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Home Modification to Age in Place…Let’s Start that Conversation

Home Modification to Age in Place…Let’s Start that Conversation

Most people do not buy their first home with the idea of living there forever. But increasingly, seniors are not only living longer but are opting to “age in place” – to stay in their homes where they are happier and more comfortable.

Age in place

Most people do not buy their first home with the idea of living there forever. But increasingly, seniors are not only living longer but are opting to “age in place” – to stay in their homes where they are happier and more comfortable.

In this series of videos, we follow the journey of John and Inge – a couple who decided to “age in place”, but with a twist – they moved from a 2 storey 4 bedroom home to a bungalow while in their sixties. They made the modifications ahead of time, so they could be in control of the process, rather than have to consider making the changes on an emergency basis.

Most consumers do not yet recognize Home Modification as an industry. Why? Perhaps it has not been a priority in our society – until now. In an article published in Reuters (May 3, 2017), the following was reported: “The number of seniors in Canada exceeded the number of children for the first time last year, Statistics Canada said on Wednesday, pointing to the economic and social challenges facing the nation as the population ages.”

We must all start that conversation – NOW. We all must look into the future – our collective futures – and start to understand the needs of the consumer not only in the Home Health Sector, but in the Home Renovation and Home Modification sector as well.

When we tell governments, home builders and home renovators, consumer product industries, and our healthcare system what we want and what we need, we can all look forward to the possibility of ageing well, and ageing in place.

Video Series Age in Place – Episodes 1 through 4

Episode 1 of 4

Episode 2 of 4

Episode 3 of 4

Episode 4 of 4

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Happy Holidays – Is your house visitable?

Happy Holidays – Is your house visitable?

At the recent National Institute of Aging conference held in Toronto, I was a speaker representing OSOT and the Home Modifications Canada Steering Group. The afternoon session was lead by a presentation by Jamie Shipley, a knowledge transfer consultant with the Canada Mortgage and Housing Corporation. He and I have done presentations together before about accessibility for seniors wishing to Age in Place.

Lesya Dyk

At the recent National Institute of Aging conference held in Toronto, I was a speaker representing OSOT and the Home Modifications Canada Steering Group. The afternoon session was lead by a presentation by Jamie Shipley, a knowledge transfer consultant with the Canada Mortgage and Housing Corporation. He and I have done presentations together before about accessibility for seniors wishing to Age in Place.

He asked that the members in the audience raise their hand if they were a “caregiver”. A few members of the audience raised their hands….

Then he asked how many of the audience help their family members (change in definition), and a significantly larger number of hands were raised.

Then, he asked that all the people who had their hands up, to keep their hands up, if those family members who needed care, were coming to their house over the holidays… and most of the hands went down…

The truth is, that most of us live in homes that are not “visitable” – what is visitable?

Visitable is now a term that encompasses adaptability, accessibility and inclusivity – it means that a home can be visited by almost anyone with no major impediments to access into the home or to the bathroom. Accessible is a concept that we as OT’s are more familiar with, but the drawback to this concept is that the issue is that it denotes that disability must exist. But age is not a disability – it is a normal life stage, and we in Canada are at the brink of a crisis….

According to statistics provided by the CMHC, by 2038, 24% of all Canadians will be seniors 65+, and 35% will be 55+. And to bring it back to today – a full third of Canadians now over 65 have some form of disability.

With all of us marching into this ageing cohort – where will we all live? There are no more Long Term Facilities that the province is building, and homes, townhomes and condominiums are being built all over without thought or incentive to making them spaces where we can easily and safely age…..

Many designers, architects, and contractors are now promoting “Inclusive or Universal Design Principles”. These include:

  • Equality
  • Flexibility
  • Simple and Intuitive
  • Easily perceived
  • Tolerance for error
  • Minimal effort
  • Size and space considerations for function

And where do we fit in? Well, Universal Design is not universal, and an OT has the knowledge skills and training to help a person function in their environments. The other issue, is that OT’s have their eye on function – and the client, and the future… This unique perspective is now being understood and valued.

To focus the lens just a bit more – Fall Prevention has been identified as the most important issue that we face and will be facing in healthcare when it comes to our ageing population. ( Tilak Dutta, PEng, Toronto Rehab)

According to Centre for Disease Control published study:

  • In 2012–2013, 55% of all unintentional injury deaths among adults aged 65 and over were due to falls.
  • From 2000 through 2013, the age-adjusted fall injury death rate among adults aged 65 and over nearly doubled from 29.6 per 100,000 to 56.7 per 100,000.
  • Falls cause more accidental deaths than all other causes COMBINED.
  • Over 3/4 of all falls occur in or near the home

And then, when we think about Dementia…

  • Dementia – mostly associated with confusion, reduced short term memory, reduced ability for new learning and later, motor coordination and visual perception difficulties
  • Alzheimer’s Dementia is most common seen in the elderly population
  • 20% over 80 years old have some form of dementia
  • Persons with Dementia who fall have 3 times the risk of death within one year than their counterparts without dementia

In order to prevent falls, the risks and risk factors need to be understood. As OT’s we can assess this, and provide a solution to meet the challenge. If it is low vision – then contrasting colours should be used. If it is reduced strength, then exercise may be indicated. If the issue is balance – is the underlying cause cardiac or neurological, or a change in medication? And what transfers are affected – how do we keep our clients from falls?

Best Practice…

Based on recommendations from the American Geriatric Society and British Geriatric Society (2010) updated in 2016 in: “Clinical practice Guideline: Prevention of Falls in Older Persons’, the summary of recommendations include:

“a home environment assessment carried out by a health care professional should be included in a multifactorial assessment and intervention for older persons who have fallen or who have risk factors for falling”

Although it does not specify Occupational Therapy, it is clear that this work is in our realm. We have the ability to assess the person, their environment, and their occupation, and make recommendations that make sense for our clients now, and in the future.

As we approach the Holiday Season, we the Board who serve OSOT on your behalf wish you all a safe, and happy holiday season, and a prosperous and healthy 2017.

As you begin to gather up your family and friends, start thinking of your own homes, your own spaces….your future selves and your own careers. This my colleagues, is where all our futures lie.

Home is where people want to age , they are happier and it is cheaper….

Prof. Barry Trentham,
O.T. Reg. (Ont) UofT

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Ageing in place? – Think Ahead…..

Ageing in place? – Think Ahead…..


If you are in the position to purchase or modify your “forever home”, you may want to give some thought to how your home will accommodate you as you age. Ageing in place is something that you may be able to do relatively easily, if you take aging in place into consideration when you purchase or renovate your home. These are a few things that you should consider…

Access, Access, Access

How easily can you access the home? If you do not have a level walkway and front entrance, is there enough room to have a lift or ramping installed (ramping requires 12 feet of run for every one foot of rise), or is there easy access through the garage, where you are protected from the elements? Did you know, if you build a walkway at 1:21 it no longer is a ramp, and you can landscape it to beautify your curb appeal?

Can you access the main floor? Is it open and without those pesky changes in level (think split level townhouses, or even those pesky 1960’s sunken living rooms) You will need this if you have any mobility issues and need to use a walker or wheelchair.

And speaking of walkers and wheelchairs, are the hallways and doorways wide enough to accommodate you and your mobility aid around a corner? If you have a narrow door to the bathroom, and you are renovating it, budgeting for door widening is a must!

And the last thing about access – is there a bathroom on the first floor that has or is big enough to accommodate a three piece bath suite? Not having the ability to accommodate a bathroom is the number one reason people with mobility issues move residence.

While you’re at it…

Already mentioned was widening the doorway to the bathroom. While you’re at it, widen the door to your bedroom, or any room in which you have an expectation of privacy.

And if you are renovating the bathroom, consider installing a rite height toilet – it saves scrubbing a raised toilet seat. Grab bars are no longer a sign of disability. They can be a design statement. Several bathroom fixture manufacturers have designed soap holders and towel racks to double as grab bars. Lastly, those fancy bathtubs are great to soak in, but treacherous to get in and out of safely if your balance or strength is compromised. Think ahead – and think of your lifestyle – do I prefer bathing or showering? Barrier free showers and walk-in baths may be something that you adopt now, rather than in the future.

Managing the elements

We have mentioned the garage, but this is such a under utilized space. With some careful planning, you can avoid using the garage as the main storage space for your home, and have your accessibility to your home sorted out. It protects you from the elements when getting into your home, but also in and out of your car. A shorter driveway will lessen the need of contracting snow removal services as you age. Also, if you have your ramping or lift in the garage, you do not change the curb appeal of your home, nor do you advertise that a vulnerable individual may live there.

If you have any questions about Ageing in Place – contact us at info@LDOT.ca

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