By Anna Hazard
Introduction to Home Levels
In general, single story rancher style homes that have all rooms on the same level are preferable to multi-floor homes as navigating steps is often one of the greatest difficulties when it comes to aging-in-place in the location of one's choice. Having all the main living quarters on the ground level for easy entrance and exit can bypass many complications that come with failing health & physical ability in the elderly. This would include having access to a full bathroom and kitchen, a minimum of a 5 x 5 foot clearance space for turning in all landings and rooms, as well as the ability to move between all areas of the house on the same level without the use of steps or threshold bumps.
The ability to maintain or regain access to the upper floors of a house is a great concern for accessibility and universal design, particularly as most older homes have all their bedrooms on the second floor or above. This is particularly true for those homes with multiple bedrooms or a large quantity of rooms. In addition, the laundry room with washer & dryer is often located within the basement of a household. However, it is often not feasible to live in a single level home as a greater amount of multiple level houses exist (and a greater amount continue to be built) as opposed to single-story ones.
Many people end up compromising by re-purposing a downstairs room as a new bedroom and moving all other necessary facilities to the ground floor. Another option would be to keep the upper floors as a separate living space for any potential future caregivers.
Interior Steps & Staircases
As one ages, staircases can become greater and greater barriers to accessing important areas of the home such as upstair bedrooms, storage areas, or laundry facilities within the basement. For those without particularly severe forms of physical disabilities (or that require the use of bulky mobility aids) that make navigating steps too perilous, here are a few tips for remodeling already present staircases for better accessibility and aging-in-place potential.
The first step (and one that should be done for safety reasons even amongst those not focused on aging-in-place) would be to examine all stairs and steps present within the house to assure that they are completely stable. This includes no potential wobbling (which can indicate an upcoming structural collapse or merely cause a fall through its unstable movement) and removing & replacing all loose boards, treads, railings, or bits of carpeting. In addition any clutter in or around the steps or landings should be removed so that they do not present tripping hazards.
The steps themselves should all have non-slip surfaces with a bit of grip on them. This includes using traction pads or gritty mosaic bands instead of normal carpeting. If carpeting is used, it should be low-pile and directly connected to the treads through a non-slip gripper base. Any stair lips (protuberances where the stair tread extends over its riser, especially when they exceed 1.5" wide) should also be removed as they can catch a toe or the tip of a mobility aid and thus become tripping hazards.
Stair treads that are too shallow to properly hold a person balancing with a mobility aid such as a cane will need to be replaced. This can be done by entirely replacing the treads & risers (basically reconstructing the face of the staircase which can become time & money intensive) or by placing slip-on casings that meet accessibility requirements on top of the normal treads.
The stairs should also have easy-to-see contrasting, such as a different color on the edge of each step (to help prevent a misplaced foot going over the edge), between treads and risers (to distinguish the vertical risers from the portion of the tread meant to be stepped on), as well as on the entire first and last step of the staircase itself to mark the end of incline and the beginning of the floor level (so that one does not reach out for a step that is not there). This can be done using bright paint or colored & reflective tape.
Handrails, Railing, and Grab Bars
In addition, every staircase should have secure handrails on both sides, thus allowing a person to climb the stairs while holding on with their dominant hand or stronger arm. This will also allow two people to pass on the stairs with both having access to a handrail to hold unto. Having two handrails will normally mean that a rail will need to be installed along the inner wall as most houses are usually built with only a railing on the outer side that is open to the air (thus leaving nothing to grip on the wall side). Some interior staircases which have walls on both sides are installed with no handrails at all and thus pose a more severe fall risk.
The handrails themselves should be made of a strong material (preferably metal) that is rounded and easy to grip. Edged rails such as rectangular or ornately shaped ones can be harder to clasp for those with hand dexterity issues and are harder to hold unto while slipping. The rails should be around 1.25" in diameter for an easy fit within most hand sizes and should be placed around 34 - 38" above the matching stair tread. The rail should extend all the way past the newel and final step of the staircase for easy entering & exit of the landing by those who may have trouble stepping up or down unassisted. If the handrail is too short to extend that far, then a grab bar can be added to its end.
All staircases & steps should always be properly illuminated, especially during the night time. This will require the presence of light switches (preferably rocker or touch type for easy manipulating by those with arthritis or other hand strength or dexterity issues) at both the top and the bottom of the stairs so that no steps need to be navigated in the dark while trying to reach a switch. Motion activated lights are optimal as they will not require fussing with switches, but manual back-up switches will also be required in case of a malfunction. Remote controlled lights are another option.
Light bulbs (two per each light outlet in case of an burnout at an inopportune moment) should be easily accessible for changing. This is particularly important for locations near the stairs, as reaching for high fixtures on steps (either requiring ladders or other dangerous balancing) are often the cause of falling injuries.
Other lighting options include LED illuminated hand rails, non-slip stair nosings with integrated lighting, and ground lights that have been embedded into the risers or the side of the walls to illuminate each step. In the case of ground and other lower level lights, the outlets should be flush with their surroundings (either the wall, risers, or treads) so that their presence does not present another tripping hazard.
In addition, a phone (either a manual landline or a fully charged mobile) should be present within easy reach of the floor at the bottom of the stairs in case of emergency (such as a fall).
View the Rest of the Series
Part 1 - Introduction
Part 2 - Exterior
Part 3 - Landscaping & Gardens
Part 4 - Patio, Porch, & Deck
Part 5 - Garage & Carports
Part 6 - Entrances, Exits, & Thresholds
Part 7 - Exterior Steps & Ramps
Part 8 - Threshold Lighting & Windows
Part 9 - Interior Doors & Halls
Part 10 - Interior Steps & Staircases
Part 11 - Interior Stairlifts
Part 12 - Interior Elevators
Part 13 - Living Room
Part 14 - Kitchen