An article by a member of the Irish Haemophilia Society on Ageing & Haemophilia.
Many people fail to prepare their homes for changes in their body’s ability to do what it always could. When we are young and agile we don’t think twice about the height of steps, how low to the floor electrical sockets are, how narrow a path or doorway is, how much we stretch to reach everyday objects. However, it is well documented that the home is the most common place for accidents due to trips and falls, so instead of considering adjustments after you end up in Accident & Emergency, why not take a good look around your home now? When looking around the home, we should consider not only safety, but also convenience, considering how our body is now and how it is likely to be in the future.

Recently we moved house because our children had flown the nest and we wanted to try living in the countryside. Since we both have arthritis in our lower joints, and we are in our fifties, we decided a bungalow would be more appropriate than a two storey house. However, the bungalow we decided upon had two steps at the front and back doors that were almost twice as high as conventional steps! A builder told me that a step should be no more than 6” high, so we had him rebuild them. Another feature of the house was that some windows had top openings only. They were quite comfortable for the previous owner to reach but we have to stand on a step-up to open and close them! Other windows in the house have side-openings which are more appropriate for people of any height.

When adding an en-suite we had the builder put in a shower with as low a threshold as possible, as well as a grab rail inside the shower. We also had a grab rail put over the bath to assist stepping in and out, as bathrooms are the most common places for people to slip. When people’s lower limbs become weaker, balance reduces, so it is vital to be able to steady oneself in potential fall areas, typically steps, stairs and bathrooms. Another feature we added to the en-suite was a motorised velux window. The ceiling is quite high so stretching with pulley strings or a pole to open and close it would be quite awkward. Fixed and removable shower and bath seats are easily available so consider if you would benefit from them.

Kitchens are the most used room in a house so consider various alterations that can improve your ease of use and particularly your safety: worktop heights, low level grills instead of eye level, lever taps are easy for arthritic hands, adequate electric sockets to prevent trailing leads or constantly moving items around. Pot drawers are more accessible than low presses, which require kneeling or crouching to reach into. Larder presses can have pull out trays so stretching to the back of them is avoided. For higher presses, don’t stand on a chair, buy foldaway steps with a high grab bar for balance and with slip proof feet.

Steps and stairs should be in good condition, particularly if carpeted. Ensure that the hand rail is also in good condition and securely fitted. Floor tiles and lino are lethal when wet, so consider having good door and hall mats to eliminate slipping or sliding. Kitchen tiles can become wet around the sink and back door of the house, so deal with these areas also.
Pathways and doors through the house should be adequately wide and unobstructed. Hallways and stairs should not be used for storage as stepping around and over objects requires good balance. If possible have a direct path from your bed to the bathroom. Walking around a bed or other furniture during the night, with poor balance, when not fully alert and possibly in the dark, is preparing for a fall!

Occupational Therapists are trained to identify dangers and make recommendations to alterations in your home to ensure your safety, so consider a consultation. It is not necessary to move from a two-storey house to a bungalow to eliminate climbing stairs, get a stairlift or consider converting the lower half of the house into an apartment.

Conversions and extensions can be expensive but health board grants are available. Conditions include an Occupational Therapist’s report and means test. For older people there are schemes whereby the local authority rehouses people in ‘independent living ‘ secure units or apartments and purchases their house at a reduced price. These units are carefully designed and often includes wardens and personal alarm systems.

Member of the Irish Haemophilia Society
February 2011