Designing with aging, disabilities in mind

debrak2008October 1, 2013

It seems more than ever people are here designing homes and kitchens with aging or disabilities in mind. I thought maybe we could put together a thread of tips.

My mom is 83 and I see these issues every day.

My tip is about thresh holds or changes in flooring. I am still surprised at how much trouble a slight change or thresh hold can give my mom. Each type of flooring feels different to her. She struggles getting her walker with wheels over even slight thresh holds. Keep in mind people who have difficulty walking don't usually lift their feet as high as a more able bodied person.

Tip: Keep flooring changes to a minimum. Choose thresh holds carefully.

Share your ideas!

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I would have to put drawers and wall ovens high on the list. I had both of my hips replaced, and grabbing something from the back of a bottom cupboard is risky. Same with bending to use an oven in a range.

If I had the space, I would have a prep sink that I could sit at using a regular chair.

    Bookmark   October 1, 2013 at 7:25PM
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A few: taller toilets, lever handles, doors that swing out in case of fire and wheelchair exiting fast, pull out work station at cabinets, stove knobs on the front of stove, ice and water in the refrigerator door.....can't reach ice otherwise, lower microwave, medical info listed in a tall prescription bottle in refrigerator and stickers on doors to let EMS and firemen know where info is, emergency contacts and info etc in a frame by phone, grabber stick for high shelves in pantry, emergency bag packed and easy to get to in case you need to go to hospital, wider doorways for wheelchairs, remote control ceiling fans and lights....great invention!, adjustable height shower head, tiled floor and large shower to roll in...easy to clean and dry up too, minimal carpet if any, no coffee tables, and try to avoid sharp corners and edges on everything you can. I'm sure I could think of more, but that's a quick start!

    Bookmark   October 1, 2013 at 8:09PM
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Ranges, ovens and dishwashers that have large knobs instead of tiny buttons, or worse, the smooth touch controls. My mother no longer has the dexterity for little buttons or hitting the smooth-touch controls "just right". And she doesn't even have arthritis or mobility issues!

    Bookmark   October 1, 2013 at 8:36PM
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Adequate lighting, self explanatory.

Contrasting elements. Not necessarily huge contrast, but enough that seperate elements can be easily distinguished. For example, cabinets and flooring that are very close in color/tone can make judging distance and height difficult, as well as navigating corners (cabinet edge blends with the floor).

Light colored counter and sink, easier to keep clean with vision problems because things left out or soiled areas are more visible.

One of the most common issues I see in people otherwise able to care for themselves is vision loss. Glaucoma, cataracts, macular degeneration, blindness from diabetes, etc.

Most of the other stuff I can think of has already been mentioned.

A single step stepstool with tall handle is helpful for any type of balance or mobility issue, it limits the extra height to one step, plus the tall handle helps stability.

Pull down shelving inserts are available for upper cabinets and may be helpful in some situations.

Enough room to easily use a walker or cane in all areas. When I did home care, it was amazing how many people didnt use needed walking aids inside their home. They didnt see the risk, and many had cramped rooms that were full of things that could catch a cane on the way by. Or the person counted on grabbing a nearby object for balance and to prevent a fall. Based on the number of falls reported, I don't think that strategy worked so well!

I hope by the time we finally get to build our dream house there are more experts in this area. I have no arches and bad knees, so single level living and planning for mobility problems is high on my list. Especially now that I'm watching my mother suffer with cysts in her knee. Even a few weeks with one leg not cooperating very much has had such a huge impact on her life.

    Bookmark   October 1, 2013 at 9:13PM
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I'm rethinking the permanent kitchen island. Of course, you can still have one...but I don't think I want one. A big table that can move when necessary or a movable island with locking wheels...both would be more flexible.

Outside...don't forget walkways and raised garden areas, if gardening is still a fun hobby :)

    Bookmark   October 1, 2013 at 9:20PM
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I just saw a rerun of This Old House, the cottage they did for an older couple, all accessible. In the kitchen they have no uppers, and touch-control drawers for opening and closing. But, they are powered; you'd need a generator in case of power outages.

My mom's kitchen was built lower for her 5' frame; the countertops are lower than normal, and the cabinets come down lower. Now that she's 89 and 4'11 it works better than ever.

L_L, mom also has a raised garden. The deer found it as convenient as we did LOL!

And, hesitate to say this because of some other threads on the topic, but, well, a powder room nearby.

    Bookmark   October 1, 2013 at 11:19PM
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I'll throw in a raised dishwasher. My mom had a respiratory disease, and leaning over to deal with the DW left her without air even when she was using her oxygen. When she was 90, she had been putting a couple of dishes in the DW, then turned to cross to the other counter and fell. I'm sure that the bending over left her breathless and the fall was partly a result of not having enough oxygen. She broke her hip. I watched it happen. The ironic part was that I'd just taken her to a PT appointment that afternoon where they evaluated her physical condition and recommended a walker. We'd already arranged for one, but didn't have it yet. A raised DW may not have prevented this accident, but it would have been helpful.

When she was 85, I got her one of these so she could have fresh tomatoes. It's at my house now and still growing tomatoes.

Here is a link that might be useful: Tomato Trolley

    Bookmark   October 2, 2013 at 1:02AM
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This is the concept I tried to keep I
In mindwhen redoing the kitchen. The raised DW is a great idea if you have the counter space to give up. Unfortunately,for me, it didn't work. But I did get to keep the MW drawer. I figured a wheelchair or a regular chair could be pulled up to the side and using it would be easier than risking spills from above as is
a possibility with OTR MW. I know my hands are starting to hurt now and I'm only 50. As arthritis advances, it wiil be more difficult to maintain my grip.
No one has mentioned a side mounted faucet. Would imagine that is easier to access as well.

    Bookmark   October 2, 2013 at 10:01AM
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robo (z6a)

DW drawers seem like a great solution as long as you're not cooking for a crowd, you could pretty much always stick to the top drawer?

    Bookmark   October 2, 2013 at 11:32AM
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robo (z6a)

DW drawers seem like a great solution as long as you're not cooking for a crowd, you could pretty much always stick to the top drawer?

    Bookmark   October 2, 2013 at 11:34AM
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These are all great ideas. My 95 year old mother could use them all. My current pet peeve is packaging. No way can she open any sealed screw tops like milk and oj. They may be sealed for your protection but surely someone can invent something better. Mom lives in an independent living apartment but it is 200 miles away. I have to open everything I buy and of course that makes it deteriorate faster. As an aging boomer myself, I think ALL showers should have hand-held shower heads on a sliding mount, all toilets should be ADA height (little ones could have a stool--maybe even one that slides out and retracts!). Kitchen redesign unfortunately is prohibitively expensive--I love the idea of a low sink that one could use with a chair. Even though she lives in a retirement home, her refrigerator is still placed against a wall which makes access to everything considerably more difficult. Also wish she had a bottom freezer refrig. I could go on and on ....

    Bookmark   October 2, 2013 at 12:08PM
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When we redid our house 3 years ago I tried to find information on this very topic and there is very little out there.

We plan on staying in our home and a couple of things we did that aren't mentioned-

-reinforced stair banister/railings - if knees or hips are sore people tend to lean on them.
- wider doorways if possible
-cabinet pulls/knobs with a high relief so that sore, tight arthritic hands have enough room to get into the space without having to bang knuckles on the actual drawers. I have had arthritis in my hands since my early 30's and this was the one that has made the biggest difference
- kitchen taps with a larger head on the sprayer portion. Many people with arthritis can't make a tight fist for the narrow heads. It was a sales clerk who suggested this for me and it was a great idea.
-if area rugs are used they are on the minimum size and no corners are in a pathway.
- be careful when selecting bathroom tiles and make sure they are non-slip
-chair in the entrance way for taking off/putting on shoes
- two levels of racks in closets - higher racks can aggravate sore shoulders and cause imbalance when reaching.

Many of the other things we did have already been mentioned. One that can't be over-emphasized is lots and lots of lighting.

    Bookmark   October 2, 2013 at 12:49PM
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As far as kitchen design is concerned I dealt with all of these. My elderly mother lives with us. She is 80 years old and loves to cook and we want her to feel able to cook as long as she can and be safe and confident doing so. Here are some of the things we did in the kitchen:

1) Lowered countertop on the cooktop and prep side (the finished height including the 3cm soapstone is 33inches.)
2) Went with induction cooktop due to safety issues. I was originally thinking high BTU gas rangetops like CC or the Bluestar but when my mom used the single hob Max Burton, she fell in love with the induction as there are no flames and she liked that the pots did not get too hot. So minimized chance of burns. We went with 36in Gaggenau induction. The knob is very very intuitive and my mom was able to pick it up in a few mins.
3) A separate prep sink which is shallower. This was easier on her back. We installed the Franke Beach and also installed a compost bin close by. But this has made prep very very easy for her. Not much lifting or bending down to reach trash etc. We also chose Kohler Karbon as the faucet here as it was easier for her to direct water where she wants and have both her hands free. The joystick was also easier than the levers we tried. We were debating whether or not to a tapmaster here. We ended up installing one and my mom loves it.
4) Mise en Place design. As she aged, my mother's stature shrunk. She is barely 4ft 10inches now. The biggest challenge in the old kitchen was reach for her. In this kitchen, we had her stand and mapped her arm reach. All of the things she typically uses for cooking is right within her reach. With lower counters, we were able to get the uppers installed lower too with the necessary 18in clearance. Now the bottom shelf of the upper is within easy reach. The canisters there have some texture to provide better grip. Nothing too heavy there. We also did shelves on the cabinet door for things like tea and coffee. The best thing was however the drawers. I do not have a separate pantry and anyways, we wanted cooking ingrediants to be within reach. We ended up sizing the drawers to fit OXO POP containers for all the staples. Super heavy duty glides which are soft close are important here. I learned about these here. These containers are BPA free, airtight and release with a simple press lift. Much much easier for arthritic hands. No lifting or twisting of heavy jars. All of the
dry goods --> rice, lentils, grains, steelcut oats are all here and have scoops already in them.

4) A place to sit and prep. We wanted to have a place where we can tuck in a stool under the counter where she can sit and prep things like shelling peas, stuffing peppers, making dumplings etc. Unfortunately we did not have space in the counter run. So instead the kitchen table is a sturdy butcher block and she has a right sized chair to do that. Standing and prepping for long is too hard for her.

5) Lighter weight cookware --> I struggle with this as I do love my Le creuset and Demeyere. But to make it easy and safe for my mom to lift, I got a few pots from IKEA which are great on induction and the weight is not too much.

Other ADA things we did in the house include:
6) No transition access One of the design principles we used was to avoid any transitions. We have no carpet and there is no transition (wooden trim piece) between the wood and the tile. Nothing to trip over. In fact there is no transition threshhold between kitchen and the courtyard even. Footmats where used have a grippy bottom to avoid tripping.

7) Bathroom: We installed a curbless shower, an ADA rated seat, a easy to reach niche near the seat for soap, champoo etc. The TP holder is a grab bar in disguise. The shower rod is installed into solid wood and can be used as a grab bar. We also got a longer shower bar so that when sitting the shower head is still easy to reach and she does not have to get her head wet. The tiles go up to the ceiling and have solid backing behind them Eventually we can install grab bars where ever necessary. There is a towel hook inside the shower stall to minimize drips and avoid falls. We did have an ADA design person review our plan and give us advice.

8) Elderly friendly furniture In every public room (living room, family, foyer, kitchen) in the house as well as her room, there are chairs which are sized right for her. Not too high, not too deep, with arms to pull herself up, softer, and heavy enough to not slide if she leans on it.

These are in perspective just a number of small things but it has been quite remarkable to see how comfortable it has made our home for my mom. I would not say that we spent too much money on it and definitely the compromizes were very minimal but just a lot of upfront thinkign and analysis has made a huge difference. And I know that when we are older in a few years, we will appreciate all of this. Just last week an elderly neighbor brought her daughter and son in law over to see our home and get ideas for the in law unit they are remodeling for her and her husband.

    Bookmark   October 2, 2013 at 1:15PM
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The NKBA has a new online course dealing with this very issue. It's only $59 for non members and qualifies design professionals for .1 CEU to maintain their training requirements. I haven't taken it yet, but I will before the year's end.

Here is a link that might be useful: Kitchens and Baths for Aging in Place

    Bookmark   October 2, 2013 at 4:22PM
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Any appliances that have "black on black" color schemes. I usually mark the controls and settings with a silver marking pen.

    Bookmark   October 3, 2013 at 12:52PM
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Something that hasn't been mentioned - many people get shaky as they get older - it's a very common neurological disorder, especially in the 60+ crowd (I became a "mover and shaker" when I was a kid :-( ). It's very difficult when you are shaking to manage those flush mount light fixtures - unscrewing the little knob is difficult. So dh and I are installing pendant fixtures in places where the flush mounts might normally go (bedrooms/closets, etc). Those are easier to deal with if you're shaky.

We decided to not plan for w/c access when we designed our new home. That would involve a huge redesign of everything and extra space - at that point it'll be time for a nursing home. Access for crutches/bad knees that's easier. Walk in shower with tile bench, grab rails, adjustable shower head, access to the entire house without stairs. Also a raised toilet in the master bathroom. You don't need to be elderly/disabled to want those things - all it takes is a broken leg...

    Bookmark   October 3, 2013 at 1:40PM
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Fori is not pleased

This is a great topic, and I've been looking into it as well for our remodel/addition. Not so much for me as I will always be young, but I do have aging parents and inlaws.

I sure do hate those ADA toilets, though. If I'm ever old enough to want to have to climb up a toilet, I'll replace it then. Of course by then I might be too old to change out a potty by myself!

    Bookmark   October 3, 2013 at 4:53PM
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Aaack! I'm only 50 and I'm old enough to need an ADA potty! Now my knees *really* creak! :-P But then, I could've used an elevated potty at 40 - so much easier when you're on crutches....maybe I am getting old and doddering? eeek!

    Bookmark   October 3, 2013 at 5:39PM
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Fori is not pleased

I betcha you're taller than me! I like the kid potties of yore. I do see how taller people might be more comfortable without dropping to sit, but some of us don't have to drop. :P

I do think induction is a good one, but again I think it's something that can be added when needed. But I like it anyway so I won't have to wait until my dotage to get it.

I do feel safer with my mom having induction. She's been almost burning down the house as far back as I can remember!

Things like wall placement and doorway widths and locations and cabinetry design are where I'd put most of my thoughts on accessible design, unless I already had someone around who needed it. But planning for upgrades of the less permanent items in the future will make it so much easier when it's necessary.

    Bookmark   October 3, 2013 at 7:20PM
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I'm 5 8! I can see how vertically challenged people might like shorter potties, though.

At least I think it's good to put backer boards in so that grab bars can easily be installed when needed. My inlaws needed their bathroom retrofitted with grab bars, hand held shower, and shower seat for my FIL so that he could come home from the hospital. It would have been far easier if those things had been included in the home's bathroom originally,, rather than putting them in after the fact...

    Bookmark   October 3, 2013 at 7:34PM
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My father is visually impaired.

For things like the microwave touchpad, they have put stickers that are a circle with a punch out in the center (about the size of a cheerio) on the buttons. This lets him feel where the button is, and the open circle in the center allows for the impulse to be transmitted.

He uses the Add 30 seconds button to cook everything. He makes scrambled eggs in the microwave every morning. In a dixie paper bowl. He cracks the egg, and stirs in a splash of milk and a tiny bit of butter. Stirs with a plastic spoon. Puts into the microwave for 1 minute total, but stirs every 15 seconds. He will just stand there and count to 15 and then stop the microwave and stir, and then hit the start button again.

He wakes up way before my mom, so this lets him eat when he wants to.

    Bookmark   October 3, 2013 at 11:42PM
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