What is an optimal healing environment? Have you had an experience where your home was not as supportive as it could be to help you heal?
For example, say you are temporarily bound to a wheelchair. Unfortunately, your home’s bathroom doors were not wide enough for the wheelchair to go through. Simple things like going to the bathroom became a major chore.
While preparing your lunch, you realized you can’t reach many of the items in your cabinets. To complicate things further, you need to get a ramp installed to your front door to enter and exit your house. A home designed to support these things would be classified as a place optimal for healing.
The majority of the information in this blog is from our friends from Designing Independence and is being shared with their permission. The goal of the Designing Independence team is to create safe and accessible environments that are functional as well as individualized to a person’s specific needs.
As occupational and physical therapists, Designing Independence has the expertise to adapt your home or office based on your specific needs.
Thank you, Designing Independence, for contributing to our Blog and educating people considering modifications to their home to better support them as they age.
Why an Optimal Healing Environment at Home?
Our home is the one building that becomes an extension of our lives. A home contains our memories. We look at our back porch and smile as we remember a summer cook out with our neighbors. Sitting in the living room drinking coffee, we reminisce a family gathering to celebrate the holidays. A home is not only brick and mortar; it is a symbol of the best part of our lives.
As we age the conversation often leads to, “Maybe you should consider a retirement home or an assisted living home.” However, most people want to stay in their current homes as long as they can because they are familiar with their communities and enjoy the memories of their dwelling.
Of course, families are concerned and want their loved ones to be safe. But, what if there was a way to improve safety at home as we age? What if we could recover from illness and injury in the familiarity and comfort of our homes? One study found that 70% of people who fell at home did not have a home safety evaluation. How do we know if someone can manage in their home safely? Especially if we do not have a professional come to assess it?
It is also worth mentioning that the cost of assisted living homes prevent them from being a feasible option for many seniors. Costs start at over $50,000 annually and can easily reach a six-figure yearly price tag.
In addition, it is important to note that no one can guarantee that you won’t fall – none of us in healthcare can. When you are in a car you wear a seatbelt, however the seatbelt won’t prevent an accident and may not even prevent an injury. But, wearing it is our best bet for preventing injury or at least diminishing the severity of injury. The same principle applies to home modifications. Creating an environment optimal for your health and healing will reduce fall risk. Home modifications can maximize safety in the place you spend the majority of your time: your home.
When we age, our bodies and minds can betray us. We may have to start making more lists, as we are unable to rely on our short-term memory. Our eyesight fails or our arthritic knees make simple movements cumbersome and painful. Stairs become a burden and navigating the kitchen a chore.
So, if you want to live at home for the rest of your life and are concerned about your home’s ability to support you if/when you are less mobile and agile, what can you do?
Step 1: Obtain a Home Safety and Accessibility Assessment
The best place to start is to have an allied health professional come to your home to perform a home safety and accessibility assessment. If you are currently receiving home health services, physical and occupational therapists can get you started. Although they are generally unable to do a comprehensive home safety and accessibility assessment, they can point you in the right direction.
The National Association of Home Builders in conjunction with AARP has developed a Certified Aging in Place Specialist (CAPS) program for general contractors, allied health professionals, interior designers and realtors.
This certification is a 3-day course and requires continuing education to maintain. Another option to pursue is getting in contact with a CAPS general contractor. These contractors increase accessibility by working in universal design. It also works great in public spaces where many different people congregate.
Examples of universal design include wider doorways, ramp entry into a home or business and elevated outlets for easier access. All of these changes can increase accessibility for a variety of individuals.
It is important to note that universal design is not specific to your needs. It also does not directly address home safety. For a custom home environment suitable to your needs, it’s best to consult with an allied health professional initially. For example, a ramp qualifies as universal design because most people safely enter and exit a building using one.
However, if you have Parkinson’s disease and tend to lean backward in standing (a common symptom of Parkinson’s disease) then going up a ramp may be more detrimental than helpful. An allied health professional who knows current and likely future symptoms of disease can address how to safely enter and exit your home, as well as safety in other areas of the home.
Considerations for Pre-Surgery and Post Surgery Assessments
If you are facing surgery in the near future, you may be concerned about your home’s ability to support you as you heal. Again, have your house assessed to support you based on your anticipated temporary disability or condition. By addressing your environment ahead of schedule, you can shift your focus to your recovery.
Considerations for Visual deficits and adaptations
Home modification and safety assessments do not only look at physical disability. An occupational therapist can evaluate low vision and help to adapt your home to compensate for visual limitations. Often these modifications cost relatively little, improve your independence, and decrease your fall risk in your home.
Considerations for cognitive deficits such as dementia and Alzheimer’s disease
Home safety becomes particularly important when your loved one’s memory starts to fade. Allied health professionals are skilled in maximizing safety in the limitations of a brain disease. Sometimes we recommend a rail in a hallway if someone is unable to remember to use a cane or a walker. Other times we offer strategies for medication adherence. Allied health professionals can also make recommendations on how much care your loved one needs and if they are unsafe to be left alone. These recommendations should be based on industry wide, cognitive testing backed by current medical research. The results from these cognitive tests can give your insight into your loved ones needs, abilities and limitations.
Step 2: Falls Risk and Balance Assessments
A balance assessment is another aspect of a comprehensive home safety and accessibility. An allied health professional conducts these assessments and current research supports their viability. These balance assessments tell us a lot of useful information.
For example, if your physical therapist notes that you cannot stand on one foot without support from your arms. This is a red flag to us. The inability to stand on one leg can lead to difficulty with stairs and stepping in/out of a bathtub. Each balance test determines functional mobility and safety with tasks in the home. Have someone assess your balance issues as well as your home. Afterwards, you can optimize the best environment for you or your loved one to thrive.
Step 3: Home modifications
After meeting with an allied health professional (physical and/or occupational therapist), they can give you a report that gives a detailed explanation of what home modifications you need. You can order or purchase some items at a store (nightlights for example). Some items may need a handyman or general contractor. Anyone hired to work in the home has access to the report from the physical and/or occupational therapist.
The report should include details about where exactly items need to be installed (i.e. grab bars, handrails, etc.), so the general contractor is aware of the therapist’s specific recommendations. Ramp or doorway width specifications also need to be included in the report. Allied health professionals can also work directly with the contractors to ensure the client’s needs are met. It is also important to make sure that the allied health professional prioritizes the most critical needs, so that you know which items need to be addressed first.
If you truly are concerned about aging at home and your home’s ability to support you, seek help from the great professionals in your community that focus on home safety and modifications. Even if you are not ready to make the modifications, you have the information to think over the hard decision of staying or moving from home.