ADA Checkup

The Problem: Home Alone

The U.S. population is aging, with 46million adults over 65 and nearly a third of them living alone.

Falls are the biggest hazard forseniors. More than one in four seniors falls each year, often withserious consequences.

Women are most likely to live alone.Nearly half of women 75+ live by themselves.

Older Seniors, andMore of Them

There are not only more seniors, but as people live longer, there are more seniors living well into their 80s and 90s.

Chronic diseases become more common inold age. Sudden illness and accidents are an increasing risk.Weakened muscles and balance problems contribute to falls.

The Americans WithDisabilities Act (ADA)

It sets safe design standards forpublic places, which are incorporated in many local building codes.

• Major provisions cover things like doorways, doorway areas, ramps and doorknobs.

• Bathroom standards cover floor space, faucets, toilet seats, grab bars and showerheads.

• Kitchen standards include sinks and countertops, cabinets, appliances and wheelchair access.

The Solutions: Caregiving &Retrofitting

Caregiving Options

There are many ways to improve safetyfor seniors, including institutional living and making homeimprovements that improve safety for seniors living independently.The costs can vary widely.

Genworth, a major insurer, hasestimated the costs of various types of caregiving:

• In-Home Care: $4,576 monthly for a home health aide.

• Assisted Living Facility: $4,300 per month.

• Nursing Home: $8,821.

In-Home Caregivers are expensiveand, in many areas, hard to find and manage. If round-the-clock careis needed, they can be more expensive than a nursing home. Relying on family members can cause stress, job loss and burnout. Home upgrades may still be needed to provide minimal levels of safety.

Assisted Living is often seen as halfway between a nursing home and living at home. It is usually less expensive than a nursing home although it provides a lower standard of care and is only suitable for seniors who are in relatively good health.

Nursing Homes may be the onlysolution in some cases but most seniors strongly prefer livingindependently in their own homes. Nursing homes are also expensiveand are generally not covered by Medicare.

The best solution is none of the above. It is living independently for as long as one is able. Living healthfully throughout life — with a good diet, exercise and active social life — can help seniors maintain an active, vigorous life well into their later years. One-time home improvements can make independent living safer and affordable.

Making the Home Safer: Retrofittingfor Safety

The cost of making a home safer forseniors is minor when compared to the $8,000 or more a family canspend each month on nursing homes or healthcare aides. A few simplerenovations can make the home much safer for about what one month ina nursing home would cost. These include:

• Stairways. Tack down carpets, install metal handrails on both sides. Consider a stairlift.

• Kitchens. Lower counters and storage bins make life easier and safer.

• Doorways. They should be widened to accommodate walkers and wheelchairs. Thresholds should be lowered.

• Lighting. Seniors’ eyesight is often impaired. Install LED lights. They are brighter, last longer and are more economical.

• Groceries. Grocery delivery and meal services make it easier to eat an adequate diet.

• Mail. Curbside mail delivery may not be safe for seniors. The Postal Service will make special arrangements upon request.

• Bedrooms. Night lights are a must. There should be a clear path to the bathroom — no throwrugs, magazines or other obstacles on the floor.

• Basements. Many experts say basements should be locked and declared off-limits. They are simply too dangerous for older people. The laundry can be moved upstairs.

The Most Dangerous Room: The Bathroom

This is the most challenging room froma safety standpoint. About 235,000 people wind up in the emergencyroom each year from injuries suffered in the bathroom.

About two-thirds of the injuries occurin older people. Most occur during bathing or showering and using the toilet. Most of the injuries involve a slip or a fall.

Obvious Solutions

• Grab Bars. They should be located on both sides of the toilet if possible and in the shower and tub areas.

• Higher Toilets. “Chair height” toilets — 15 to 17 inches high — are safer and more comfortable. Retrofit kits are available for older toilets.

Slippery Showers

Showers are a slip and fall risk foreveryone. It’s easy to slip in a cramped, slippery place. Falls canbe serious because there are so many hard objects nearby — toilets,sinks, tile floors. A few safety improvements include:

• Grab Bars. They’re essential and must be properly installed — anchored in studs, not attached with glue or butterfly bolts.

• Shower Stools. Stools eliminate the need to balance while showering but getting up and down can be tricky. Again, grab bars are a necessity. Non-slip surfaces can also help.

The Walk-In Tub Solution: A SaferBathtub

Grab bars, a bench in the tub, a highertoilet — they may improve safety somewhat. But a more compellingsolution is the walk-in tub. Why is a walk-in tub safer? These are afew of the reasons:

• Lower Step-In. Walk-in tubs typically have a 2½ to 7-inch threshold, compared to 15 inches for most standard tubs.

• Built-In Features. Walk-in tubs typically have built-in safety features including grab bars, a seat or bench, anti-slip floors and anti-scald valves.

• Spa Features. They may also have features like water massage that can soothe aching muscles and help seniors relax.

What It Is

Very simply, a walk-in tub is a highbathtub with a door and a water depth of about 30 inches, instead of12 to 20 inches in a regular tub. The door opens in to prevent waterfrom escaping and the tub fits in a standard-sized space, making foreasy installation.

Most walk-in tubs are the samedimensions as a regular tub — 60 inches in length and 28-32 incheswide.

Standard Features

• Lower Step-In. As previously mentioned, the lower step-over height makes it much easier and safer easier to get in and out.

• Deeper Tub. Standard tubs only hold about a foot of water. Walk-in tubs are deeper, about two and a half feet, making for a more relaxed, spa-like soak. The consumer sits on a built-in bench instead of on the floor, again making it much easier and safer to get out.

• Handheld Showerhead. This makes it easier to wash every part of the body without reaching or straining, and is also good for shampooing the hair.

• Sealed Doors. Water-tight sealed doors — which open in, not out — keep water from spilling out.

Safety Features

• Anti-Scald Valve. Prevents sudden changes in water temperature, which could lead to scalds and falls. Maximum temp should be set at 120 degrees or less.

• In-Line Heater. This is another device that helps keep the temperature stable. Especially good for long, therapeutic soaks.

• Textured Seat. Prevents slipping, making it easier and safer to get in and out.

• Textured Floor. Provides better traction, helping to prevent slips and falls.

• Grab Bars. Standard on most models. An essential safety feature.

Custom Features

• Neck Rest. It’s more relaxing to lean back and rest your head on something.

• Heated Seats. They keep you warm while the tub is filling.

• Rapid-Fill Faucet. Reduces the time needed to fill the tub, to as little as 2 to 5 minutes.

• Rapid-Drain Feature. Reduces the time needed to drain the tub.

• Massage Features. Water jets and air jets can massage tired muscles and make bathtub more relaxing and therapeutic.

• Self-Cleaning System. Why clean the tub yourself? Add a little bleach and soap and let the tub clean itself.

• Built-In Towel Bar. No need reaching for a towel. You can put one at arm’s length.

Ready to Buy

It’s not hard to make the case forwalk-in tubs. Nearly everyone agrees they’re safer and morecomfortable. But are they affordable? At less than $10,000 in mostcases, they’re less expensive than a new car, an elaborate vacationor other expenses we undertake without too much thought.

Remember, a one-time investment in awalk-in tub — with a few other modest upgrades — can make it easierand safer for a senior to continue living independently rather thanspending $8,000 a month or more on nursing homes, in-home health careand other ongoing expenses.

Most seniors are living comfortably inretirement, with fewer than one in ten living in poverty. Many havepaid off their homes and have seen their children grow up and moveaway, leaving them with a reasonable amount of disposable income.

Home improvement projects are verycommon, with 51% of homeowners saying in a recent survey that theyplanned to start a renovation project in the next year.

Most home improvement projects arestarted for one of two reasons:

• Return on Investment. Though an admirable motive, this is not always realistic. Many home improvement projects don’t increase a home’s market value enough to cover their cost.

• Quality of Life. Home is where we spend most of our time, especially if we’re older, so a project that improves safety and comfort is a good use of funds.

Where to Buy

For most consumers, the moststraightforward method is to schedule an in-home consultation withone or more contractors or manufacturers’ representatives. Checkreview sites like ConsumerAffairs to find the most-recommended.

Do-it-yourselfers can order a tubonline or buy one at a superstore like The Home Depot or Lowe’s.But this may require hiring a plumber, carpenter and electrician andcomplying with all local building codes. Be sure to budget for all ofthis.

Warranty coverage varies but most majormanufacturers offer warranties that cover all major components for anextended period, often for life. Some may also offer a service plan,often called an “extended warranty.” Consumers should lookcarefully at these before making a decision. A high-quality itemshould be trouble-free for many years.

Financing: How to Pay

There are several ways to finance abathroom upgrade.

• Pay Cash. Seniors are often reluctant to take on debt and prefer to pay cash, even for major expenses. However, this depletes their cash supply and, in effect, forces them to pay in advance for years of usage. Many financial advisors counsel senior consumers to hold onto their assets and, in effect, pay as they go, through the use of credit.

• “Secured” Loan. These loans are “secured” by collateral, usually the consumer’s house. They amount to a second mortgage. Consumers who hit a temporary rough patch could lose their home. Such loans should be avoided unless there is no alternative, most consumer advisors say.

• “Unsecured” Loan. This is anything from a credit card to a bank or credit union loan. Most seniors with regular income should be able to qualify for a reasonably priced home improvement loan without pledging any personal assets. Be sure to shop around for the best deal. Avoid “payday” loans and other short-term lending.