January 23, 2022

Can home and flooring modifications make it safer to age in place?

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From Flooring Clarity

In the United States, an estimated one in three adults above 65 falls every year. About 25% of these adults sustain moderate to severe injuries that make it challenging to move around or live independently and increase the risk of early death. Many of these falls are caused by flooring issues.

Injuries from falls, especially among seniors, can be prevented by home modifications. This article looks at some home and flooring modifications you can implement to make it safer for seniors to age in place. We will focus on the falling risk statistics and some of the things you can do to reduce this risk in each room used by an older adult. Finally, we look at some resources you can turn to when doing home modifications for seniors.

Quick Statistics About Falls Among Seniors

To help you get an idea of how serious the problem of falls is among seniors, here are some quick statistics and facts to digest:

  • 3 million seniors are treated in emergency departments every year for fall injuries.
  • 300,000 older people will land in the hospital every year because of a hip fracture.
  • Non-fatal fall injuries consume about $50 billion a year in costs, while fatal falls gobble $754 million for the same period.
  • The World Health Organization reports that “Adults older than 65 years of age suffer the greatest number of fatal falls.”
  • The risk of a fall for seniors living in an institution is higher than those aging in place.
  • The number of people who fall and the rate of falls can be reduced through fall prevention measures.
  • According to the World Health Organization, “Factors related to the physical environment are the most common cause of falls in older people, responsible for between 30 to 50% of them.”

Common Risk Factors For Falls 

Common Risk Factors For Falls

To get an idea of the flooring modifications you may need to implement to help a senior age in place, you will need to consider external and internal risk factors.

It’s important to remember that a culmination of risk factors causes a fall. Therefore, any home or flooring modifications should be a result of considering all the risk factors.

In their paper published by the US National Library of Medicine, Tony Rosen, Karin A. Mack, and Rita K. Noonan conclude that “Increasing awareness of the potential hazards associated with rugs and carpets, combined with simple environmental changes may benefit older adults by decreasing the risk for fall injuries.”

Some of the internal and external factors that contribute to falls, identified by the Centers for Disease Control and Prevention (CDC) and the US National Institutes of Health, include:

  • Weakness in the lower body
  • Difficulties with balance and walking
  • Vision problems
  • Foot pain
  • Medication that affects balance
  • Unsafe walking surfaces
  • Broken or uneven steps
  • Clutter and throw rugs that create a tripping hazard  
  • Inappropriate footwear
  • Poor lighting

Most of the hazards above can be eliminated by making home and floor modifications and ensuring that there is adequate lighting for seniors to see their way when moving around clearly. Even for those factors that cannot be eliminated, knowing them ensures that you can take measures to make sure that they do not result in a fall or injury. 

Do Home Modifications Make A Difference?  

Home modifications have been touted as part of the solution for ensuring that seniors can age safely in place, but is there evidence that these modifications lead to safer environments? To get our answer, we looked at studies done in this area.

Reduced Need For Transitioning To An Institution

Brian K. Unwin and others, in their article published by the American Family Physician Journal, cite conclusions showing that “In general, environmental assessment and home modification appear to be most successful in preventing falls in older adults when conducted as part of multidimensional risk assessment (for factors such as medications, vision, environmental hazards, and orthostatic blood pressure) with an individualized action plan.”

Unwin and colleagues note that home modifications can avert or delay seniors’ transition from home to nursing home care or assisted living. They propose that home modifications can allow individuals “to stay within their homes and neighborhoods, and remain engaged in their existing social networks and activities.”       

Reduced Caregiving And Fear Of Falling  

In their study entitled Housing Design and Community Care: How Home Modifications Reduce Care Needs of Older People and People with Disability, Phillippa Carnemolla, and Catherine Bridge focus on how home modifications could lead to a reduced need for caregiving among seniors.

Carnemolla and Bridge cite studies that suggest that while there is no link between home modifications and function, there is evidence indicating â€œa reduction in fear of falling and increases in safety.”

Inexpensive Modifications Make A Difference 

Dr. Michael D Keall and colleagues produced an article published by TheLancet.com entitled Home modifications to reduce injuries from falls in the Home Injury Prevention Intervention (HIPI) study: a cluster-randomised controlled trial. They note that “Despite the considerable injury burden attributable to falls at home among the general population, few effective safety interventions have been identified.”

From their study, Keall and others concluded: “Our findings suggest that low-cost home modifications and repairs can be a means to reduce injury in the general population.” This implies that not having enough money cannot be used as an excuse for failing to make the necessary flooring modifications that will ensure seniors age in place safely and comfortably.

Home Modification Tips For The Elderly 

To determine what needs to be done to ensure that seniors’ living spaces are safe and have no health and safety hazards that may lead to falls and injury, look at each room separately.

Bathroom

Bathroom

If not appropriately modified, the bathroom presents one of the biggest fall hazards. This is because water can make floors and surfaces slippery.

To reduce the risk of slipping and falling in the bathroom, install enough secure grab bars.

Apart from making sure that the bathroom floors are always dry before an older adult uses them, also place non-slippery mates in the room.

Install adequate lighting.

A shower chair can increase stability when an older person is bathing. Install a handheld showerhead so that the senior doesn’t have to move around a lot when bathing.

It may be a good idea to get rid of the bathtub and install a shower stall if possible. This will get rid of the need to step into and out of the tub when bathing.

Kitchen

If seniors are genuinely independent, they should be free to use all rooms in their house, including the kitchen. In this room, ensure that there is adequate lighting. Items used frequently should be easy to access.

Remove throw rugs from the kitchen. You also need to ensure that the floors are cleaned each time the kitchen has been used.

Nonskid floor wax makes kitchen floors less slippery. 

Living Areas 

Living Areas

Seniors will spend a lot of their time in a house’s living areas. Thus, it would be best if you looked around these areas to ensure that:

  • Furniture is not on the way.
  • No extension cords are running across walkways.
  • No newspapers and clutter are on the pathways. 
  • Light switches can be accessed before walking into a room.
  • Area rugs are firmly in place using double-sided tape.
  • All loose parts of broken wooden floorboards are repaired as soon as they are discovered.
  • There are no torn mates or carpets around the house.

One of the best ways to ensure enough living room pathways is to determine the senior’s needs. This may mean that you need to remove some things that are in the room purely for aesthetic reasons if they make the place cluttered.

The Bedroom 

If it’s possible to move the elderly to a bedroom on the ground floor, this may be an ideal thing to do. A ground-floor bedroom will mean that the older person doesn’t need to go up the stairs all the time when they need to get to the bedroom. It’s also essential to make sure that the bedroom is near the things and areas the senior uses every day, like the kitchen, bathroom, coffee machine, or dishwasher.

It is not always possible to move the older person to a bedroom on the ground floor. In that case, you may want to consider a stairlift. This is a mechanical device for lifting people with mobility issues up and down the stairs. To use a stairlift, you will need to install a rail on which the stairlift will travel up and down the stairs.

Rails on the side of the bed will ensure that the senior has something to hold onto when getting into and out of their bed. It also ensures that they don’t roll over and fall from the bed.  

Stairwells and Hallways  

Stairwells and Hallways

While you can decide to live in a single-floor home to reduce the risk of falls associated with stairs, it’s not possible to get rid of the hallways. The National Council on Aging provides some tips on ensuring that your stairways and hallways are free from tripping hazards: 

  • Remove clutter to ensure that things such as books or shoes are not left on the steps.
  • Put strips of bright colors on the top edge of the step facing you so that you can clearly see where the step is.
  • Lighting both the top and bottom of the stairs ensures that you can always see what’s in front of you. Also, place a switch at the top and bottom of the stairs to turn the lights on.
  • If the staircase has a single rail, add a second one, ensuring that the installation is secure and provides adequate support.   

Floor-Specific Modifications 

Floor-Specific Modifications

Because the floor state is a massive contributor to the fall hazard, you need to pay specific attention to it. Also, the seriousness of the injury from a fall will depend on the type of floor you have. A softer carpet or rubber floor would likely result in a less severe injury than a floor paved with stone tiles.

You may need to take a risk assessment to identify uneven floors, those prone to being wet, and old carpets no longer securely held to the floor. Replace these with softer flooring such as rubber.

When looking for the flooring material to modify the home of a senior, consider the following factors:

Slip resistance: When there is too little friction, slips occur. To select a slip-resistant floor material, consider the coefficient of friction (COF). Higher values indicate that a surface is less slippery.    

Comfort: You want to select floor material that is comfortable in different seasons. 

Cushioning: Even when you have done everything you can to prevent a fall, you can’t be 100% guaranteed that a fall will not occur. Ensure that you select material that provides a cushion against a fall, like cork.  

Maintenance: If the older person cleans their own house, ensure that you select easy-to-maintain material. You may go with something like a low-pile carpet because you want to mix cushioning with ease of maintenance. Low-pile carpet has shorter fibers and tighter loops. 

Aesthetics: Just because you are looking for flooring material for the elderly doesn’t mean that it should have no aesthetic appeal.      

Home Modification Resources For Seniors 

Attempting to do home modifications on your own may be difficult for most people. The great news is that several organizations provide resources for home modifications. Here are some of them:

National Association of Area Agencies on Aging: An organization whose “primary mission is to build the capacity of [its] members so they can help older adults and people with disabilities live with dignity and choices in their homes and communities for as long as possible.”

The National Association of Home Builders: Is a network of contractors “which develops, tests and evaluates new materials, methods, standards, and equipment to improve the technology and the affordability of America’s housing.” This is the organization you should be talking to if you want to ensure that the company or individuals doing your home or flooring modifications know what they are doing.

The National Association of the Remodeling Industry: Is an association of home remodeling professionals. It promises to provide “tips and tricks so that consumers have a positive remodeling experience with a professional, qualified remodeler.” 

Rebuilding Together: A nonprofit organization with local associates who “help older adults remain safe, healthy and independent in their homes and communities for as long as possible.”

US Department of Agriculture: Gives loans to assist low-income seniors in making their homes safer living spaces through a program known as the Section 504 Home Repair program.

SOURCE: FLOORING CLARITY

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