Making Home Safer for Seniors: A Room-By-Room Assessment

Marlo Sollitto  

Evaluating a senior’s ability to safely age in place is a complex process. Older adults want to stay in their homes rather than move to assisted living or other adult care communities, however each senior has their own needs and concerns regarding functioning independently at home.

One approach to creating a safer environment for seniors is applying the methods of universal design. Universal design focuses on designing, constructing or adapting buildings, products and environments to make them accessible to all people, regardless of age or disability.

Home Modifications for Aging in Place

General Household Safety Tips

  • Move furniture to clear walking paths.
  • Make light switches accessible by placing them no higher than 48 inches and replacing toggle switches with rocker style
  • Improve overall lighting in the home. Light dark pathways or countertop areas with easy to install rope lighting. Add task lights and night lights wherever needed.
  • Replace doorknobs with levered handles or pulls or add doorknob grips.
  • Mark changes in floor levels with tape or paint in a high-contrast color.
  • Remove loose carpeting and unnecessary throw rugs. Fasten down area rugs with double-sided rug tape.
  • Remove all electric, cable and extension cords that run across or near walkways. If necessary, place electric cords behind furniture.
  • Replace unsteady chairs with chairs that have sturdy arms to make transitioning from sit-to-stand easier.
  • Lock thermostats to control temperature.
  • Remove clutter by donating or disposing of items that are no longer of use.
  • Make sure trash receptacles are easily accessible from inside the home and can be brought to the curb without obstruction.
  • Repurpose a closet or other area on the main living level to make laundry machines accessible. Replace top-loading machines with front-loading appliances that are easier to use. If necessary, laundry can be outsourced to a per pound laundry service or added to the tasks completed by a personal home care aide.
  • Ensure smoke alarms and carbon monoxide detectors are placed in all key areas. Test them and change batteries regularly.

Bathroom Safety Tips for Seniors

  • Install grab bars for additional support while toileting and while getting into and out of the shower/bath.
  • Abundant lighting for the overall space as well as tasks is essential. Special waterproof incandescent lights should be placed in the ceiling of a shower and over a tub for extra visibility.
  • Set the hot water heater to 120 degrees Fahrenheit or lower, clearly label hot and cold faucets and consider installing anti-scald devices on faucets to prevent burns.
  • Showers should have a step-free entry. There are step-in tub models available that feature a door for easy entrance and exit. The shower should be fitted with a seat, a hand-held shower sprayer, and a niche to hold soap and shampoo at a level that can be reached easily.
  • Floors should be slip-resistant wood, vinyl, or tile with a lot of grout for traction. Add non-skid decals to any slippery areas in the bathroom.
  • All cabinets and drawers should be fitted with levers or pulls rather than knobs.
  • A comfort-height toilet model should be selected that is 2 inches higher than normal and easier to transfer onto from a wheelchair. A toilet seat riser can be added to an existing toilet.
  • Lighting modifications along a hallway can provide a clear path to a bathroom in the dead of night when eyesight is failing.
  • Curbless showers with a bench allow someone to roll a wheelchair in and bathe.

Age-Related Macular Degeneration Explained in 30 Seconds

Age-related macular degeneration (AMD) is a leading cause of vision loss in the United States, affecting as many as 11 million Americans. Without proper treatment, AMD can lead to loss of sharp, central vision and cause legal blindness. This short PSA gives an introduction to Taking a Closer Look at AMD—a film  that gives an overview of the disease—including risk factors, symptoms, diagnosis, and treatment options.

6 AGE-RELATED CHANGES THAT INCREASE SENIOR FALL RISK AND WHAT TO DO ABOUT THEM

senior fall risk

Seniors are at high risk for serious falls

The gradual physical changes of aging add up to increased fall risk for older adults. In fact, the CDC says that people aged 65+ have a greater than 25% chance of falling. And if someone falls once, their chance of falling again doubles, meaning there’s over 50% chance of a second fall. This is serious because falls are a leading cause of lost independence and ability. Seniors often aren’t able to recover fully from the trauma, their overall health declines, and their care needs increase significantly. We explain the top 6 age-related changes that increase senior fall risk, typical fall-related injuries, and share 5 ways to reduce fall risk.

6 age-related changes that increase senior fall risk

1. Decreased strength
Muscle loss starts very early, around age 30. In older adults, less muscle means less strength and weaker bones.

2. Weaker sense of balance
Many body systems work together to keep us standing upright. Age-related changes and medication side effects can make it more difficult for seniors to stay balanced.

3. Declining eyesight
Vision helps us keep our balance and avoid obstacles. As vision worsens, so does the ability to stay upright and clearly see what’s in our path.

4. Loss of flexibility
Age and health conditions make seniors less flexible, especially in hips and ankles. This stiffness increases the likelihood of falling.

5. Decreased endurance
Not being able to endure physical activity like standing or walking for a reasonable amount of time increases fall risk.

6. Declining ability and desire to walk
Continuing to walk will improve strength, balance, flexibility, and endurance for older adults.

However, many seniors become less active and fall into a negative cycle where less activity leads to less strength and balance. That leads to even less activity as their physical abilities keep declining.

Centenarian study suggests living environment may be key to longevity

Source: Washington State University / Date: June 17, 2020

Summary: Where you live has a significant impact on the likelihood that you will reach centenarian age, suggests a new study. New research suggests that people who live in highly walkable, mixed-age communities may be more likely to live to their 100th birthday. They also found socioeconomic status to be correlated, and an additional analysis showed that geographic clusters where the probability of reaching centenarian age is high are located in urban areas and smaller towns with higher socioeconomic status.

Based on where the person lived, the researchers used data from the American Community Survey, Environmental Protection Agency, and other sources to assign a value or score to different environmental variables for their neighborhood. The variables they looked at included poverty level, access to transit and primary care, walkability, percentage of working age population, rural-urban status, air pollution, and green space exposure. Subsequently, they conducted a survival analysis to determine which neighborhood and demographic factors were tied to a lower probability of dying before centenarian age. They found that neighborhood walkability, higher socioeconomic status, and a high percentage of working age population (a measure of age diversity) were positively correlated with reaching centenarian status. While more research is needed to expand upon their findings, the researchers said the study findings could eventually be used to create healthier communities that promote longevity in older adults.

Urinary Incontinence in Older Adults

Urinary incontinence means a person leaks urine by accident. While it may happen to anyone, urinary incontinence is more common in older people, especially women. Incontinence can often be cured or controlled. Talk to your healthcare provider about what you can do.

What happens in the body to cause bladder control problems? The body stores urine in the bladder. During urination, muscles in the bladder tighten to move urine into a tube called the urethra. At the same time, the muscles around the urethra relax and let the urine pass out of the body. When the muscles in and around the bladder don’t work the way they should, urine can leak. Incontinence typically occurs if the muscles relax without warning.

Causes of Urinary Incontinence

Incontinence can happen for many reasons. For example, urinary tract infections, vaginal infection or irritation, constipation. Some medicines can cause bladder control problems that last a short time. When incontinence lasts longer, it may be due to:

  • Weak bladder muscles
  • Overactive bladder muscles
  • Weak pelvic floor muscles
  • Damage to nerves that control the bladder from diseases such as multiple sclerosis, diabetes, or Parkinson’s disease
  • Blockage from an enlarged prostate in men
  • Diseases such as arthritis that may make it difficult to get to the bathroom in time
  • Pelvic organ prolapse, which is when pelvic organs (such as the bladder, rectum, or uterus) shift out of their normal place into the vagina. When pelvic organs are out of place, the bladder and urethra are not able to work normally, which may cause urine to leak.

Most incontinence in men is related to the prostate gland. Male incontinence may be caused by:

  • Prostatitis—a painful inflammation of the prostate gland
  • Injury, or damage to nerves or muscles from surgery
  • An enlarged prostate gland, which can lead to Benign Prostate Hyperplasia (BPH), a condition where the prostate grows as men age.

How to Make a Home Safe for Your Aging Parent

Woman helping older man up stairs

With loved ones living longer and needing more care, many families struggle with the best way to help an aging relative. Adapting your home to accommodate another’s needs is a step some are hesitant to make. But if you’re contemplating this move, consider advice from the experts who say the trend is likely to continue as the nation’s population ages. “We’re hearing more from the caregivers that are modifying their home so their older relative can move in with them,” says Sandy Markwood, chief executive of the Washington, D.C.-based nonprofit National Association of Area Agencies on Aging, also known as n4a. Local agencies can provide in-home safety assessments, Markwood says. But she acknowledges the accommodations are often not easy.

Step 1: Low-cost safety tips

Many people find that they can make these changes themselves.

• Add textured, no-slip strips in the bathtub and shower.
• Apply nonslip wax
 on floors.
• Place a waterproof seat
 or chair in the shower.
• Put nonskid treads on steps.
• Remove throw rugs.
• Remove wheels
 on chairs.
• Replace standard doorknobs
 with lever handles.
• Replace toilet
 with a raised or high-profile toilet.
• Use rubber-backed bathmats.

Step 2: Expensive changes

These modifications often require professional help to make a home more accessible for a wheelchair.

• Alter the shower for walk-in rather than step-over entry.
• Create zero-threshold entryways.
• Move light switches
 for easy reach from a wheelchair or bed.
• Widen doorways 
and hallways.

Senior Dental Care: Treatment Considerations

Dental care for seniors involves unique considerations. Seniors are more likely to suffer from a host of oral health issues resulting from the natural aging process, their inability to receive proper oral health care due to financial constraints (no dental insurance) or their inability to provide adequate dental hygiene care for themselves.

These factors, combined with the limited dental benefits provided by state aid programs for the aged, blind or disabled, leave many seniors at risk of ignoring tooth decay and tooth infection until there is no alternative but tooth extraction – which is the only dental procedure covered by many state aid programs such as Medicaid or Medicare.

Tooth Loss, Periodontal Disease and Other Dental Concerns for Seniors

Prior to tooth loss, seniors may experience tooth sensitivity or discoloration due to a loss of enamel and dentin (hard, calcareous tissue beneath the enamel), or root deterioration caused by gum recession. Seniors are more prone to periodontal disease (gum disease) resulting from improper dental hygiene practices, poor diet, ill-fitting dental appliances and/or diseases such as cancer or diabetes. In fact, the supporting bone structure for the teeth, including the jaw, may shift, which can play havoc on a senior’s bite and may contribute to tooth decay. Seniors are also more likely to suffer from inflammation of gum tissue, dry mouth syndrome (often caused by medications) or oral thrush (a fungal disease causing ulcers and whitish spots on membranes of the mouth due to its effect on the immune system).

Dental Hygiene for Seniors

  • Brush, floss and rinse with mouthwash properly to maintain dental hygiene, as instructed by your dentist.
  • Look into special toothbrushes to clean hard-to-reach areas of the mouth.
  • Know the warning signs that indicate your mouth, teeth or gums may be in jeopardy, including tooth sensitivity, teeth grinding, pain, mouth sores, bumps, swelling, loose teeth, jaw popping or clicking, difficulty quenching thirst, swallowing or chewing (dry mouth syndrome).
  • Visit your dentist as often as he or she recommends for regular dental hygiene checkups.
  • Maintain dental appliances such as dentures and dental bridges properly.
  • Consider seeing your dentist before and after surgery.
  • Tell your dentist about any medications that you are taking or changes to medication.
  • If brushing and flossing are difficult for you, try to elongate the toothbrush with tongue depressors or something similar, or ask for assistance. You may also try using a soft washcloth or gauze to remove debris from the teeth, rinsing frequently. Use this method until you are able to brush your teeth again. People suffering from arthritis or a similar medical condition that limits manual dexterity can try inserting the back end of a toothbrush into a standard tennis ball for better maneuverability. Your dentist may recommend other such innovations designed to make the practice of oral hygiene simple and effective. 

Keep Older Adults Safe from Injury

As May ushers in Older Americans MonthExternal, CDC joins the Administration for Community LivingExternal (ACL) to celebrate the many ways older adults make a positive difference in our communities and in our families.

We can all help keep the older adults in our lives safe from injury and independent longer. Did you know that every minute of every day someone 65 years or older falls in the United States? That means one out of four older Americans will fall each year, and falling once doubles an older adult’s chances of falling again. However, falls are not a normal part of aging and there are steps every older American can take to stay safe.

Get a Checkup Every Year

Improve Strength and Balance to Reduce Fall Risk

Check for Safety to Avoid Home Hazards

Tracking down the cause of memory loss in Alzheimer’s

Tracking down the cause of memory loss

Computer image of tissue from the brain of an Alzheimer’s patient: a clump of protein plaques (yellow) leads to the deterioration of nerve cells (grey) that are then destroyed by cleaning cells (purple). Credit: Leiden University

by Arno Van ‘T Hoog,  Leiden University

Memory loss and confusion are signs of Alzheimer’s disease. Physicists Serge Rombouts and Martina Huber have developed new methods to help medical science get to the bottom of this insidious disease. It wasn’t planned, but Alzheimer’s disease has become a recurrent theme in the career of physicist Serge Rombouts, Professor of Cognitive Neuroimaging at the LUMC and the University’s Institute of Psychology. He received a Ph.D. in 1999 for a technique using an MRI scanner to visualise the brain activity of Alzheimer’s patients, and dementia has continued to crop up in many of his projects ever since. The ultimate aim: to use a brain scan to determine whether someone has dementia, in addition to the interviews and memory tests that doctors use to reach a diagnosis.

Distinguish from other forms of dementia

“The problem is that at an early stage Alzheimer’s disease has all sorts of similarities with other forms of dementia,” says Rombouts. “You want to distinguish between these at as early a stage as possible, and this diagnosis is also useful if you want to try out new treatments. The disease process in the brain begins 10 to 15 years before symptoms such as forgetfulness become apparent. And treatment may have a much greater effect if you begin years earlier.”  A scan diagnosis is not available yet, but with the right methods researchers such as Rombouts can now see differences between brain scans of Alzheimer’s patients and healthy test participants. “The thing is that this can be seen most clearly if we compare the two groups with each other. Unfortunately, you can’t, form a reliable diagnosis by placing an individual patient in the scanner.”

Peering inside the brain

The technique that Rombouts uses to visualise the brain does so by looking at brain activity. The blood flowing through active brain regions is more oxygenated and the scanner can register this. This data can be used to make coloured images of cross sections of the brain with some areas in red or green. The colours in themselves do not mean much, says Rombouts. It’s more of a way to clearly visualise the data.

In the past, volunteers were asked to carry out a task in the scanner, but nowadays they simply have to lie still on their backs. All sorts of activity can already be seen on the scans because the brain is never at rest but is always full of thoughts, plans and memories. The brain uses 20% of our total energy when we are at rest, says Rombouts. That busy traffic between brain regions can also be seen in a scan.

Diagnosis from brain patterns 

“We hope that a gradual change in spontaneous brain patterns will be of use in Alzheimer’s diagnosis. The hope is that artificial intelligence will play a part in this. Powerful computers can compare thousands of brain scans and perhaps make new links that people are unable to see.”

Mapping protein plaques

Martina Huber, who works at the Leiden Institute of Physics, uses a similar form of technology as Rombouts, but she uses this to map molecules rather than the brain. We know, for instance, that the amyloid-beta protein clumps together and lodges in the brain, and that this probably plays a role in the disease’s progression. These protein plaques are even visible under a microscope in people with an advanced form of Alzheimer’s. 

How and why amyloid—which we all have in our bodies –clumps together is still unclear. But Huber’s spin-resonance instrument may help provide an answer: this can determine, at a temperature of -263° to the nearest half nanometer, how proteins come together to form a clump. As it is impossible to study this in the human brain, Huber works with test tubes. She places these in a man-sized, ice-cold piece of equipment that is continuously being improved in collaboration with the Fine Mechanical Department.

Harmful accumulation

Huber: “We now know that a smaller accumulation of a few to a few dozen amyloid proteins that have not yet formed plaques is very harmful to brain cells. Physicists are trying to map this process in a test tube. We can see which pieces of the proteinseek each other out and how proteins can change shape if they start to clump.”

The snag is that many proteins not stable Lego-like bricks, but are instead a hyperactive spaghetti of loose tangles that take on a hundred different shapes per second. Using liquid helium to substantially cool these drastically reduces this activity. “To measure in this chaos you simply need other methods. We are able to chart this chaos by using knowledge from physics plus new methods. What drives us is the desire to keep on improving the equipment so that we can answer these kinds of question from the medical world.”

Preventing clumping

Although Huber’s lab won’t be producing a new Alzheimer’s medicine in the near future, knowledge about how proteins behave will help doctors and pharmacists in their hunt for a treatment: a substance that prevents clumping, for instance. “But that’s a big step itself,” says Huber. “You don’t want to promise too much. In the large field of Alzheimer’s research, we are working on one piece of the puzzle. And there’s no saying where the next breakthrough or Alzheimer’s drug will come from.”

Falls Prevention

Did you know that 1 in 4 Americans aged 65+ falls every year? Falls are the leading cause of fatal and non-fatal injuries for older Americans. Falls are costly—in dollars and in quality of life. However, falling is not an inevitable part of aging. Through practical lifestyle adjustments, evidence-based programs, and community partnerships, the number of falls among seniors can be reduced substantially.