Many different floor plans or homes are called “accessible”, when indeed they may not be.  An “accessible” home which has steps to a raised front porch, or which has a kitchen too small and enclosed for a chair or scooter to turn, will not provide the ease of living which is necessary.

If you or a family member has special needs, or you’re thinking ahead to a time when it might not be quite as easy to get around your home, consider each of these features before making a decision on what to include in your home.

Accessible Home Features

Bathrooms

• Roll In Showers
• Built In Shower Benches
• Grab Bars
• Room for Maneuvering (5 Foot Minimum Diameter)
• Knee Space Under Countertops/Reduced Height Countertops

Kitchen

• Room for Maneuvering
• Reduced Height Countertops
• Built-in Range Countertops with Front Controls and Knee Space Below
• Pull-Out Shelving (Slide Out Shelves)
• Accessible Electric Outlets and Switches
• Roll-Under Kitchen Sinks

Accessible Homes

• Ramps and Walkways
• Enlarged Garage
• Egress (exit) Door From Bedroom
• Enlarged Hallways and Doorways
• Non-Slip Flooring
• Low Pile Carpet
• Turning Radius in Laundry Room

No matter which features you’re looking for, a good remodeler or home builder can incorporate just what you need in your plan.  Look for remodelers or home builders who are known for creating appealing, affordable, and accessible spaces, and check references.   A reputable builder or remodeler will also be happy to suggest cost effective methods and floor plans, and provide you with different options to consider.

Then, one night, in between the soccer carpool, the school open house, your son’s college essay, and the proposal for work  you’ve yet to write,  the phone call comes. Maybe your mom fell and broke her hip, maybe your dad’s cough turned out to be pneumonia. Whatever the diagnosis,  that phone call jolts you out of your complacency and into a world you know nothing about. Mom and dad’s needs have become greater than your capacity to fulfill them. The doctor says that mom can no longer live alone even if dad acts as her caregiver. The hospital discharge planner hands you a list of independent and assisted living facilities. That may be the only direction you receive from the physician and the social worker. After much discussion, mom and dad, now in their mid-eighties, finally agree to relocate to a smaller, safer community. The responsibility to find good care, a safe environment with good nutrition and plenty of opportunities to socialize, rests squarely on your shoulders and maybe an out-of-town sibling or two.

How elated and surprised you felt when mom and dad acquiesced to relocating. You may have even found a community they like with food that’s “pretty good.”  But don’t get too carried away. You still face a huge obstacle. Until recently, this obstacle wasn’t even recognized as a reason why older adults feel immobilized and unable to consent to the care they know they require.  One client called it “the elephant in the room.”

It’s the house and everything in it.

How can a generation of scarcity thinkers who kept just about everything walk away from a 50-year accumulation of possessions, some very dear to them? They can’t. And you, a full-fledged member of the sandwich generation, have neither the time nor the patience to assist them. How then do you accomplish downsizing and transitioning your parents with the respect they deserve, allowing them the control they so cherish? How do you turn a three-bedroom home into an 800-sq. ft. apartment?

You call a senior move manager who belongs to the National Association of Senior Move Managers. Senior move managers understand that this life transition ranks at the top of the stress meter, along with death and divorce. We know the physical limitations of our clients and their frustrations with bodies and minds that leave them too frail to participate fully in the moving process.  We help them sort through their belongings, deciding what to take with them, what to give away, what to sell or donate. As we sort through their belongings, we encourage mom or dad to give voice to the memories evoked by the object. This process gives them an opportunity to grieve for their many losses, becoming a stepping stone instead of a stumbling block to their new lives. We may make a memory book of photos of the items they can no longer keep.  We create floor plans so that we take only the furniture that will fit. We take the familiar; the chipped dishes, the worn easy chair, the old tool box, because it eases the transition and lessens the sense of loss. We pack their things and take photos of their displayed collectibles  so we can duplicate them in the new home when we unpack them. We listen to their stories about their children or their marriages. When old sibling rivalries flare up, we smooth ruffled feathers. We  stage their home for sale, bring in appraisers for items of high value, arrange specialty shipping, schedule interviews with estate sales companies and movers, haul away trash, organize document shredding and hazardous waste removal. We supervise moving day, make the beds, put everything away, hang pictures and install electronics.

We bring the supplies, we bring the labor but most importantly, we bring compassion, for this is not an easy move for any of the family members.

Silver Boomerang: How Care Manager can improve the situation for family with aging loved one? Are Care Managers for every situation?
Tina Cheplick: The nuclear family is not what it used to be and older adults must now rely on others for their Care. The need for caregivers who are compassionate and understanding of cultural differences is great. We need to continuously find a balance between caring for elders while adhering to best nursing practices, approaching every elder as a unique individual is our mission.

Silver Boomerang: What to look for when choosing a Care Manager?
Tina Cheplick: Care managers are everywhere and each Care manager provides a different model. A family member searching for a Care manager must be able to connect with the Care manager as they define what it is they think they need. Family members may ask for or think they need one particular thing but end up through the process realizing that they need something entirely different. I also think family members must look for credentials, years in the field so a sense of trust can be established.

Silver Boomerang: Do you see new Obama laws toward seniors and nursing and efficient and sufficient ones? What would you want to address?
Tina Cheplick: Health Care reform is getting a lot of attention. While there is much discussion going on, it has been fairly quiet on eldercare insurance. The Medicare and Medical/Medicaid programs must be reviewed and redefined without jeopardizing the Care of those elders using these programs. New creative ways must be piloted to see if programs can changed effectively. Congress must stay neutral as they learn from such pilot programs and not be swayed by big corporate lobbyists. The training of caregivers, higher career ladder opportunities for bedside Care with higher wages must be part of the home Care package. How we train, review, and provide leadership in understanding our elders must reflect in our nation’s health Care system and ultimately the job itself. Too many times our industry of skilled nursing looses the person while abiding by the structure.

Silver Boomerang: What is the most important among often overlooked benefits of home care?
Tina Cheplick: Most elders will agree staying at home is where they want to be. If the elder can stay there while their Care is managed safely it should be the first option as long as the essential players are in place. Families, case managers, and caregivers must be able to work together for this to occur.

Silver Boomerang: What are signs that should signal family that the aging loved one needs a caregiver?
Tina Cheplick: Usually a slip in any of the activities of daily living. If there is a need to provide supervision, cueing, and/or reminders, families members should know this signals a warning flag.

Silver Boomerang:.What are signs that should signal family that the aging loved one needs to be moved to nursing home?
Tina Cheplick: When the need to have an “awake night staff.” Often with Sundowners caregivers redirection, personal Care or provide behavioral management

Silver Boomerang: Do you recommend social activities for aging at home? If so would you recommend a few?
Tina Cheplick: Social activities are a plus. I am an active community board member for one of our day programs here in northern California. Memory games, such a Scrabble, puzzles, and even word games found in the newspaper can occupy an hour during the day. Getting elders involved with home planning, using calendars, and even some sort of exercise not only are beneficial for health but for overall well being. One of my clients used to knit. It took some time but eventually we got her into knitting again.

Silver Boomerang: What would you recommend as a coping mechanism to those who are caring for advanced stages of Alzheimer’s, Dementia, Parkinson?
Tina Cheplick: Support groups in your local county are always a help. In addition families should contact their Area Agencies on Aging for resources. Taking Care of oneself is essential in giving to others.

Silver Boomerang: From what services of volunteers can seniors with families benefit the most?
Tina Cheplick:I think it is important for families to look at what groups have given them support in the past and rely on that source.

Kim Charles

Silver Boomerang: How can a Care Manager improve the situation for family with an aging loved one?
Kim Charles: My goal as a Care Manager is to give my clients as much choice as possible.  Ideally, Care Management is a team approach involving the Care recipient, their family, medical professionals and other interested parties.  The Care Manager’s unique qualifications help him/her to coordinate information and planning efforts among those involved with the Care recipient.  By being proactive and taking an informed look at options, we can often come up with a plan of Care that captures at least most of the client’s goals.

I try to involve families as much as possible.  Many of my clients are adult children who live away from the area where their parents reside.  The stresses of long-distance care-giving can be eased to some extent by finding a trusted Care Manager who will “check-in” on the Aging loved one and is available to advocate for their specific needs.  Care Managers are familiar with area resources and can make informed recommendations for family members about services such as home care, senior housing, and local healthcare providers.

Silver Boomerang: What is the most important among often overlooked benefits of home care?
Kim Charles: Not every client desires to remain in their home as care needs increase, but many do want to live at home.  It may be obvious, but one of the biggest benefits of a familiar setting is that it is familiar.  Even the best-planned transitions can be stressful and somewhat disorienting especially to older people.  Sometimes the placement of a few strategic supports in the home setting can make it quite possible to “age-in-place”.  Another benefit is that home care is often more cost-effective than an institutional setting.

Silver Boomerang: What would you recommend as a coping mechanism to those who are caring at home for advanced stages of Alzheimer’s, dementia, Parkinson’s?
Kim Charles:I have considerable respect and sympathy for caregivers.  Caregivers often find themselves fulfilling roles for which they have had no formal training.  I try to be familiar with area Caregiver Support Groups and educational opportunities for caregivers.  My agency has a Family Caregiver Support Program.  I often make referrals to that program.  Local chapters of Alzheimer’s associations, and other organizations affiliated with specific diseases or disorders can provide helpful resources.  As a Care Manager, I try to give caregivers “permission” to take a break to care for themselves.  This is a must for their own physical and emotional health; but it is hard to do.

75 years old lady lives next door to me. She lives alone though she has 43 years old son but he has his own family and lives far ?wawy from his mother. They installed new eNeighbor system that consists of motion detector that old lady wares all the time with her and monitors with central monitoring system that controls detector’s moving and can automatically call 911 if there is no movement for a long time.

Happily my neighbor has no diseases that normally belong to her age – she has no Alzheimer’s or Dementia, she can do most things to care about herself and she is making Sunday cookies for neighbor’s children.

Last week I’ve seen 911 rescue team cars near my old neighbor’s home late night. Motion detectors in lady’s bedroom and bathroom registered that she had not left the area in her usual pattern and relayed that information to a central monitoring system, prompting a call to her telephone to ask if she was all right. When she did not answer, that incited more calls — to a neighbor, to the building manager and finally to 911, which dispatched firefighters to break through her door. She had been on the floor less than an hour when they arrived.

Those newest devices are quite expensive and that’s why remain largely unproven and are not usually covered by the government or private insurance plans. Doctors are not trained to treat patients using remote data and have no mechanism to be paid for doing so. And like all technologies, the devices — including motion sensors, pill compliance detectors and wireless devices that transmit data on blood pressure, weight, oxygen and glucose levels — may have unintended consequences, substituting electronic measurements for face-to-face contact with doctors, nurses and family members.

Source: Julia Anna Alison. Choice Eldercare