Age Proofing The Livability of Your Home with Deb Messecar

By Deborah Messecar
WebMD Live Events Transcript

Learn how to make sure that the home of your dreams doesn't become a nightmare as you get older.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

Mature_Years_Mod   Thanks for joining us for the Health In Your Mature Years Program. Today's guest speaker is Deb Messecar from OHSU. She will be discussing Age Proofing the Livability of your home as your needs change.  Welcome Ms. Messecar and thank you for joining us today. Would you like to begin by explaining the importance of "Age Proofing the Livability of Your Home".

Speaker_Messecar  I'd love to start talking about this. Let me give you all a little background of how I got interested in this topic in the first place for many years, before becoming a professor of nursing, I was a visiting nurse so I have probably visited easily over 1,000 homes, making visits to older persons who were receiving home health care.  One of the physical therapists that I really enjoyed working with told me one day how sad it made her to meet people who had worked hard all of their lives to build or buy a their dream home when they were in the 40s or 50s. Only to find when they got older that the home they loved was becoming impossible to live in.  As a result many of them were facing having to give up their home to move to a place where they could function independently.  Now usually this severe kind of conundrum was due to a pretty severe immobility problem.  However, even in my own home today, I know that there are many small and inexpensive changes I should be making to make many tasks easier and to improve my quality of life now and in the future.

Well you might say, I get around just fine and I love my home just the way it is, what are you talking about.  Let me share a little information about some of the normal changes of aging and as I do that, I want to talk about strategies you can use to make your home more supportive of your functioning.  Lets start with vision changes.  That?s probably one of the biggest changes we notice as soon as we turn 40.  As we get older a number of things happen with our eyes.  First the lens becomes less transparent and thickens and this results in needing a lot more light to see than when you were 18.  Some of you may have already noticed that in the elimination at your doorstep, you cant find your keys in your purse.  This is due to this requiring more light to see.  In fact we know that a 60 year older person needs three times the amount of light that a 20 year old needs to see the same thing.  That?s quite a difference and unfortunately many of our building codes do not take this factor into account.  So houses are wired to accommodate actually very low levels of light.  The negative consequence of this has been the dramatic increase in the sale of halogen torches.  These halogen torches are actually quite dangerous because they generate a lot of heat in addition to the strong light they project and they are easily knocked over and can cause an intense fire.

 So the best way to solve your illumination problems is to do the following, first, make sure you have adequate task lighting.  Task lighting is lighting that you can direct by moving it closer to your work.  In some instances these task lights are mounted on a moving are and even include a magnifying glass.  Just increasing the wattage of your overhead bulbs is a bad idea, first, because it creates more glare, which older eyes are more sensitive too and second because if the wattage is higher than what the fixture allows it can start a fire.  There are also some new lights that actually use fluorescent bulbs but look like regular lamps.  These lights put out a lot more candle power, while using very little energy. 

 The next normal vision change I want to talk about is sensitivity to glare.  If you are over 40 you may have already noticed that when it is particularly sunny outside or light is reflecting off of snow or a white sidewalk that your eyes hurt.  This is sensitivity to glare and the eye only becomes more sensitive to this as we age.  Glare can come from reflections off of indoor surfaces.  As a young person, you don?t notice indoor glare because it doesn?t make your eyes hurt, but as you get older, light reflecting off of heavily polished floors or off of walls painted with glossy paint can create a glare situation that tires your eyes and contributes to task difficulties while preparing food, sewing, etc..  In fact my aunt once said that going into my mothers home was like going to a tanning booth.  She had tried to compensate for her vision loss by putting very high watt bulbs in her fixtures and had painted her walls with high gloss white paint.  Outdoor areas should be provided with sun screens such as gazebos, wood trellis and fences.  Also, wall mounted valance or cove lighting that conceals the source of light and then spreads it indirectly upon the ceiling and down the floor is recommended to reduce glare, and it also happens to be very pretty.

Well now lets talk a little about hearing.  One of the other things that happens to us as we age, is we develop a condition known as presbycusis.  This results in a hearing loss of high frequency sounds.  You may notice that another difficulty is background noise.  Some people find it increasingly more difficult to hear if there is a lot of background noise.  I remember reading an interview of Mark Hatfield the former senator from Oregon, who said that he avoided certain restaurants because they had a lot of background noise and consequently he was not able to understand at all what his dinner companions were saying.  So in the home, appliances that don?t make a lot of noise make sense.  Another thing that can get problematic in the home is setting the volume of the TV or radio.  What you will find is that hearing is aided if the bass is turned up and the treble is turned down.  Also, there are ear phones that are available that can help someone with this kind of hearing loss be able to enjoy TV or radio without blasting everyone else out of the house.

We have kind of covered two of the big sensory changes that happen with normal aging.  Now lets move on to mobility or ambulation.  We all change the way we walk and hold our balance as we get older.  The step of an older person is shorter, higher, and wider based with more time spent in support before the next move is made. This has several implications for stair climbing, rushing to get up to answer the phone and getting up and out of bed chairs etc.  This wider gait means we are a bit more unstable plus, if we do catch our foot we are less able to regain balance.  

So what does this have to do with your house? Entrances and exit areas that were fine when we were younger can now become pretty hazardous.  Stair heights of 7 inches which are fine when we were younger now represent a hidden hazard.  Especially when we get in a hurry or get distracted suddenly.  Having a hand rail becomes a lot more important and having a rail that is built at the proper height and extends far enough and is secured properly becomes more important.  Lighting on stairs is also very important.  This is an example of how one change of aging can interact with another to produce an increased likelihood of falling and falling as we get older is very serious business.  In fact, the most frequent cause of deaths in the home is falling.  So as you see, another thing to be thinking about is what are homes entrances and exits like even if you?re not old, you don?t want someone else to fall coming in or out of your house. 

Once you get inside the home, the surfaces used to cover the floor can have a big impact on how easy it is for you to get around.  I once had a patient with severe arthritis who's daughter brought her to live in the house next to hers.  Her daughter had all of the floors made level with one another and had them covered in a hard wood flooring so that the floor was smooth and even the mother with the arthritis was amazed at how much less pain she had walking in that modified house.  In her previous home, she had thick luxurious carpeting that while pretty to look at created a lot of drag when she tried to walk on it.  Particularly because she had trouble bringing her feet up for each step.  So a smooth flooring surface has benefits not just for wheelchair users, but also for anyone else who has trouble walking. 

 Now it is not a normal change of aging to need a wheelchair or a walker but even people who are relatively free of chronic disease can sprain their ankles or require bunion surgery and find themselves suddenly needing to use assistive devices like canes, and crutches and wheelchairs to get around.  To find out how user friendly your house is just imagine yourself trying to do a normal days activity in a wheelchair, when you do suddenly you will realize that your halls are too narrow that you have many different levels in your home that you maybe cant even get into the bathroom and making a meal is impossible.  Suddenly you now have what is known as an accessibility problem and these can be very tricky to solve.  There are some architects and designers trying to work on these issues.  The thought is if all buildings are made accessible from the beginning when they are first built then we wont have these problems.  This approach is called universal design. By universal design we mean things that work for everyone, young, old, sight impaired, mobility impaired etc.

If your house wasn?t built using the principles of universal design it can be modified using these principles and your house doesn?t need to have an institutional hospital look to be well designed for accessibility.  Several author-designers have published books on this topic that show absolutely beautiful interior designs that can accommodate a whole range of limitations.  In addition to taking the more expensive approach such as remodeling there are many little small changes that can be made that will achieve the same end and still look nice.  For example, it is possible to design a new access to the house that acts as a ramp but doesn?t stand out as one it instead looks like a very pretty added on design feature.  These kind of retro-fited designs have also been used in bathrooms to install showers and tubs that work well and safely.  For someone who has limited mobility there is a center for universal design that is run by the University of North Carolina.  You can visit them at their web site by typing in universal design in your search engine.  Also, if you are interested in getting help to finance one of the more expensive projects the Home Modification Action Project at the UCLA gerontology center has resources to help you find financing.  Well I guess I am getting close on time so that wraps it up.

Mature_Years_Mod Our time is running out is there anything else you would like to cover on the subject before saying good bye?

Mature_Years_Mod Our hour has come to an end. Ms. Messecar.  Thank you so much for being our guest speaker today. We have certainly learned a lot. Please check the event board to see what other topics will be covered in next week's Health In Your Mature Years Program. Thanks you for joining us today. Take care and have a wonderful afternoon.

Speaker_Messecar Thank you and Good bye

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