Thursday, September 21, 2017

"Falls Can Result From Extended Reach"

Looking at falls in the home and preventing them to the extent we can as aging in place professionals, especially during September ("Falls Prevention Month"), many things need to be evaluated and taken into account. Typically, issues of access lead the list because we want to make sure that people can enter their homes easily and safely, that they can move about freely, that there are no barriers or impediments to easy movement or maneuverability in their living space, and that there are no stumbling or tripping hazards that can interfere with safe use of the space.

Doing things which create a safer environment for our clients is a top priority. We are interested in eliminating clutter and anything that can interfere with visual perception such as glare, awkward reflections, or busy patterns in flooring, upholstery, accessories, or wall coverings.

Additionally, an area of evaluation and design that often is overlooked or minimized in its consideration is the concept of reach. It may be that everyone is considered to have relatively the same amount of reach as anyone else, but this is far from being true.

Several factors affect reach - the extension of the arm to touch, grab, use, or retrieve nearby objects or controls. First is a person's general physical height. A taller person typically has longer arms and can reach things farther in front of them and higher above them than someone who isn't as tall or doesn't have as long of arms.

Second is the position a person is in when they are reaching for an item. Someone seated generally has as long of a forward or lateral reach as someone standing, but their vertical reach is going to be quite less than someone who is standing. Seating can reflect someone when they are eating, working at their desk, watching TV, or in a wheelchair. It can also describe someone resting on the floor or watching TV from that position, playing with grandkids, or exercising.

Third is the relative health of the muscles, joints, and tendons in someone's arm, shoulder, hand, elbow, and wrist. Even when someone has unobstructed access to a light switch, faucet, or cabinet door pull, they may need to be in closer proximity to it to actually touch or use it than someone else due to a more limited range of motion. In essence, they just can't reach as far as someone else of similar size not dealing with the same type of limitations in their muscles or joints that restrict how far they can extend their arms outward from their bodies and at what angle from the shoulder.

Then there is the ability of someone to touch an item such as the door or faucet handles, the switch, or a food item in the pantry or cupboard, and to actually grasp and control it. This is part of what we mean by reach also.

While much attention is given to general access and safety in the home - as well as how conveniently located switches, controls and other operational and functional items are in the home - much less focus is given to someone's general ability to reach and use such items there in the home and how an attempt to reach farther than what is safe, a slip or fall can result.

Reach even applies to other areas of the body besides the arms, hands, and shoulders - notably, the legs, knees, and lower body. Consider when someone of shorter stature sits (or by necessity has to sit) on a high stool to eat at a 42" countertop - or when they try to use a "comfort height" (19" or so) toilet and their feet don't make full contact with the floor. Climbing or descending steps when one's knees, hips, or ankles does not allow for full extension of those joints means that less than a full step results.

Reach is not limited to the upper body - or to any joint. People can have full use of their joints with no limitations, or they can be dealing with severe limitations to a number of joints. Reach is a design factor that needs to be considered and impacts planning for safe usage of a space and eliminating falls that can come from overextension or overreach.

____________ 

Steve HoffackerCAPS, CEAC, SHSS, is a licensed Certified Aging In Place Specialist - Master Instructor and best-selling author of aging in place books. To learn about this and other programs for aging-in-place or universal design, visit stevehoffacker.com or call 561-685-5555. Also, check out the "Aging & Accessibility" groups on Facebook and LinkedIn.