Most Americans want to remain in their homes as they age, even if they should require assistance and care. More and more American homeowners age 45 and older are showing interest in receiving information about remaining in their homes as they get older.

We start aging from the day we are born. We face ever- changing challenges depending upon our stage in life, and sometimes we face the same challenges no matter if we are one or ninety-one; wheelchair dependent, or just having to deal with a temporary cast.

With a little forethought when the houses are first built, most of these issues can be avoided very easily, and without much additional cost. If we initially design our homes for EVERY stage of life using universal design principals, we lessen the likelihood of having to overcome inconvenient (and sometimes life-threatening) obstacles posed by our own homes. Much discussion on designing for aging in place focuses on ways that designers can improve accessibility and functionality for persons with limited mobility or other types of disabilities. Designers can play another, important role in assisting occupants as they age. By creating environments that ensure their safety and provide sensory and cognitive stimulation, designers also can help keep elderly persons healthier longer.

Although the CDC report, The State of Aging and Health in America, does not specifically mention design, it does highlight several areas of concern that, “if effectively addressed, will significantly improve the quality of life for older adults.” Some of these involve indoor environmental issues that can be addressed in part by design solutions:

• Maintain cognitive function and possibly prevent cognitive decline by providing surroundings that stimulate the senses and curiosity, and that evoke positive emotions while helping to relieve stress and depression
• Prevent or delay disease or disability through environments that encourage physical activity
• Prevent falls, which are the leading cause of hospitalization and injury among the elderly

These may seem like small improvements when viewed within the context of other health issues affecting the elderly. Yet, they could greatly benefit potentially millions of older adults for many years, as well as reduce health care spending and caregiver burden.

The biggest difference from general residential design is increased emphasis on and depth of the client profile. We always ask our clients about their personal preferences and desires. We always find out what about their home they like or hate. We always ask about the improvement they hope this project will have on their lives. Those are still relevant questions, but now we frame them in a more personal way:

• Are some household activities more difficult now than they were in the past?
• Do you have health conditions that may impact your ability to use space and design?
• What else about your health and prognosis should I know to do a good job on this project?

If you think these questions are too personal, think first about aging. It is really popular. Everyone is doing it. This is a trend that cannot become dated. The facts on aging are pretty clear. It is not an acute illness like the flu or bronchitis. It’s a chronic condition, meaning it will not get better in the short term. We have to live with the impact. Aging is progressive, meaning change will continue and it is downhill from here.

Prognosis is no more than what a reasonable person can expect from dealing with current information. If you have grown to be sore after a day working in the garden, yoga may help, but it will not bring a reversal. Maybe you are stiff and sore more often, take longer to recover from tennis aches, make more trips to the bathroom and sleep less regularly. None of that is so bad. It is the cost of progress we all aspire to, considering the alternative! If you are being treated for other conditions, your doctor should help you know what to expect.

It is important to remember that people age differently, for different reasons and at different rates. Just because two people may be 80 years old, their flexibility, cognitive skills and physiology may not be the same at all. One may be able to ride a bicycle to the store, while others may not be able to walk down the hallway unassisted. Therefore, you must really do your homework. Each and every project will bring its own unique aspects and challenges. Accessibility issues are highly specific to each individual’s household and usually depend on the occupant’s degree of independence in daily living. We help decipher what is most appropriate for those specific needs.

In order to determine what adaptations are needed to make the home accessible, it is important to conduct an assessment of the person with regard to their physical condition and to evaluate the living space to determine what can and can not be implemented. Gather and organize information about each client by asking questions about their particular strengths and limitations. You will need to identify if there are problems associated with everyday living in specific areas and rooms.

Sometimes, the client cannot or will not be forthcoming in revealing issues that they may face or might have to face in the future. Therefore, you must learn to collaborate with others, working as a team to provide the most appropriate solutions to each and every project. By communicating with family members, caregivers and medical professionals, such as physical therapists, occupational therapists, doctors or nurses, crucial information can be gained about your client’s current and future limitations. With this information, you can then plan the appropriate design solutions for your client’s particular needs.

As designers, we tend to focus on the aspects of an installation, such as width of doorways, bath layout or kitchen design. There are an infinite number of products and approaches that can be employed to meet your client’s needs. We must keep current with all the new technical information, products and resources that are available to assist in making decisions.