RespiteMatch.com Health Blog

Key Words
home adaptation, home modification, home safety

Glossary
Activities of daily living (ADLs): Skills that a person must be able to perform in order to live independently.

Instrumental Activities of Daily living (IADLs): Important but not essential skills for someone living independently since services such as home care can provide the required support.

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Home modification involves adapting a home so that a person with disabilities can perform the activities of daily living as safely and comfortably as possible, while maintaining some degree of independence.

The modification can be simple — removing scatter rugs to prevent slips and falls — or complex — installing a stair lift or elevator to improve accessibility. The type of modification required will depend on the nature of the individual’s disabilities and the physical set-up of the home. An investment in home modification may eliminate or possibly delay the need for institutional care.

Home modification:

helps people with disabilities retain their independence and continue living at home for as long as possible
is suited to people who have some degree of mobility and do not need intensive medical care
can be a relatively inexpensive alternative to institutional care
can include home adaptations for people with dementia
You may hear or read about ADL’s. Specialists in gerontology evaluate seniors’ abilities using 2 lists; the first is Activities of Daily Living or ADLs. If your parent has problems with any of the following, the need for outside help or other intervention is obvious and critical:

Maintaining continence
Eating
Getting in and out of bed
Using the toilet
Bathing
Dressing
The second list is Instrumental or Intermediate Activities of Daily Living or IADLs. It is more difficult to know if an individual has problems with any of these unless you live with him. This is where your observation on visits can be critical.

Using the telephone
Shopping
Preparing meals
Housekeeping
Doing laundry
Using transportation
Managing medications
Managing finances
Even though help may needed in one or more of the above IADLs, a senior can still remain independent. Top

Things You Should Know

Seniors, housing and safety

93% of Canadian seniors live at home — with a spouse or family member
82% of seniors living at home have at least one chronic health condition
Over 45% of Canadians over 65 have difficulty with one or more activities of daily living
Most seniors with Alzheimer disease or other dementia live in health-related institutions
The overwhelming majority of seniors wish to continue living at home for as long as possible
60% of all injuries reported by Canadian seniors occur in the home and surrounding area
Financial assistance may be available for home modifications relating to age-related and physical disabilities
Source: Statistics Canada, Health Canada

Key problem areas in the home

stairs and steps
bathrooms
kitchens
basements
exteriors: exits, walkways, driveways, garages
security

Things to Look For
Risk factors for difficulty with activities of daily living

poor vision
problems with depth perception
hearing problems
diminished sense of smell
diminished sense of touch
decrease in sensitivity to heat, pain, pressure
incontinence
height extremes — very short, very tall
obesity
physical weakness
reduced mobility
poor balance, gait
use of cane, walker, wheelchair
poor grip
lack of coordination
limited reach
cognitive impairment
chronic illness
polypharmacy
a fall history
Note: More accidents happen in the home than anywhere else. Fall prevention is a critical issue for the elderly. In Ontario alone, falls cause over 600 deaths annually for those over 65. (Ontario Medical Review 1992.) A broken hip can mean immediate loss of independence. Many of the guidelines below will help decrease the risk of falls in the home. If necessary look for a fall prevention program in your area.

General Home Modification Options

To improve lighting and visibility

place light switches close to room entrances
install light switches at the top and bottom of stairs.
install lighted switch plates
use high-watt light bulbs in stairways and other hazardous areas
provide sufficient, even lighting throughout the home
install additional lighting, if necessary
install a voice or sound activated adapter to turn on lights and appliances
install under-the-cabinet lights in the kitchen
place a night light in the path between the bedroom and bathroom
install cordless battery-operated lights inside closets and cabinets
install motion-sensitive exterior lighting
use bright colours
use contrasting colours
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To enhance safety and support

remove loose rugs
secure mats with non-skid backing or double-sided carpet tape
secure telephone and electrical cords
install non-slip flooring, especially in kitchens and bathrooms
use non-skid mats or adhesive strips in bathtubs
remove thresholds
rearrange furniture to move it out of paths and walkways
place barriers at dangerous locations
edge stairs with bright non-skid tape to highlight changes in floor levels
install rubber treads on uncarpeted indoor and outdoor stairs
install handrails and grab bars, particularly in stairways and bathrooms
clamp adjustable safety rail onto edge of bathtub
install anti-scald devices on faucets and shower heads
install smoke detectors near kitchens and bedrooms
install plug-in carbon monoxide detectors
install a portable security intercom
install an emergency response system
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To improve accessibility, ease of use and convenience

install a wheelchair ramp
arrange furniture to leave wide corridors for wheelchairs or walkers
ensure chairs have arms and seats that are high enough to allow for easy sitting down/getting up
widen doorways by removing mouldings and replacing hinges
install revolving shelves
convert a ground-floor room into a bedroom
install a bed rail and/or handrails
install a commode (portable toilet) in the bedroom
Lower closet shelving and cabinets
Install slide-out shelving, adjustable rods, baskets and other closet organizers
Replace round doorknobs with lever handles
Attach lever adapters to round doorknobs
Install lever-handle faucets in kitchens and bathrooms
Replace fixed shower heads with flexible hand-held shower heads
Install a raised toilet seat
Install a shower or tub chair
Install crank-operated windows
Buy clocks with large numerals
Buy telephones with large buttons