Friendly House Case Studies Home Tour Home Assessment Suggestions Friendly Kitchen Links and Resources

Additional Information
Why Home Modifications
Home Modification and Safety
Financial Resources
Basics of Accessibility
Facts on Elderly Population
Understanding Different Abilities
Test Your Knowledge

Understanding Different Abilities

As we age, certain physiological changes ensue. The age and the rate at which these changes occur differ from individual to individual. Some of the characteristics of aging adults that make universally designed living accommodations desirable are:

CHANGES IN VISION

  • Yellowing of the lens
  • Opacity of the cornea
  • Weakening of the muscle controllers
  • Crazing of the cornea
  • Flattening of the lens (farsightedness)
  • Loss of sensitivity to intensity of color
  • Loss of sensitivity to blue and other "cool" colors
  • Less ability to discriminate between closely related colors
  • Slower adaptation rate to light-to-dark conditions
  • Loss of ability to discriminate fine detail
  • Loss of ability to discriminate closely related distances, such as curbs and steps.

    CHANGES IN HEARING

  • Presbycuses or selective frequency hearing loss, especially in the higher frequencies
  • Losses in the ability to distinguish low-volume sound

    CHANGES IN STRENGTH, FLEXIBILITY, AND MOBILITY

  • Loss of strength in the lower extremities, causing a "drop" to chair surfaces when sitting
  • Less ability to bend the knee joint to an acute angle in order to position the center of gravity over the heels for egress from a chair
  • Greater reliance upon arm strength to lift the center of gravity from the seated surface and stabilize the body for transition from standing to sitting
  • Longer seated durations, yet earlier onset of discomfort owing to tissue loss over the ischial tuberosities
  • Graduation transition from normal walking gait to a "shuffling" gait, whereby the aged adult thrusts feet forward out from under the center of gravity

    RELATED FACTORS TO CONSIDER IN THE DESIGN OF LIVING SPACE

  • "Tremor" experiences in early morning and at end of day
  • Loss of grip strength in palm from 95 pounds in youth to as little as five pounds
  • Loss of "pinching" strength, or tip prehension strength in the fingers, from 30 pounds to zero pounds in extreme cases
  • Greater need to use whatever appendage of the environment presents itself for stability when walking, climbing, or changing position
  • Early onset of fatigue on inclined walkways or ramps
  • Need for armrests on dining chairs that fit below table surface, with solid back support, because aged adults do not lean forward when dining, but use the backrest of chairs for support.

    DISABILITY PROBLEMS WITH POTENTIAL SOLUTIONS: A Quick Reference Guide

    Mobility
    Problem:
  • Reliance on a wheelchair
  • Joint inflammation resulting in lack of movement
  • A person can easily move around in a space but needs to sit and rest periodically
    Solution:
  • Utility carts for transporting large items
  • Easy access to sink, electrical outlets etc
  • All purpose work surface at comfortable height
  • Cabinet and countertops that allow sliding of items
  • Raised toilet seats

    Balance Impairments
    Problem:

  • Walking
  • Carrying things
  • Bending over
  • Getting in and out vehicles
    Solution:
  • Lavatory with open knee space
  • Easy to reach storage
  • Accessible heights that would require little or no lifting/lowering

    Uncoordination
    Problem:

  • May result from fatigued muscles
  • Symptoms include spasticity, tremors, weakness, and impaired sensation
  • Safety is the most pressing issue
    Solution:
  • Positions that promote better motor control
  • Equipment that stabalizes objects

    Strength
    Problem:

  • Muscle strength decreases with aging and various diseases
    Solution:
  • Energy conservation and work simplification
  • Small work triangles
  • Reduce steps
  • Promote individuals to pace themselves

    Sensation
    Problem:

  • Sensory perception decreases with aging and various diseases
    **See further description below
    Solution:
  • Enlarge visual cues for braille
  • Mirrors to check difficult to see areas
  • Use other sense to compensate

    Perception/Cognition
    Problem:

  • Color, depth perception changes over time and in various diseases
    **See further description below
    Solution:
  • Color
  • Contrasting materials
  • Use of organizers
  • Single function controls
  • Dual cues to keep person focused

    SENSORY-PERCEPTUAL SYSTEMS THAT CHANGE WITH AGE

    Vision
    The normal aging of the eye involves many changes. The cornea becomes flatter, the scler (white of the eye) becomes yellowed, and the pupil decreases in size. The lens becomes less elastic and more rigid, and also yellows slightly. The end result of these changes can include:
  • impaired depth perception
  • color blindness
  • decreased ability to focus on close objects (presbyopia)
  • reduced ability to adjust to light
  • cataracts
  • glaucoma

    The amount of light that reaches the retina of the average 60-year-old is only one-third of that seen by a 20-year-old. Because the changes occur gradually over a long period of time, many individuals do not realize the extent of their visual limitations.

    Hearing
    Presycusis, a type of neurosensory hearing loss, is the most common cause of hearing impairment in the elderly. Presycusis was originally thought to result exclusively from age-related changes in the cochlea (inner ear). It is now known that environmental factors also contribute to age-related hearing loss. Like age-related vision changes, those changes that occur in hearing are gradual and not always recognized or acknowledged. It is important to stay alert to signs of hearing loss such as:

  • frequent requests to repeat information
  • complaints of hissing or ringing in the ears
  • failure to react to sounds coming from behind
  • reduced comprehension when surroundings are noisy

    The inability to understand the spoken word because of reduced hearing can lead to suspiciousness, anxiety, agitation, and paranoia, even in individuals who do not suffer from dementia.

    Taste
    By age 70, it is estimated that two-thirds of the taste buds in the mouth have "died." Perception of sweet tastes declines, causing many older people to use more and more sugar. Flavors decline in their distinctiveness, which encourages the use of extra salt to "bring out the flavor."

    Sugar and salt become potential health hazards when used to excess, leading to late onset diabetes and high blood pressure.

    Smell
    The sense of smell also declines with age. Our sense of smell can be crucial in warning us of fire or toxic hazards. The ability to discern certain odors can also bring pleasure and spark memories.

    Touch
    Many elders are at risk for falls because of a number of disorders that cause changes in the peripheral nerves and proprioceptors, thereby reducing feeling and the ability to recognize the position of the limbs. Numbness or loss of sensitivity is a common complaint.