Your Home, Today and Tomorrow

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AL: What are the main safety issues to consider for people who want to safely remain in their own homes?

Osaki: Falls are the leading killer of elders in Hawaii, so you want to make sure you have non-skid surfaces and no-trip hazards like loose rugs.

After that, look for easy access and use. Entryway accessibility is a big issue here because we don’t have many level lots.

If you only have a few steps to the entrance of your home, you could install a ramp. Beyond that, you’re going to need either a chair or platform lift. Other options include an elevator, a retrofit, or demolishing your existing entryway and starting from scratch, but these options are more complicated and costly.

AL: What about securing a home against crime for an elderly family member?

Osaki: It’s a good idea to make sure the main window of a house—like the one in the living room—is low enough for a seated person to see out of so they know who is coming to their door. If your loved ones live in a condo, you want to make sure there is a second peephole mounted at wheelchair height.

AL: What are some common mistakes people make when retrofitting their homes to age in place?

Osaki: I’ve heard a lot of horror stories from people who went with an unlicensed contractor.  For example, individuals have fallen because the grab bars used to help support them gave way due to improper installation, so be sure to go with someone who is licensed.

You should bring in a designer and contractor from the start. Find out how many remodels for the elderly the designer and contractor have done and ask to see pictures and call former clients. You might also consider bringing a Certified Aging in Place Specialist (CAPS) on board, and make sure you all work together to keep costs in check.

AL: Hawaii has the largest number of multigenerational homes in the nation. How can a family modify an existing home to accommodate an older family member while still ensuring a certain degree of privacy for everyone?

Osaki: Use space strategically. Dedicate a portion of the main level of the house to the elder’s bedroom and full bath. Ideally, that should be as close to the parking area as possible.  Locate the rest of the family to another part of the house, but share a common living and kitchen area. That way, all family members have a place to retreat to as well as a common space where they can enjoy each other’s company.

People think teens will bother older family members. But if you think about it, a lot of older people are hard of hearing and in fact it’s their television that keeps everybody awake at night. There’s no way to completely soundproof the house, but you can put in sound buffers to reduce noise. You also want to be cognizant of where you place rooms so that noise won’t be an issue.

The main thing to remember is that while trying to ensure privacy, you don’t want to isolate an elder from the rest of the family. They want to feel they are part of the family and aren’t a burden, so psychologically, socially, emotionally and physically, you need to make sure you’re not constructing barriers.

AL:  What can family members do to support their loved ones as they go through physical and emotional changes in their home and life?

Osaki: You really need to try to put yourself in someone else’s shoes and be considerate and compassionate. One thing that’s often missing is an understanding of what it’s like to grow old. In our seminars, we ask participants to grab three golf balls or a softball, then put a sock over their hand and attempt to turn a doorknob or open a cabinet. This is a great way to mimic advanced arthritis without the pain.

Other times, we’ll ask people to put on an old pair of sunglasses and smear Vaseline on the outside. That’s what it’s like to have advanced cataracts.

AL: What are some basic design concepts to accommodate those who are wheelchair-bound?

Osaki:  About 40 percent of the homes here in Hawaii are at least 60 years old. That means they were built before durable medical equipment like wheelchairs and walkers became commonplace, so they lack wide doorways and halls. One of the first things to do is to expand these areas so that hallways have 36 inches clear width. Entry and rear doors should have a minimum of 32 inches clear width, though 36 inches is preferable. You also need to make sure level changes in the home are accounted for.

Appliances should have side-swinging doors, not ones that open from top to bottom. Elevate them 12 to 18 inches above ground so they’re at a comfortable height for someone who is seated.

Counters are typically 36 inches off a finished floor, which is too high for someone in a wheelchair to use. Ideally, you should also have one that is 30 inches off a finished floor so that a person seated in a wheelchair can also participate in preparing food. That also works out nicely for toddlers who want to help in the kitchen. And if you have the luxury of having two sinks, it’s nice to put one at a lower height.

Finally, the bathroom is the most dangerous room in the house, so you’ll need comfortable-height toilets. A low- or no-threshold shower, which removes any barriers to entry, allows someone in a wheelchair to roll in.

AL: What can a Certified Aging in Place Specialist do?

Osaki: A specialist can identify problem areas in the home and make suggestions on how to correct them. Originally, the CAPS certification was to train people in the building industry on the essentials of making a home safe to age in place. Today, medical professionals such as physical and occupational therapists are also seeking certification.

AL: Where is the best place to look for a CAPS in Hawaii?

Osaki: Go to the AARP (American Association of Retired Persons) or National Home Builders Association website and do a search for CAPS in Hawaii.

AL: Are there any local organizations to contact for help?

Osaki: Project Dana is a local nonprofit that provides support services for the elderly. They have trained volunteers who will go into your home free of charge to assess its safety in terms of preventing falls.
St. Francis’ Stay Healthy at Home program also offers a home safety assessment.
Our company also offers free seminars, including “Building Your Accessible Multi-Generational Home.” Anyone interested can contact Graham Builders  at bonnie@grahambuilders.com or 593-2808.