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Barrier Free Environment for Elderly Disabled
HelpAge India is a leading national level voluntary organization working for the cause and care of the disadvantaged older people in India. It is one of the founder members of HelpAge International, which represents the cause of the elderly at the United Nations and is also closely associated with Help the Aged, UK. Our patrons include the Former Presidents of India Mr. K.R. Narayanan & Mr. R Venkatraman. The governing body consists of many eminent personalities who tirelessly work for this noble cause. This book is part of a series of books published by HelpAge India to provide information & guidance for various issues related to age care.
With the advancement in medical science, life of an individual has increased. One can easily live up to at least 80 years of age. It means that one will be old and have all the problems, physical as well as mental ones, associated with old age for at least 20 years after retirement or say after 60 years. If a person can live a healthy and independent life for this period he can age graciously. For this, the built and unbuilt environment which is free of barriers and is thoughtfully provided for will help tremendously to make the elderly feel comfortable in his own home and not resort to the care of old age homes as most of them may be left alone to fend for themselves. We are suggesting a few such provisions that can be incorporated in the built environment.
You may at one time or another, temporarily or permanently become disabled due to a fall or ill health.
You may have to resort to the use of wheel chair or walker. The entrance to the house therefore, should be made accessible by means of a ramp having a gradual slope of 1: 12.
As far as possible you should live on the ground floor and let the younger members of the family live on upper floors. If you have to live on the upper floors you would be advised to use stairs slowly and carefully. It is actually good exercise for you if you are in good health. You should always use the handrails while climbing stairs. The tread surfaces should have slip resistant material.
The steps should be provided with nosings that have slip resistant strips as shown in the sketch below. Slanted nosings are preferred to projecting nosings so as not to pose difficulty for those of you using walking stick or walker as these aids may be stuck in the recessed space or projecting nosing. In addition, open risers should be avoided. The stairs should be constructed with regular sizes of tread and riser Half steps and triangular steps at turnings are to be avoided. Landing at regular and short intervals must be provided to enable you to rest. Even lighting of those areas having steps or stairs is necessary to prevent falls.
The first and last step both treads and riser, on every stair flight, should be marked with a paint that has a colour in contrast to the gray of the steps to make it more defined. This will enable you to move around without hesitation.
The built environment in and around homes should not be cluttered with objects like flower pots, dustbins, etc. in the corridors, passages, pathways in gardens etc. There should be no projecting elements in the passages like pipes, columns etc. It is best to recess all appliances and fittings wherever possible. These precautions if taken will go a long way to make you feel independent in your own homes and help you perform your daily activities easily. In fact, it will encourage you to be active.
The maximum number of times the elderly have a fall is in the toilets where the floor becomes slippery with water spilled on the floor. The floors can be made anti-skid by use of anti skid tiles or rubber mats. The toilets should at all times be kept dry after use. You are advised to wear comfortable footwear with rubberized soles. This will reduce the tendency to slip. The toilets can be provided with grab bars made out of 50 mm dia steel bars.
This will enable you to confidently use the toilet even when you are frail with age or poor health. You can start training yourselves to use English W.C. at a younger age as they are much safer to use later in old age. Most of you with painful knee joints will also be comfortable on an English W.C. sanitary fittings may have lever action handles to facilitate easy use by arthritic fingers and wrists.
The furniture layout in residence should be simple and uncluttered. This will facilitate in easy movement about the home even when you feel a little unbalanced which is sometimes caused by loss of hearing or poor health, It will help you to feel confident and encourage you to fend for yourselves in performing daily routine chores, which otherwise you would have a tendency to put off for fear of falling.
The furniture should also be comfortable. The seats should not be too low or else you may have problems getting up as often as required as it takes a great amount of force to lift yourself up from the sitting position.
Most of you will have diminished vision. Your eyes may not be able to with stand glare of bright lights. As the muscles of your eyes become weak it may be a problem to adjust to darkness after bright lightsorviceversa.lt is advised to cut the direct glare of bright sunlight or artificial light inside wherever possible. The exterior spaces just outside the windows can be lit up by means of bulbs to reduce the contrast of brightly lit interiors and dark night outside
The switch plates should be well located and as far as possible be of contrasting colours against the wall for easy location. The corridor inside the house and path ways outside in the open with contrasting colours or defined edges will help you to move about confidently.
Most of you will suffer from diminished hearing. It will become more difficult with age to hear with clarity to what others have to say. Simple measures can be adopted to treat the rooms for better acoustics. Use of sound absorbing materials in the form of upholstery, tapestries, carpets, durries help a lot in cutting off repeatative echo of sounds and thus make the general conversations clearly audible.
As you have diminished resistance to infections, the built environment should be kept as clean as possible. It is suggested that the inside walls should have smooth and even surfaces. This can be achieved by giving a punning of plaster of paris on all walls. These smooth walls will not let dust or cobwebs settle on them. Also smooth walls and rounded wall corners will not cause injuries to your skin which may bruise easily caused by diminished elasticity of skin.
As most of you suffer from loneliness and depression caused by family circumstances or poor health, aesthetically pleasing and well-maintained environs can boost your morale enormously. You may find yourselves a window or balcony to view the world passing by outside to amuse yourselves. Similarly you can enjoy watching your grand children engage themselves in their daily activities from a well selected corner in the house without disturbing them or coming in their way.
J. SAFETYAND SECURITY
As the most vulnerable members of the society, safety against theft and murder should be provided for. You may limit the number of entry points to your house thereby, having better control on who enters and leaves. You may be advised to never entertain sales-persons who come to your house as there is no way of checking their true identities. You may also check the identity of the service people before letting them in. A peep hole in the entrance door, chain on the latch or sophisticated access control systems can give you necessary control over the entry to the house.
There should be at least one emergency call device accessible (such as telephone, neighbors alarm, intercom switch etc) in the elderly persons private quarters and toilets. Most of you will suffer from diminished sense of smell caused by old age. It is all the more important to have well ventilated homes. Good quality wiring with adequate provision of power will reduce the chances of short-circuiting, which cause fires. Use of fire retarding materials in interiors helps in giving ample time to you to evacuate the premises. The use of those materials and paints in interiors that emit toxic fumes on getting burnt should be avoided.
Mostly elderly people become forgetful. Certain simple measures in their daily activities may be suggested to elderly people who live alone, such as they should be advised to consult a checklist for shutting and locking all doors, windows and cupboards before retiring for bed or when leaving the house.
Other books in this series
HelpAge India thanks Dr. Kiran Sohal Specialist in Architecture for Barrier Free Environment for preparation of this manuscript.
Edited by Dr. Shubha Soneja, Head R&D, HelpAge India. (No part may to reproduced or copied in any way without written permission.)
Note: Old Age Solutions would like to thank HelpAge India for providing us this book.