A Home Modifications Program for Older Persons

Introduction

Based on significant growth of the elderly population, both in total numbers and as a percentage of the overall population, there is a need to provide information to assist older persons to remain in their present homes. In 2000, there were 34.8 million Americans aged 65 and over, and this is projected to reach 70.3 million by 2030 (Administration on Aging, 2001). Surveys reveal that approximately 85% of older persons want to remain in their homes for as long as possible, although one-half of those homes were built prior to 1960 (American Association of Retired Persons, 2000).

Research shows that the most common physical changes in older persons are reduction of general mobility, visual ability, and auditory ability (Kennedy & LaPlante, 1997). These physical changes have an impact on ability to stay in one¹s home. The bathroom and kitchen typically produce the greatest challenges. An American Association of Retired Persons (2000) survey revealed that about one-half of older persons have modified their homes to help them age in place. However, it is more common for older persons to adjust their own behaviors based on the deficiencies of their homes as opposed to performing modifications.

The Gerontology Action Group was charged by Colorado State University Cooperative Extension to develop an educational program to identify best elder practices in adapting existing homes. The focus was determined to be home modifications, defined as adaptations to the home that make it more comfortable, safer, and easier to carry out daily activities (National Research Center on Supportive Housing and Home Modifications, 2001). 

Possible home modifications were collected from a variety of sources, including guidelines in the Fair Housing Amendments Act, the Americans with Disabilities Act, and the National Research Center on Supportive Housing and Home Modifications. Through an Internet search, over 50 Cooperative Extension publications and programs on housing for older persons were located. With feedback from county Extension faculty, educational modules were developed and materials purchased.

Program Description

The program consists of a variety of materials contained in a medium-sized suitcase weighing approximately 20 pounds. It has wheels and a handle and is relatively easy to mail, carry, and roll to needed locations (Figure 1). The materials can be mixed and matched, depending on number of program participants, amount of presentation time, and learning objectives.

Figure 1
Suitcase Containing Home Modifications Program

Overhead Transparencies

The overhead transparencies are suitable for use as an introduction for a general audience, or they can be selected as brief educational modules. Information includes:

• Demographics: Population size and growth, marital status, and living arrangements.
• Physical changes: Types of changes that affect need for home modifications.
• Understanding the importance of housing for older persons: Significance of housing, a quiz to examine knowledge about housing, what to consider for aging in place, and housing options.
• Home modifications: reasons for performing home modifications; types of modifications typically made; interactive exercises of possible modifications in the kitchen, bathroom, bedroom and living room; and descriptions of modifications ranging from no cost to expensive.

Video

Home Sweet Homeis a 22-minute video by the Aid Association for Lutherans directed at older persons and their children. In the tape, age-related changes are discussed and home modifications visually displayed.

Product Catalogs

Product catalogs are included for program participants to look through so they can develop a better knowledge of types of modifications, places where they can be purchased, and cost.

Assistive Devices

Assistive devices that can be easily purchased at low cost are in the suitcase. During a program, older persons can see and feel the actual devices. A tactile and visual experience creates a higher comfort level for participants so they will be more likely to purchase and add these devices in their homes.

The 38 devices include a large lettered alarm clock, a digital thermostat, kitchen utensils with large rubber handles, a carpet gripper, a cutting board safety pad, a door knob opener and D-handle, a flexible shower head, a grab bar, a gripper, motion-activated light controls, a radius toothbrush, and a reacher.

Illustration Boards

Illustration boards consisting of floor plans, materials, and rendered perspectives show program participants how modifications might look in their homes. These include larger scale modifications such as installing a ramp, designing an accessible bathroom, and relocating important daily activities to one floor of the house.

References

Finally, references and Cooperative Extension fact sheets provide additional resources if participants want to gain more information about home modifications.

Program Implementation and Evaluation

The suitcase containing the above contents was made available to County Extension offices in March 2001. County Extension faculty presenting a home modifications program contact the housing specialist and either pick up the suitcase or have it mailed to them. As of July 2001, a total of 14 programs were conducted. An evaluation instrument included:

• Questions rating knowledge of devices for home modification before and after attending the program,
• Whether enough information was provided,
• How many of the assistive devices were seen before,
• Intention to modify their homes within the next 6 months, and If help is needed to buy or install home modification features.

Results from evaluations conducted with participants of the home modifications program were positive. There was an increase in knowledge by participants as a result of the program. The average number of assistive devices shown during the program previously seen was 12, meaning that 26 of the devices were new to them. The assistive devices most commonly selected as most helpful to remain independent in their homes were the gripper, doorknob opener, and grab bars. Participants desired additional information on costlier forms of home modifications such as converting a main-level living room into a master bedroom and bathroom suite.

The program also received positive responses from the Gerontology Action Group members who delivered it, particularly in their ability to mix and match different components based on their needs. To reduce scheduling conflicts, a PowerPoint presentation on a CD-ROM was sent to all county Extension offices.

To receive a free copy of the CD-ROM containing the home modifications program, please e-mail the author.

References

Administration on Aging. (2001). Profile of older Americans. Washington, DC: AOA.

American Association of Retired Persons. (2000). Fixing to stay: A national survey of housing and home modification issues. Washington, DC: AARP.

Kennedy, J., & LaPlante, M. P. (1997). A profile of adults needing assistance with activities of daily living. Washington, DC: National Institute on Disability and Rehabilitation Research.

National Research Center on Supportive Housing and Home Modifications. (2001). Home modifications resource guide. Washington, DC: NRCSHHM.