Tuesday, July 26, 2016

"Knowing 'What' Is Not The Same As Knowing 'Why'"

To get started on any home modification or renovation project, but especially one that focuses on aging-in-place, we conduct a home assessment or evaluation. Sometimes, it's called a home audit also.

The purpose of the assessment - done by someone such as a contractor, occupational therapist (OT), physical therapist (PT), designer, consultant, assistive technology professional (ATP), social worker, or other health care professional - is to look at the home and determine deficiencies it might have that can be corrected easily.

This can be defined as the "what" - learning about what is present. We look at the physical features of the home and its characteristics. Nothing is overlooked when gaining an initial impression of what exists. We don't know yet how what we observe impacts the residents or how it will factor into a suggested or recommended renovation or solution.

We start at the front door - actually outside it to include the area leading up to the door - and look at passageways, doorways, door hardware, light switches, the amount and type of light available, windows (location, size, and ease of operation), flooring, cabinetry, door hardware, countertops, appliances, bath fixtures, electrical outlets, closets, each room in the home, laundry facilities, ventilation, and similar features.

This gives us a good picture of the what exists in the home and its relative condition and general age.

Then, we look at how people operate in a space. We want to see if they have any issues using their living space. Do we see them struggling with using controls, outlets, knobs, or handles? Do we detect any issues with retrieving items from cabinets, furniture, or closets? Are there mobility issues in terms of getting around in their space? Balance or other issues?

This still is part of the "what" picture - examining what is going on in the living environment. We must know this important part before we can recommend any course of action. However, this is only part of the assessment. The second part is determining the "why."

Once we have a good idea of the basic condition of the home and what is going on as far as how the occupants are using their home, we are concerned with how accessible, safe, comfortable, and convenient various aspects of the home are to the people living there.

It's one thing to know about what is present, It's quite another to understand why it affects people in certain ways and impacts their ability to function well in their space.

Just knowing that people are having issues or difficulties in using the faucet, turning on the light switch, using the toilet, opening the door, walking across the room (on their own or with some type of assistance), using a kitchen appliance, getting in or out of bed, or any of the many other tasks they perform or need to do inside their home is the starting point for determing why those issues exist and then creating solutions to eliminate or minimize as many of them as possible - subject to what the clients will consent to having done, the severity or complexity of the needed improvements, and the ability to pay for the improvements deemed necessary.

Whether it's their stature, vision, mobility, balance, stamina, range of motion, reach, physical strenght, gripping ability, coordination or other issues that affect their ability top use their space as well as they should, we take the "why" things are not effective and suggest modifications to the "what" to make things better.

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Steve HoffackerCAPS, MCSP, MIRM, is a licensed Certified Aging-In-Place Specialist instructor and best-selling author of universal design books. To learn about this and other programs for aging-in-place or universal design, visit stevehoffacker.com or call 561-685-5555.