I just returned from a visit with my 84-year-old mother who was in the hospital because she fell and hit her head. Though she suffered only a nasty black eye and a shock to her system, it was clear to all of us that the danger of her falling had become critical. With my sister, I undertook the task of relocating her to an assisted living apartment. For over a year, Mom had been adamantly against this move, but after her fall, she agreed to it.

No one likes to admit that they are getting older, and that they can’t do things the same way they used to. Many of my parents’ generation continue, with increasing effort, to keep up their lifestyle and routines that have served them well for many years, until there is a crisis. This can come in the form of a fall, a fender-bender, or a diagnosis of self or partner, and suddenly, things need to change. Most often, new arrangements, and all of their attendant upheaval, occur at a moment of maximum stress, when one’s abilities to adjust and cope are already under strain.

With 20-20 hindsight, we can see that the time to have made some accommodations would have been BEFORE the crisis. My sister and I wish we had been able to convince Mom to accept her need for increased assistance many months ago. It would have been so much easier for her to adjust to new patterns and routines when in good health, and the improved arrangements might even have prevented the crisis.

Foresight about the realities of aging-in-place, that is, making accommodations to one’s home for accessibility and safety, requires facing the possibility of loss of abilities that have been taken for granted. It requires clear-eyed practicality and application of “the golden rule” to one’s self.

Appropriate architectural accommodations in homes for aging-in-place, also known as universal design, includes integration of the following:

• Smooth, ground-level entrances without stairs
• Surfaces that are stable, firm, and slip resistant
• Wide interior doors, hallways, and alcoves with 60″ × 60″ turning space at doors and dead-ends
• Removal of throw rugs and clutter
• Bright and appropriate lighting, particularly task lighting
• Accessible switches throughout home, including at both ends of the stairs
• Additional railings
• Grab bars in bathrooms
• A hand-held, flexible shower head
• Functional clearances for approach and use of elements and components
• Lever handles for opening doors rather than twisting knobs
• Components that do not require tight grasping, pinching or twisting of the wrist
• Clear lines of sight to reduce dependence on sound

For a new home, these accommodations can be smoothly integrated at the outset of the design. For retrofit of an existing home, it can involve some ingenuity to achieve these goals. Increasingly, many of my clients, often “baby boomers” in middle age, are asking for the benefits of universal design. They tell me they want to stay in their homes “for the duration.” They want their homes to be accessible for friends and parents who may use wheelchairs or walkers. They understand that big changes can occur at any time of life.

There is no time like the present to plan for the future.

Related article: Universal Design: What Is It and Why You Should Care. Image courtesy of James Estrin,The New York Times.

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