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Excerpts from
Preventing the Fall:
Designs on Building Safe Homes for the Elderly
by Gina Rollins

Solutions ... can be as simple as repainting walls to create more contrast with floor surfaces or as complex as adding first-floor additions for those who can no longer negotiate stairways.

There are no hard-and-fast guides. The structure of a person's home, their disability, physical traits and even the way they use a space all determine the most workable solution, according to Bill Lusby, owner of Adaptive Access, a remodeling company located in Katy, TX.

Universal design concepts, which seek to make products and environments usable by as many people as possible, can be difficult to retrofit in older homes.

Be careful not to over-simplify or make inappropriate modifications. A common error, for example, is installing grab-bars without proper structural support.

Fall Prevention Home Modifications

General Areas

  • Create color contrasts between walls and floors; lighter-colored floor surfaces are preferable.
  • Minimize changes in walking surfaces, and use slip-resistant coverings such as rough tile and carpet with short, dense pile.
  • Increase lighting and reduce the contrasts in lighted areas.
  • Install wall-mounted light fixtures, accessible while standing on the floor, that use two bulbs.
  • Install more outlets to minimize the use of extension cords.
  • Relocate switches so that the homeowner doesn't have to walk through darkened areas.
  • Modify small changes in levels, especially single steps.

Stairways

  • Install handrails on both sides of the stairs and extend them one foot beyond the last step at both top and bottom; position top of the railing at elbow height of the homeowner.
  • Use handrails that allow the homeowner to use a "powergrip," i.e., encircle their thumb and fingers around it, and allow hand clearance between the handrail and the wall.
  • Mark the nose of each tread with a contrasting color; paint is a good marking agent.
  • Use a different color contrast to mark the first and last step.
  • Limit stair rise to seven inches; make tread at least 11 inches.
  • Use incline risers with 15-degree angles.
  • Remove thick (3/8 inch or thicker) carpets and underpads on treads.

Bathroom

  • Securely install grab-bars* in tub/shower and near toilet at height and angle best suited for homeowner's needs; tubs/showers typically require two bars positioned for support when entering and exiting, respectively.
  • Install slip-resistant tile.
  • Increase door width to 30 inches for homeowners with wheelchairs or walkers.
    *New products now on the market are designed to overcome the one-inch gap that typically exists between fiberglass shower enclosures and walls.

(The full article originally appeared in the September 2000 issue of Safety & Health magazine.)



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November 15, 2001

Copyright 1999, 2000, 2001 * All Rights Reserved

 "(The issue is) multi-factorial and often involves balance problems, medications, osteoarthritis and the environment. Falls on stairs and in bathrooms are the most common, but people fall in different ways and places. We used to oversimplify and say that if you fixed one element, you fixed falls, but it's multi-dimensional."

- Jon Pynoos, Ph.D.


"The elderly need two-to-three times the light people need in their 20s and 30s, and they also lose spatial perception, so if you have a blue baseboard against a blue chair, it makes the wall appear further away than it is."

- Mark Warner, architect, gerontologist


"We don't like to see slick surfaces like glossy tile or hardwood floors with high-gloss polyurethane coating. Even shag carpeting can be a hindrance to those with assistive devices like walkers."

- Dale Ritzel, Ph.D.


"The ADA (Americans with Disabilities Act standards) says grab-bars should be parallel to the floor and 32 inches from the floor, and many use that as a standard [in residences], but it makes little sense. Does that equally serve a woman who is 4-foot-11, or a man who is 6-foot-2, or a person who is paralyzed on the left side because of a stroke?"

- Bill Lusby