Caregiver Comforts: Taking Shape of Change By Rebecca Stahr, ASID, CAPS and Teresa Nunn, M.S, National Association of Home Builders Remodelors™ Council, Washington, DC
Thirty-two-year-old Heather Nunn prepares to move into her new house. The ranch-style home in Athens, GA, sits on a lovely wooded lot and comes complete with a picket fence. Other amenities include attractive wide doors, a spacious open floor plan and a large curbless shower.
Heather suffered a traumatic brain injury in 1987 and must use a wheelchair. These home amenities are just a few of the modifications made to the property to make it as safe and comfortable as possible for both Heather and her caregiver. Other modifications include grab bars in the bathroom, a large roll-in bathing area complete with an adjustable height shower head and a fold-down seat, a closet with a wide entrance and shelves and racks adjusted to Heather’s personal requirements. These features will be just as important to her caregiver as they are to Heather.
Heather’s parents, who have provided care for her for the last 17 years, want to ensure that the environment will support her caregiver as much as it accommodates Heather. Their first-hand experiences have exposed them to the daily stresses, minor inconveniences and major hazards, including falls and body strains, associated with caring for a disabled person.
A recent National Long Term Care Survey estimates that 7 million informal caregivers support people in their homes. Three-quarters of these caregivers are over 70 years old. Informal caregivers include unpaid spouses, parents and friends whose time, energy, health and well being often come in short supply. Many do not understand the benefits of home adaptations. Others do not feel they have the time or money to make formal housing modification and “make do” with homemade items that fill an immediate need.
Lifting, transferring and bathing disabled people pose the most dangerous situations for a caregiver. Strained muscles and falls happen most often in bathroom where wet floors and tight quarters require difficult maneuvering. Grab bars become as essential for the caregiver as for the assisted in this area. The disabled person can often assist the caregiver in these difficult movements by using the grab bars while, many times, the caregiver uses the grab bar to steady themselves while facilitating transfers and lifting actions.
Showers or baths with easy entry and integrated seating help both the caregiver and the recipient. Adjustable height and hand-held showerheads enable many disabled people to bathe themselves. Non-slip flooring surfaces impart a greater sense of security underfoot when a fall often takes its toll on the caregiver as well as the disabled one.
Wider doorways allow for two to enter, often moving abreast rather than following one another. “Rocker-style” light switches, located lower on the wall, lets the caregiver operate the switch with an elbow or forearm rather than a hand when their hands are full. Lever door handles also allow for less precise movements when caregivers are otherwise encumbered. Handrails on both sides of steps aid an ambulatory person.
Winston Churchill was wise when he said, “First we shape our homes and then they shape us.” But, shouldn’t a home adapt to the person rather than the person adapt to the home? Ask any caregiver or person with a disability who has been forced to answer this question.
Based on U.S. Census statistics from late 1994, 20.6 percent (about 54 million) of the population at that time had some level of disability. Nearly 10 percent of the same group had a severe disability.
When people think of disabilities they envision a person using a walker or wheelchair, and relegate it to the older population. However, statistics show that a number of young people live with disabilities. For example, in the age group from birth to age 21, 32 percent of people have disabilities ranging from sensory deficiencies to requiring the care of another person for one or more activities of daily living, according to the Census statistics.
Although the likelihood of disability increases with age, an accident or acquired illness can change a life at any time. Universal design is the design of products and environments that allow people of all ages and abilities to live somewhat independently. If homes incorporated universal design principles in the building process the environmental support delivered would not only be an asset to caregivers and the person with the disability, but to every visitor, at any age, at any time. Having a home with improved bathroom access and use, more convenient reach ranges, more appropriately placed appliances, cabinetry and utilities, as well as a myriad of other features, increases the convenience, comfort and control to individuals.
The cost of home modifications for Heather’s home came to about $10,000 for materials and labor and included the major modifications of removing and replacing a standard bathtub-shower with a pre-fabricated roll-in shower unit, replacement of the bathroom sink in favor of one that has easier access from a wheel-chair, new flooring in the bath and widening one arched entrance and three doorways in the structure. Other modifications, included in this cost were lowering and replacing six wall switches with rocker style controls, installing adjustable rods and shelves in two closets and replacing all door handles with lever controlled models. In some cases, these medically necessary modifications (such as wider doorways or a roll-in shower) can be deductible on your taxes, if backed up by a letter from your doctor.
These modifications were accomplished with the guidance of a National Association of Home Builders Certified Graduate Remodelor (CGR) who holds the NAHB’s Certified Aging-in-Place Specialist (CAPS) designation. Trained in both remodeling good practices and the ability to assess the needs of an individual and recommend solutions and products, these professionals should be your first source when anticipating home modifications.
Heather says when you’re in Athens, “come and visit.” Her wide doors are open to everyone. Heather joins a number of Americans who want to live in a safer, convenient and comfortable place, at 32 and all ages.
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