to, and which causes them the most difficulty, is undoubtedly the emotional component – the need to acknowledge the fact of these changes, whether existing or pending. And often, we put off making the changes we know we may need while it’s still easy, and end up in a crisis that forces decision-making at the worst possible times.

We don’t like to face the thought of our own mortality, even when the evidence continues to mount. It’s a natural human reaction. We don’t want to let go of who we once were, the things we could do before, the hopes and dreams for the future. We don’t want to acknowledge that there is indeed a sunset period to life, and that we must all face it someday. We don’t like the idea of letting go of cherished possessions, or moving to a place that doesn’t hold the same memories of our present homes. We are afraid of what life will look like as we lose abilities, and as our friends also decline – and inevitably die. We hang onto our stuff for dear life, as if it’s the only anchor that will remind us of who we are and where we have been, as if we can keep time from advancing if we just don’t change a thing in our environments. We hold onto our old ways of doing things, and outdated, nonfunctional homes, often because of fear that somehow admitting to what’s inevitable will somehow make it come to pass more quickly and take something away from us now.

Some people are lucky enough that they will be able to stay in their own homes for the rest of their lives, and without modifications. For many of the rest of us, though, changes are inevitable, even if only because of declining incomes, or desire to just not have so much house to take care of any more. But the first – and most ongoing – hurdle we have to face is the one in our own heads.

Also, as we Baby Boomers age, the stresses our sheer numbers will put on the health care and elder care systems will overwhelm both, and more and more long term care will have to occur in our own homes. We must plan in advance for these changes, if we are able to. Most people want to remain at home as long as it’s humanly possible anyways, but we are going to face the situation where there is likely not going to be any other choice for many of us who might actually prefer or need to utilize services such as assisted living at some point, just because of overload on the system.

Fortunately, there is a lot of help out there even for mental adjustments we may need to make. Good therapists and support groups can be invaluable, and there is no shortage of reading material. A good interior designer will also be exquisitely sensitive to needs, and can open doors that you haven’t even thought about. There are many strategies for combing through your possessions in an orderly way and deciding what to keep and what needs to find a new home, so that we can “right-size” our lives.

Identifying the things you own that have the most meaning to you and taking them with you if you move even if you have to jettison the rest can go a long, long ways towards helping ease the pain of change, for example. Do you really need that entire collection of decorative boxes you’ve amassed over the years? Or are there a few choice pieces that hold the most meaning for you, and which would help remind you of all of the rest? Can you photograph them and save them that way instead of taking them with you physically? Do you ever even look at all of those old photo albums that are piled up in the den, or would just keeping a few photos, framing them beautifully and using them in your new home still give you as much joy?

Start editing your possessions by asking yourself what single item you would take with you if you were told you had to evacuate your home immediately, and were only allowed to take one thing (ignoring whether it’s actually portable or not). Then repeat this exercise with the thought that you could only take one more item, and so on.

Looking at the move or remodel as an exciting opportunity to start afresh can help immensely as well. Even if the reason for remodeling your bathroom and kitchen is because you are now in a wheelchair, or expect you will be in a couple of years, if you can look at this as a positive thing that will help you continue to live as normally as possible, and increase convenience for you and everyone else living in or entering your home, you will be far, far ahead of the game. There’s no reason a fully accessible home has to look like a hospital, and it can easily be a showcase, just as any other home.

Consider, for example, that you get to have a brand new bathroom – focus on the wonderful new things you will have, and how simple things like taking a shower will now be much easier than they have been – or possible in the first place. Order beautiful cabinetry, tile, lighting, and fixtures. There are even beautiful grab bars made now that will coordinate perfectly with the rest of your bathroom fittings. The additional space you will need will make the room more functional for everyone. Make the space a sanctuary, not something institutional in character, and it will become a destination for the whole family – a source of joy, peace, and comfort, instead of a reminder of loss or impending loss.

Because loss and change are inevitable parts of life. They affect us in so many ways. The outlook we bring to the process, and to any home or office changes we must make, can make all the difference in the world – and that much, at least, need not cost a cent.

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If you would like an evaluation of your existing space to see if it is suitable for aging in place or accommodating a known or expected disability, or for assistance in designing a new home that will fully support your living your life to the fullest regardless of your own current or future physical needs (or those of your family members), and you want to ensure a beautiful as well as highly functional result, please contact me.

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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.

(more…)

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