Key considerations in home safety and modifications by SAGE

Key Considerations in Home Safety and Modifications PRESENTED BY KELLY W. KENT

Services & Advocacy for GLBT Elders (SAGE) is the country's largest and oldest organization dedicated to improving the lives of lesbian, gay, bisexual and transgender (LGBT) older adults. Our mission is to lead in addressing issues related to lesbian, gay, bisexual and transgender (LGBT) aging.

National LGBT Elder Housing Iniative

• • • • •

Building Housing Training Providers Changing Policy Educating Consumers Expanding Services

Presentation Objectives

Presentation Objectives • To better understand the demographics facing local communities • To understand the additional implications for LGBT aging older adults • Understanding different types of home modification • A basic overview of safety modifications individuals can make to their home to more safely age in place.

Understanding the Issue

Aging Demographics •

It is estimated that there are currently 3 million LGBT older adults 50+ in the United States.

•

That is roughly the size of the City of Chicago

•

By the year 2040, this number could reach 7 million LGBT older adults.

Aging Demographics • Today, 1/3 of households 50+ pay more than 1/3 of their monthly income for rent/mortgage. • By 2024, it is projected that an estimated 4.7 million low income households 50+ will have annual incomes less than $29,999.

• Cost burdened households are at risk of not paying for needed medications, transportation and food.

LGBT Specific Implications • 2014 report by the Equal Rights Center found that 48% of older same sex couples applying for senior housing were subjected to discrimination. • Mainstream affordable housing and assisted living/nursing homes have often not received training for staff in cultural competence of the LGBT community.

LGBT Specific Implications • Despite continued advocacy, housing discrimination continues to be an issue for LGBT aging older adults. • The LGBT community often struggles with affordability in older age due to history of discrimination and economic marginalization.

The Solution • LGBT-welcoming multi-family developments. 1. Provides Culturally competent services 2. Welcoming community of peers and allies 3. Affordability is taken into consideration • Aging in place best practices provide alternatives for communities unable to galvanize political will or that do not have economies of scale. • Cultural Competency training for staff of all affordable housing, assisted living/nursing homes serving LGBT aging older adults.

Home Safety

Fall Statistics Recent studies have shown: ◦ Every 17 seconds an older adult is treated in the ER for a fall. ◦ 1 and 3 adults age 65 and older fall each year. ◦ Approximately 20 – 55% of unintentional falls occur inside the home with 75% of those occurring during the performance of routine daily tasks (e.g. getting in and out of a chair, bathing, toileting, going up and down stairs). ◦ Falls are the leading cause of death in the elderly

Causes of Falls The 2 Major Causes: ď ą Health and age related changes ď ą Hazardous situations

Home Audit - Gathering of pertinent data about the existing living accommodations - Identifying areas of concern and simple ways to improve the safety of your home. - Room mock ups can provide you examples of things to look for that are common areas of concern. - Identifying organizations to engage that can assist you in improving the safety of your home.

Home Audit by Room

Home Modifications by Room

Bathroom

Kitchen

Bathroom Statistics - Approximately 234,000 bathroom injuries are treated in the U.S. for those 15+ each year annually.

- Approximately 80% of household falls take place in the bathroom area. - About half (53%) of the older adults who are discharged for fall-related hip fractures will experience another fall with in six months. - Falls are the leading cause of death due to injury among the elderly 87% of all fractures in the elderly are due to falls.

Taken from CDC study published 6/2011republished NYT

Tub Seats BENEFITS: - Reduces falls and provides comfort - Height adjustable legs - Textured plastic seat & back for nonslip grip - Sliding transfer benches assist with transfers from wheelchairs or walkers to bathtub

Shower Seats Benefits: - Reduces space - Fold down option provides retractable storage when not in use. - Come in various lengths, sizes and finishes

Slide Bars and Handhelds

Grab Bars - Come in various lengths, sizes and finishes - Can be substituted in place of a towel bar

- Must be placed in wall blocking or studs and use specialty mounts - Suction cup grab bars are not consistently reliable

Comfort Height Toilets BENEFITS: - Easier to sit and stand than standard model toilet - 17â&#x20AC;? tall as opposed to standard 15â&#x20AC;?

Kitchen

Stairways and Hallways

Functional Storage Store frequently used items at a height between shoulders and knees. Use a stepstool with handrails if necessary to reach higher cabinets. Install lever handles on doors and faucets for ease of use. Install D handle hardware on cabinet doors and drawers for ease of use.

Hardware and Faucetry

Other Kitchen Safety Considerations

Other Areas of the Home

Home Audit by Area – Hallways and Doors Hallway and Door Considerations ◦Width of doorway openings? ◦How high is the threshold (including patio/deck)? ◦How wide is the hallway? ◦Does entry from the hallway require a 90 degree turn?

Laundry Room

Offset Door Hinges BENEFITS: -Adds up to 2 inches to doorways, allowing barrier free access for some wheelchairs and walkers -Installs using the same holes and screws of existing hinges -Easier and less expensive way to broaden doorways

Flooring Repair or replace worn and torn carpeting (short, dense ¼” pile carpets are best). Remove throw rugs and other items that are easy to trip over. Secure area rugs with double-sided tape or carpet mesh. Use non-slip, non-wax flooring. Make thresholds even with floor. Accent thresholds with visual contrast Remove clutter and loose cords from pathways.

Stairs Install handrails on both sides of the stairwell. Add reflective, non-slip tape or paint on the top edge of non-carpeted steps. Add a light switch at the top and bottom of staircase. Make sure carpeting is firmly attached on steps and worn spots are repaired.

Low Rise Steps BENEFITS: - Treads are much longer and risers are much shorter than traditional steps - Allows feet to be on the same step as a walker

Stair Lifts Considerations:  Transfers  Postural Control  Mobility at both ends  Power  Straight on or bend in the stair

Folding Ramps: Purchase & Rent Ramp Considerations Ramp rise to run - ADA is 1:12 A power w/c can navigate 1:10 Materials should be pressure treated or rated for outdoor use.

Lighting Place nightlights where there is the most night activity. (glow in the dark light switches) Place an easy to reach lamp beside the bed. Keep a flashlight handy. Use task lighting for areas that are used for reading and fine motor dexterity. Use stick-on lights under counter spaces, stairs and in closets Consider remote control systems.

Funding for Modifications Medicaid HCBS Waivers (dependent on state plans) Veterans Programs Non-Medicaid Government Assistance (examples in NYC: RESTORE (Residential Emergency Services to Offer Repairs to the Elderly) and Expanded In-home Services for the Elderly (or EISEP) Non-Profit and Foundation Assistance Organizations offering tiered fee structure Out of Pocket

Medicaid  Like Medicare, Medicaid doesn't cover all physical modifications to the home. However, some state Medicaid programs have special pilot programs that can help with home modifications.  As an example, the resource limit in New York State for a single person to qualify for non-MAGI Medicaid is $14,550, and it is $21,450 for a married couple who both want to qualify.  For New York State, Medicaid redesign has increased the housing related eligible activities for participants.  This varies state-by-state

Out of Pocket Organizations do exist that provide affordable home modifications. Rebuilding Together is a national non-profit with affiliates across the country who have completed more than 10,000 projects per year. Typically provided on a sliding scale based on income. www.rebuildingtogether.org

In Summary

In Summary • There are simple, cost-effective interventions you can make to your home to increase its safety. • Engaging an organization that providers lower cost home safety assessment and home modifications. http://rebuildingtogether.org/our-impact

Non-Standardized Assessments - Department Area Agency on Aging (AAA) developed assessments (in your specific locality) - AARP Home Safety Checklist (http://assets.aarp.org/external_sites/caregiving/checklists/ checklist_homeSafety.html) - Rebuilding Together â&#x20AC;&#x201C; Safe at Home Checklist (http://www.state.nj.us/humanservices/doas/documents/c hecklist.pdf)

Questions & Follow Up Kelly Kent Director, National Housing Initiative kkent@sageusa.org 816-832-7526

Much of the best practice interventions highlighted here were drawn from generous sharing of resources from Rebuilding Together Clay County. To find out more: http://rebuildingtogether.org/our-impact