Home Remodeling – Essential Knowledge

Design for Aging in Place

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Universal Design & Aging in Place

As already discussed, design and remodeling for aging in place is the prime practical application of the principles of Universal Design.

When it comes to execution, design for aging in place means “elder-proofing” a home. And this has special importance and application in the kitchen and bathroom.

But it is also important when it comes to an elderly person navigating around the home.

Why is This Important?

All we need to do is look at the aging statistics and remind ourselves that we will all be old someday. And it is philosophically important that we are able to live independently at home, where we can thrive, rather than in an institution where we are less able to live a full life and, for that reason, tend to deteriorate much faster.

The U.S. Centers for Disease Control and Prevention (CDC) defines aging in place as “the ability to live in one’s own home and community safely, independently and comfortably, regardless of age, income or ability level.”

We want to help our Baby Boomer population enjoy their retirement life longer, more fully, and in style by suggesting the subtle incorporation of aging-in-place design features into their remodel project. And, of course, the recommendations here are also for the benefit of younger people who may be planning long-term for themselves, or who need to make provisions for older family members.

The typical American home is designed for able-bodied young adults. But as the baby boom generation ages, boomers are looking for ways to make the typical home accommodate their changing bodies. They want this done as invisibly as possible and without loss of the style and comfort that they currently enjoy. Many designers and remodeling contractors are responding to the challenge.

This response stems from the Universal Design movement, also called “design for all” or “inclusive design,” where the concept is to make homes and furnishings function well for everyone, regardless of age, size, shape, or ability.

Our senior population now has the reason and the resources to comfortably and safely stay in their own home (with or without caregiver help) rather than go into Assisted Living or a nursing home. More than 90% of seniors would rather live in their own homes than move into some kind of facility. Currently, there are more than 46 million US seniors over age 65. This is predicted to increase to almost 90 million by 2050.

Obviously, this is putting great pressure on the existing housing stock to adapt to the task of accommodating this population. In fact, aging in place is forcing a revolution in the remodeling industry.

And let’s not forget that the design principles involved are also highly appropriate as we make provision for the proper treatment and accommodation of our wounded warriors.

How We Cover Aging in Place on This Site

First, in this post, we briefly discuss remodeling for aging in place and then provide a 130-point aging-in-place remodeling checklist, where we try to cover all bases.

Second, in our many separate posts on the bathroom, the kitchen, and the laundry room, we make specific references to what needs to be done to accommodate aging in place. And this means making the use of these areas senior-friendly and safe. (Please refer to the index on the home page)

Third, and also in this post, when it comes to seniors moving safely around the home, we discuss what needs to be done to accommodate visual impairment. This includes appropriate lighting, visual touches, and the addition of tactile elements. We include a 21-point checklist for this.

Of course, these recommendations apply to anyone who is suffering from visual impairment, not just seniors.

Designing for Aging in Place Remodeling

A well-designed remodel provides for aging in place in elegance and style and there is a large array of design ideas, design standards, resources, and manufactured items from which the remodeler can draw. We have listed many of them below and in doing so note that ADA (Americans with Disabilities Act) compliance and Universal Design standards, while having different purposes, both make useful contributions to the cause of aging-in-place remodeling.

The features we have listed in the checklists below are organized for reference and with some repetition to help you think through your own requirements. Every feature is by no means applicable in every case. Rather these are menu items and food for thought for people considering aging-in-place remodeling.

Technology Caution: Smart Home technology is all the rage but don’t obsess about it and remember that some older people can get confused by tech. A user-friendly underlying physical infrastructure is what really matters with aging in place. It is permanent, while the tech is ever-changing.

That said, by all means, explore the voice-activated applications offered by Alexa and Google Home and increasingly incorporated by appliance and lighting manufacturers. And also explore third-party services that will set up home automation for you.

Aging in Place Checklist

Accessibility

1: Adapt the lower floor of the home for possible one-level living

2: Wider (48”) hallways (structure permitting)

3: Easy garage or parking access

4: At least one entry is without steps

5: Door peephole at a low height

6: Doorways 36″ wide with off-set hinges on doors

7: Pocket Doors

8: Automatic Door Operators

9: Levered door handles instead of knobs

10: Easy to open or lock patio doors and screens

11: Lower window sills especially for windows on the street

12: Shelf outside the front door (to place packages while searching for keys)

13: Wheelchair ramps

14: Wheelchair lifts

15: Stairway power chair lifts

16: Railings

17: Patient Lifts

18: Stair Lifts

19: Elevators

20: Pool and Spa Lifts

21: Lever-style door handles (easier than gripping knobs for people with limited dexterity)

Lighting

22: Additional lighting Installed to remove dark areas and help illuminate transitions or steps

23: Increased incandescent general and specific task lighting but prefer LED

24: Increase natural light (windows, skylights, solar tubes)

25: Automated lighting (motion sensors)

26; Adjustable controls on light switches

27: Illuminated switches in bedrooms, baths, and hallways

Electrical

28: Electrical outlets at 18 inches instead of 12

28: Light switches at 42″ instead of 48

29: Strobe light or vibrator-assisted smoke and burglar alarms

30: Additional outlets in front of cabinets

31: Larger panels (or sub-panels) to accommodate new appliances, medical devices, lifts, etc.

32: Back-up generator power for medical devices

Plumbing

33: Anti-scald devices (the skin of the elderly is less sensitive to heat and can be inadvertently scalded)

34: Foot pedal-operated faucets

35: Other hands-free faucets

Ventilation

36: Programmable thermostats for heating and cooling

37: Ceiling fans w/ remotes

Flooring

38: Hardwood or tile flooring for ease of cleaning (but not so good for falls)

39: Vinyl flooring for a softer feel

40: Non-Skid flooring

41: Anti-slip coatings

42: Backer pads to prevent rugs sliding (preferably no rugs at all)

43: Step highlighting

44: Low-pile commercial carpet glued directly to the floor

Visibility

45: Contrast colors between floor and walls

46: Color borders around the floor and countertop edges

47: Matte finish paint, flooring, and countertops

48: Non-glare glass on artwork

Security

49: Wi-Fi caregiver cameras to view what is happening in the house from any computer

50: Door cameras to see who is at the door from any computer or on closed-circuit television

51: Trip/fall alarms

52: Medication reminders

53: Emergency response system (installed or wearable)

Kitchen Specific Aging in Place Remodeling

Kitchen Accessibility

54: Kitchen-floor edging in a contrasting color to help orient people with limited eyesight

55: Easy access ABC-rated fire extinguisher (A for paper/wood; B for flammable liquids; C for electrical)

Kitchen Cabinets and Counters

56: Kitchen cabinets with pull-out shelves

57: Easy clean countertop surfaces

58: Create a workspace with knee/ wheelchair clearance

59: Easy-to-grasp cabinet knobs or pulls

60: Place sink near the stove (but have a “landing” counter space in between

61: Task lighting under upper cabinets

62: Adjustable upper shelves and pull-out lower shelves

63: Variety in height of kitchen counters with some as low as 30 inches

64: Color or pattern borders at counter edges

65: Lazy Susans

66: Pull-out storage

67: Full extension drawers

68: Cabinet doors that retract to leave knee space for people in wheelchairs

69: Extra deep and high toe kick to allow wheelchair user foot space

70: A counter that slides out from under the oven

71: Rounded counter edges

72: Counters and sinks you can raise and lower

73: Movable kitchen island on lockable casters

74: Comfort height counters

75: Multi-height counters

76: ADA-compliant cabinets (higher toe kicks, lower countertops, etc.)

77: Pull-out steps around the perimeter of cabinets for easy reach of upper cabinets

78: Roll-out shelving

79: Cabinet lifts

80: Glass-front upper cabinets for visibility

81: Plenty of storage within the so-called “optimal reach” zone. This is the space between 20 and 44 inches above the floor and 20 inches from the body)

82: Use drawers rather than cupboards where possible.

83: Use of C or D-type handles on cabinets

Kitchen Appliances

84: Accessible appliances, such as drawer dishwashers positioned on either side of the sink in lieu of the standard dishwasher with its awkward drop-down front.

85: A multitasking convection/microwave at shoulder height

86: French door ovens to avoid stooping for the awkward dropdown front oven

87: ADA-compliant appliances

88: Easy-to-reach controls

89: Dishwasher elevated for greater accessibility

90: Dishwasher drawers

91: Cooktop controls in front

92: Color-contrasted controls for people with low vision

93: Magnetic induction cooktop for greater safety

94: Side-by-side refrigerator/freezer (doors have narrower swing radius)

95: French door oven (easier to use than the drop-down front oven)

96: Gas sensor near gas cooking, water heater, and gas furnace

Kitchen Sinks and Faucets

97: Single handle control, side-mounted for easier reach

98: Adjustable height sink

99: Hands-free faucet

100: Pull-out sprayer

101: Pot filler faucet located close to the cooktop

102: Reduced depth sinks (for wheelchair access)

103: Motorized sink (raise and lower to suit a wheelchair user)

104: Easy-to-reach disposal switch

105: Anti-scald device for faucet

Bathroom Specific Aging in Place Remodeling

General Bathroom Accessibility

106: Telephone jack (yes – mobile phones are not senior-friendly and we like landlines for backup)

107: Wet Room: incorporates a shower, tub, and toilet all in one easy-to-clean area

108: Bathrooms with a turnaround and transfer space for walker or wheelchair (36″ by 36″)

109: Wheelchair-accessible sinks and vanities

110: Anti-scald device on the water heater

Vanities/Faucets

111: Lever faucets and faucet mixers with anti-scald valves

112: Hands-free sink faucets (proximity triggered or foot pedal operated)

113: Accessible sink (cantilevered to allow for wheelchair below)

114: Higher bathroom counters

Toilet-Bidet

115: Taller (comfort height) toilets rather than institutional toilet extenders

116: Wall-mounted toilets for easier cleaning

117: Automatic/Hands-free flushing devices

118: Bidet or “washlet.” This is a toilet seat bidet by Toto. You need an electrical outlet nearby

Showers/Tubs

119: Temperature-controlled shower and tub fixtures

120: Stall shower with a low or no threshold and shower seat/transfer bench

121: Bench in tub

122: Bench in shower

123: Grab bars at the back and sides of the shower, tub, and toilet or wall reinforcement for later installation)

124: Walk-in tub

125: Walk-in/roll-in accessible shower

126: Bath lifts

127: Easy-use, adjustable height shower heads

128: Shower hoses and hand-held shower heads

129: Multiple shower head systems (“Shower Tower” by Kohler)

130: Steam shower/sauna: great for anyone but exercise proper caution.

Remodeling for Visual Impairment

When making home modifications for elderly people, we always have in mind current or future visual impairment.

Understanding Visual Impairment

Visual impairment is not at all the same thing as blindness. There is a range of visual impairments ranging from low vision to total blindness. In fact, of all the people with visual impairment, only about 15% of them are totally blind, that is with no visual perception at all.

This means that there is a great deal that can be done to improve the living environment of the 85 % who are in the category of low vision or partially sighted.

It is especially important to understand visual impairment in the context of aging in place, which is a major theme in this guide. This is because ultimately all of us will become visually impaired.

Everything we talk about here is also related to aging in place. Most of the home modification recommendations for aging in place apply to the visually impaired.

Visual impairment occurs naturally as we get older and independently of any disease of sight. An elderly person in good visual health needs almost three times the lighting as one in his late teens or early twenties. This is because as we age the amount of light that reaches the back of our eyes decreases, which makes objects look dull and less defined.

Remodeling for the Visually Impaired

A remodeling project for low or no vision people focuses on two areas:

  1. Enhancing the visual experience to maximize the use of remaining sight, and
  2. Enhancing the tactile experience of the home as an aid to getting around without sight.

This has the twin purpose of making the home safer and easier to navigate – with safety being paramount.

The Macro and Micro Home Environment of Visual Impairment 

Changing the home living environment to suit the visually impaired is a very big subject.  So it is important to distinguish between the macro and the micro parts of this effort.

An example of the micro part would be the various ways to mark clothing and tag kitchen utensils to make them easy for the visually impaired to work with them.

An example of the macro part would be making sure that the home’s infrastructure, such as the lighting system, is optimized for the visually impaired.

As remodelers, we are concerned with the macro part of this picture. It is the most important part because it provides the foundation upon which all the micro parts of the effort are built.

Nonetheless, our remodeling work must pay attention to and accommodate the micro parts of the project. And so that we don’t lose sight of them, we have provided a checklist of the major micro items further down in this post.

Enhancing the Visual

Proper lighting is important regardless of visual impairment. It reduces eye strain and fatigue; reduces the chance of accidents and injury, and helps in the accomplishment of specific tasks. This is probably the most important contribution of remodeling for visual impairment.

For people with vision loss, adapting to changes in lighting becomes difficult. It affects balance and can lead to falls.

Ambient Lighting

Ambient light is a general light that brightens a large area. It helps with mobility because it aids in identifying obstacles to movement.

Pro tip: make sure the ambient light spreads evenly throughout the room. Place the light source in such a way as to reduce the creation of shadows. You want to avoid overly bright and dark spots in the room.

Task Lighting

A task light is one that focuses on a specific area allowing one to accomplish a given task, usually related to food preparation, reading, writing, crafting, etc. Task lights, except for kitchen and bathroom applications, are not permanently mounted. They will be table lamps or floor-based gooseneck lamps. However, depending on the planned location of portable task lights, the remodeler must make appropriate provisions for wall or floor sockets.

Pro tip: the location of the task light matters. Do you want it for a recliner? For a table? When using a magnifier? Adjustable lighting will help you position the lamp better for your task. The worst possible place for a task light is directly behind the shoulder. This throws reflected glare directly back in your face.

Here is an example of good portable task lighting available on Amazon: 

Standing Magnifying Lamp

  • Magnifying floor lamp
  • Flexible gooseneck

Accent Lighting

Accent lighting is used for such purposes as enhancing the appearance of artwork. It is not paramount in creating a good environment for the visually impaired but can be an important contributor to the overall ambient lighting in the home.

Lighting No-Nos
  • Do not use ambient lighting as task lighting. If the distance from the light source to the task is too great, there will be insufficient light for the project.
  • You should not be able to see the bulb when a task light is properly positioned.
The Language of Lighting
  • Wattage: the amount of energy that produces the light
  • Lumen: the brightness of the bulb
  • Kelvin: the color temperature on the Kelvin absolute scale of temperature. A lower Kelvin (2700K – 3000K) is “soft white” and adds a warm, yellow/reddish color to the white. A “bright white” is at around 4000K.  A higher Kelvin (5000K+) is “Daylight/Full Spectrum” and gives off a cool, bluish-white tone.

Important note: One should avoid going over 5500K, as this is in the blue-violet range and produces glare. Individuals with vision loss may well have a preferred (more comfortable) color temperature depending on their condition and should consult their specialist on this.

Artificial Light Sources

We look for artificial lighting with high lumens and low wattage, that is, bright light with high energy efficiency. Here is a brief rundown of available types of light sources:

  • Incandescent bulb (regular light bulb): this is inefficient, creates light by heating wire within the bulb, and does not provide adequate lighting when compared to alternatives.
  • Halogen: a type of incandescent bulb that uses a halogen gas atmosphere within the bulb. It is more efficient than the regular light bulb but puts off a lot of heat.
  • Fluorescent: typically found in commercial buildings and characterized by long bulbs containing argon or mercury gas. Causes the most glare. Produces UV rays. It is known to bother many visually impaired people.
  • CFL (compact fluorescent): more energy-efficient than incandescent bulbs. It also produces UV rays. Considered a mercury hazard.
  • LED (Light Emitting Diode): long lifespan, durable and low maintenance. No heat or UV rays. Saves energy. Comes in a variety of Kelvin.

In our opinion, when remodeling for visual impairment, LED lighting is the only way to go. This is because the great variety of available Kelvin can be made to suit individual vision comfort preferences. There are other good reasons too.

Lighting Installation

Replace all lighting with high lumen, low wattage, dimmable LED lights (use dimmable lights to accommodate household members who are not low vision and do not need or want intense lighting).

Use Occupancy Lighting

Occupancy sensors turn lights on when someone enters a room and then turn them off when they leave. This is convenient and energy-efficient and saves the visually impaired from having to grope for a light switch.

  • Replace old switches with rocker-style illuminated switches.
  • Install lighting in stair risers or illuminate stair treads with, say, LED ribbon.
  • In kitchens and bathrooms, install fixed task lighting in areas such as under cabinets, around mirrors, over food prep areas, over sinks, and over stovetops.
Maximizing Natural and Reflected Light

And let’s not forget the best light of all-natural light. Whenever we can, we should work on increasing the amount of natural light that enters different parts of the home and is then reflected around the home.

In ascending order of expense, this would include:

Using Paint

  • Starting with the outside, paint the underside of your eaves or roof soffit white. This has the effect of increasing the reflection of light through windows.
  • Use light and bright paint colors on walls and ceilings. Paint has what is known as a Light Reflectance Value (LRV) which is scaled from 1% for pure white to 100% for black and with values for all other colors falling in between. Ceilings should for sure be painted white.
  • Use gloss paint: the higher the gloss, the higher the LRV. And, on a practical note, it is also easier to clean.

Using Reflective Materials

Installing glass, glossy ceramic, or metallic tiles in kitchen and bathroom backsplashes.

Replacing Windows

  1. Thick mullions or sashes restrict the passage of natural light, and so do very Low-E coatings. Discuss alternatives with an experienced window company.
  2. Installing new windows or replacing sections of the exterior wall with glass blocks.
  3. Installing skylights. Skylights are a very effective way to bring natural light to targeted areas.
Using Colors

The use of colors in a remodeling project for the visually impaired goes hand in hand with considerations of lighting.

Solid bright colors (red, yellow, orange) reflect light well and help the visually impaired see things better.

Use contrasting colors: For example, a dark solid-colored border around a white light switch will make it stand out. And a contrasting color nose tile on a step is a good safety measure. Floors and walls should be in contrasting colors. And in bathrooms, porcelain plumbing fixtures should not be the same color as the walls or floors.

In the kitchen and bathroom: Use contrasting colors to make cabinetry hardware, plumbing fixtures, and appliance fronts stand out. Also make sure the countertop not only contrasts with its surroundings but is also a light color with no confusing patterns, to make it easier to see the working surface.

If there are glass patio sliders, decorate them with contrasting color decals to help awareness of the presence of glass.

Enhancing the Tactile

Unlike vision, the sense of touch does not diminish as we get older. So as visual impairment increases so does the reliance on touch increase as we find our way around the home.

The remodeler is relatively limited in the tactile department when compared to the visual but nonetheless, can make an important contribution in these areas of home navigation and safety.

  • Use contrasting floor surfaces. Tiled areas and carpeted areas provide useful landmarks for the visually impaired. Many homes already have this. For example, changes in the floor surface can indicate a transition from a hallway to a bedroom.
  • Install non-slip tiles in showers.
  • Install grab bars in bath and shower areas.
  • Install handrails on both sides of the staircases.
  • Use an induction cooktop to reduce the risk of accidental burns. Otherwise, avoid using a flat-topped range so that there is a change in texture to indicate the presence of burners.
  • Install tactile overlay stickers or bump dots on appliance controls, for example for the microwave.
  • Use tactile materials, such as textured wallpaper, in designated areas. An example would be a strip along a hallway at chair rail height.

The Details of Organizing for the Visually Impaired

As we go about our task of remodeling for visual impairment, we need to bear in mind and, to the extent we can, facilitate all the supportive things that should be done when we are finished. Here is a 21-point checklist of the main items:

Furniture Arrangement

1: When choosing new furniture, select items with textured upholstery. This makes it easier to identify them when you can’t see them well.

2: Locate chairs near windows so you can read or work with the benefit of natural light.

3: Place dark chairs in front of light walls and vice versa.

4: Put colored lamps or vases on tables close to major furniture items to help you identify them from a distance.

5: Use dark-colored cushions with light-colored furniture and vice versa.

6: Position furniture close to the television; get a larger hi-def television

7: Eliminate low-profile furniture like coffee tables or end tables that can be tripped over,

Lighting

8: Introduce table and floor lamps for task lighting.

9: Use blinds or sheer curtains to reduce glare from windows

10: Place mirrors to eliminate glare.

Marking

11: Use fluorescent tape to mark door handles and other items.

12: Label everything. Labeling includes marking things like cans of food with rubber bands

13: Color-code household items

General Safety

14: Remove clutter from the floors

15: Tape rugs down or remove them altogether.

16: Make sure the fire extinguisher is easily identified and located. Same with the first aid kit.

17: Make sure there are no electrical cords to trip over.

Organization

18: Maximum use of closet and drawer organizers throughout the house.

19: Use special care in the separation and organization of medications.

20: Eliminating clutter from work areas

21: Organize kitchen items in ways that will help identify them.

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