Universal Design: Helping Older Adults Maintain Their Independence

Functional and Attractive

Unobtrusive, attractive, and practical, universal design creates environments with minimal hazards that people of all ages and abilities will find useful. Many elements decrease the need for bending, lifting, or reaching, but the term also applies to consumer products designed for simplicity and convenience.

"Universal design has to be invisible and blend with the existing design of the home," says Dick Duncan, director of the Center for Universal Design at North Carolina State University. "It must have a normal and natural appearance, be every bit as effective, and be easier to use. The design features don't call attention to themselves but make a huge difference in people's lives."

Age and Independence

Advancing age and conditions such as arthritis can make getting around, opening doors, and stepping into the tub more difficult. Not surprisingly, a study conducted for the American Association of Retired Persons (AARP) found that 82% of middle-age or older adults surveyed wanted to continue living in their own homes for as long as possible. Even the 23% who anticipated that they or someone they lived with would face mobility problems within the next five years, hoped to live in their own home.

Quick Fixes

Inexpensive and easily implemented modifications and assistive devices can dramatically improve an older person's well-being. William C. Mann, OTR, PhD, chairman of the University of Florida's Occupational Therapy Department, found in a controlled trial that frail older adults who used assistive devices experienced less functional decline and pain and needed less health care assistance than did similar functioning elders without devices.

By "giving people what they needed, they remained more independent," Mann says. "The devices were not really expensive high-tech devices. They assisted with bathing, grooming, dressing, mobility."

The experts recommend several relatively minor things people can do in an effort to stay independent:

• Use a reacher to pick up items on the floor
• Install a bedrail on a regular bed or instead use an electric bed
• Use a shower chair with rubber feet
• Add grab rails in the bathroom
• Add a second handrail to the staircase, a light switch at both the bottom and the top of the stairs, and nonslip strips
• Place a wire rack in the sink to ease bending
• Mount a jar opener under a wall cabinet
• Use lightweight cookware, nonslip bowls, and thicker, padded-handle utensils and molded glassware to make eating and drinking easier
• Use a tab grabber to open soft-drink cans (this is especially helpful for people with arthritis)

"There's something like 24 or 25,000 different assistive devices available," Mann says. "Find things that will make life easier and safer, and it will make a difference. The more people use these tools, the more active they are going to be. And they will be healthier as a result."

Home Modifications

Some universal concepts, such as step-less entries and wider halls and doorways, entail more effort and are sometimes only possible during the building of a new home or the remodeling of an existing one.

When architect Bill Devereaux designed the National Association of Home Builders' Lifestages ‘99 house, he included skylights to brighten the entryway and halls, added three different levels of countertops to accommodate those who prefer standing and sitting, raised the dishwasher, and contrasted countertop trim and surface colors. He also adjusted the height of rocker-style light switches and electrical outlets and installed a kitchen sink that moved up and down.

"I tried to keep in mind that not everybody ends up in a wheelchair, but they end up, usually, with some diminishing skills," says Devereaux. "Many things, like contrasting the color of the walls from the color of the floors, are subtle things that don't cost much to do."

Renovation Ideas

Duncan says the best time to introduce universal features to an existing home is when people are renovating for another reason. People in this situation might consider the following suggestions:

• Install a tub with front-mounted faucets, wider and softer edges, or a built-in door
• Substitute a shower with a built-in or fold-down seat, a hand-held water control, and an infrared soap dispenser
• Install kitchen vanities or adjustable-height vanities in the bathroom to decrease bending
• Add carousel and pull-out shelves to lower kitchen cabinets, and pull-down shelves to wall cupboards
• Put in granite or another heat-resistant countertop near cooking areas, so a person can quickly put down hot items (granite tiles are more affordable than a custom-cut piece)
• Leave an 18-inch "landing area" next to each appliance and make countertop corners rounded
• Replace cabinet knobs with loop-style hardware
• Purchase appliances with universal design, such as a side-hinged, wall-mounted oven, a ceramic flat-surface (easy slide) cooktop with front or side controls, and a side-by-side refrigerator
• Raise the washer and dryer
• Remove interior doors to provide clearer openings
• Replace dead bolts that have small twist knobs with slide bolts

The experts say that little things count, too. For example, reorganize cupboards to store frequently accessed items between waist and shoulder height, and switch to lever-style handles and faucets to aid in opening doors and turning on water.

Putting It All Together

"A lot we did with color, lighting and flooring products, along with grab bars. Minor changes have a major impact on the quality of life, " says Bakker, a certified interior designer, gerontologist and research associate in Gerontologic Design at the Weill Medical College of Cornell University. "I used the color-contrasting theory to separate the foreground from the background. Some of the chairs I did in a lighter or darker color, depending on the color of the flooring."

Bakker has drawn on her experience with her mother to help others make changes and has written the book Elderdesign: Designing and Furnishing a Home for Your Later Years . Bakker also recommends installing richly hued grab bars and changing light-switch wall plates to a color contrasting the wall but complementing the room's decor.

Assistive devices and home modifications help people to age gracefully and with dignity, because they enable them to do more for themselves. By incorporating universal design when planning renovations or building new homes, older adults can enjoy the best of all worlds: convenience, aesthetics, and peace of mind.