Changing Bodies Beg for Changing Homes
On a recent visit to Ashland for an infusion of drama at the Oregon Shakespeare Festival, we settled into an historic cottage within walking distance of theaters and restaurants.
A traditional two-story bungalow, the house had transitioned from family home to vacation rental when a previous owner moved into a senior living facility. Updating included installation of a high-tech steam-sauna-shower-tub unit in the downstairs master bathroom.
A Plexiglas case wrapped around a dizzying array of buttons, showerheads, Jacuzzi jets and audio jacks to create a cocoon of indulgent bathing options. But getting into that cocoon posed challenges. Bathers must clear a tub ledge 22 inches high, through an opening just 20½ inches wide, between a pair of sliding doors.
I might have shrugged and categorized the unit as a somewhat misguided attempt at modernization of a vintage home had I not gone to Ashland fresh on the heels of a conversation with Ginny Saunders, Certified Aging in Place Specialist. Now I saw the tub as an ill-advised investment in a rental unit available to guests of diverse ages and physical abilities.
Saunders, former owner of The Hand Therapy Clinic in Eugene, spent 22 years making life easier for people with hand, wrist or arm limitations. Sometimes the challenges were short-term, the result of a break or sprain. Sometimes they were chronic, the product of accidents, disease or degeneration.
“I loved the work,” she says. “I loved the creativity. What occupational therapists do is we adapt environments so people can go home and live with one arm if that’s what they have now. Can you brush your teeth? Can you fix a meal? Occupational therapists want to know what you need to live. It’s about finding something adaptive that will help them do the tasks in the safest possible way.”
But even a rewarding business delivers challenges that can wear a person out. At age 58, Saunders retired to give herself more time for travel, gardening and tending the alpacas at her Creswell farm. Eight years later, economic realities and renewed energies pulled her out of retirement and back into business. Perhaps it’s not surprising that skills gained in two decades of occupational therapy guided her transition into an encore career that helps adults live comfortably at home amid limits that come with age.
“I relish free time but I found that too much of it is too much,” says Saunders, now 68. “I like to get outside of myself at times and I know how good I feel when I am in service.”
After training as a Certified Living in Place specialist, she founded LiveAble, a consulting service focused on people whose strength, flexibility or balance has been diminished not by injury but by years. It is work that responds to a growing need in an aging population.
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`”The fastest growing age group in the United States is 85 and up,” Saunders says. “Of those people, 85 and over, almost all have lost some level of function and need some assistance in daily living.”
Most of those people, it seems, want to stay in their own homes. The American Association of Retired Persons (AARP) reports that nearly 90 percent of seniors hope to age in their homes. Even when they begin to encounter difficulties with daily tasks, 82 percent choose their home over a move.
I’m in the minority on this one. I’m already mulling the attractions of downsizing. Still, it seemed that my own house was the place to start in understanding what would be required to make a private residence truly age-friendly.
Where would I begin, I asked, if I wanted to create a comfortable, safe and satisfying living space should I decide to stay put for 20 more years? Start with the bathroom, Saunders advised. It’s the place to begin in any house. It’s where the most in-home accidents occur. She measured doorways and hall widths and toilet seat heights when she came for a preliminary visit. She eyed the bathtub skeptically and offered a few observations.
At 28” wide, the doorway into the bathroom is too narrow for a walker or wheel chair, she advised. It could be expanded by removing the door since the bath is attached to the bedroom. But still, there’d not be space for a wheelchair to turn and approach the toilet. But there’s a solution, she assured me. Because the small bath holds a separate shower, the tub could be removed to provide more floor space. A toilet with a higher seat--at least 17 inches from floor to top of porcelain bowl—would add ease and comfort.
Of course, we’d want grab bars on two walls of the shower, and a sliding shower fixture that could be used standing or sitting on a stool. The grab bars and showerhead, she stressed, are modifications to make now. Why wait for a fall, or a close call? But typically, people resist those preventative changes.
Start in the Bathroom to Curb Home Injury Risks
“People say, I’ve never had a problem with that, so I don’t need to be concerned yet,” she says. “We never think we will have a problem but statistics say otherwise. I try to say, think pro-actively.” Saunders’ warnings returned to me as I climbed into that Plexiglas shell in Ashland.
“If you are holding on to any part of a sliding shower frame or door, that is dangerous,” she had cautioned. “It’s risky. Those doors are not made to support body weight.”
More questions emerged as I considered her 17-inch recommendation for toilet height. That puts the rim almost three inches higher than the toilet now in my bathroom. In the kitchen, I measured the seat height of our old-fashioned wooden chairs. They came in right at 17 inches. Padded dining chairs were just slightly higher. So how come a “standard” toilet seat is two or three inches lower than a “standard” chair?
That’s when I called Dotty Powers, showroom manager at Keller Kitchen and Bath Showcase in Eugene. Good question, she agreed. But things are changing fast. The “standard” toilet is no longer the standard that most clients use when remodeling or building.
Of more than a dozen toilets currently on display in the Keller showroom, only one is now the traditional 15-inch height, Powers says. The rest sit at least two inches higher in a design deemed “comfort” height in the plumbing industry. They represent a significant evolution in bathroom fixtures, influenced by a burgeoning construction category called “universal design” for homes, buildings and fixtures that offer comfort and safety for users of varied ages and abilities.
“I have been in this business more than 30 years and the thing that is exciting to me now is manufacturers are coming out with designs that are very pleasing without looking institutional when people remodel or build,” says Powers.
I met Powers 15 years ago when selecting plumbing fixtures for a new home. I don’t’ remember any talk about “comfort” heights or grab bars back then.
“It’s a conversation we have every single day now,” she says. In past years, suggestions of universal design or “comfort” products were apt to provoke a disgruntled “Do I look that old to you?” from shoppers, she says. Now, attitudes and products are getting an update.
“We have all these baby boomers coming in, doing remodels or creating space for a parent to live with them,” she says. “They are so open to this. And more products are coming out that keep a house stylish, looking good. It’s definitely a trend.”
Do an Internet search for “universal design” at www.aarp.org and you’ll turn up checklists and guidelines for creating accessible spaces in existing or new buildings.
But aging in place with health and comfort is more than picking up the scatter rugs or installing grab bars and entry ramps, stresses occupational therapist Saunders. Her work often reveals the health risks that seniors encounter when physical limits reduce life at home to life in a recliner chair.
When it’s difficult to get up for bathroom trips in the night, people often stop drinking water, she says. Dehydration can lead to urinary infections and to mental confusion that may be mislabeled dementia. Muscle strength wanes until it’s hard to stand long enough to brush teeth, shower, or make breakfast.
“As a baby boomer myself, I know that most of us want to age at home,” she says. “But now that I have seen this, I realize there are lots of things to consider. How can we be more creative in solving challenges? How do we continue to live daily with some integrity and autonomy? I like this work because it is interviewing and listening and working with family dynamics. It is quite wonderful.”
Carolyn Kortge of Eugene is a former Register-Guard editor and writer,
and author of The Spirited Walker. Contact her at firstname.lastname@example.org.