Aging in Place by Room - Part 14 - General Interior Flooring

By Anna Hazard

Introduction

The flooring throughout the main interior portions of the house are an important, if often overlooked, aspect to aging in place. Due to health issues such as vision, vestibular, or other balance problems, falling becomes more likely at the phase of life where it also becomes far more dangerous (with a greater risk of breaking bones or sustaining other major injuries from a simple tripping or falling event). According to the Centers for Disease Control and Prevention more than a 1/4 of all adults over age 65+ will have a falling event each year with over 20% of these accidents leading to injuries severe enough for hospitalization.
 
Fall prevention is a major concern for the elderly which is an issue that can be further addressed when modifying a home to properly age-in-place. In particular, when it comes to flooring and accessibility, safety, & universal design, one should keep in mind that...
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• The installed floor should always be slip resistant (both when dry and when wet)
• Be easy to traverse and walk over as well as to maneuver around with various mobility aids (from plain canes & walkers to full blown wheelchairs)
• Should be low maintenance for those without the proper health or energy for extended cleaning or repair
• Should have some cushioning for shock absorbance during falls

General Recommendations

In general, the floors should always be kept dry and free of standing liquids whenever possible (as not only does it pose a slipping risk but liquids can also seep into seams & untreated surfaces thus damaging the flooring itself). The floor and all areas of common travel should also remain clutter free without low lying objects that can be tripped over.

​Ground surfaces booth interior and exterior should have enough of a texture to be slip resistant yet still smooth enough for wheels & other mobility aids to easily glide over. The American Disabilities Act (ADA) declares that ground and floor surfaces along accessibility approved routes should be stable, firm, and slip resistant as mobility aids such as wheelchairs require regular/uniform surfaces that are stable & both hard and dense enough to easily roll across.
 
Flooring should also be non-glare to not create visual disturbances that might cause someone to trip. Intricate and contrasting patterns used uniformly throughout the flooring should also be avoided as they can cause further depth perception issues in the elderly and those with visual acuity problems.
 
Throw rugs & other smaller area rugs should be avoided due not only to the increased number of floor transitions with their edges, but they often pose as other slipping risks due to their small size & low weight causing them to slide, bunch  up, or otherwise create bumps that can be tripped over.

​If cushioning is needed in a particular location for extended use, heavy duty water proof anti-fatigue mats can be used in such areas where standing in place for extended periods is expected (such as kitchen sinks & work counters). They cushion and reduce the pressure on feet, but their styling usually contains texturing (for increased slip proofing), gently sloping beveled edges for a smoother transition, and a heavy weight and rubber grip on their bottoms that keep the mat itself from moving. Mats that are raised too high from the normal level of the floor or which have an abrupt change in edge threshold should be avoided as they pose their own tripping risk.

Floor Thresholds & Levels

The flooring should be kept an uniform and consistent as possible throughout the entire household as the threshold between changes in floor styles and textures (such as walking from hardwood to carpeting to tile) is a major tripping hazard. The smoother and overall fewer transitions across flooring surfaces, the better. In particular, any changes in flooring should minimize the height difference in-between the transitions (such as avoiding going from a flat hardwood floor to a tall plush carpeting).

​Having room transitions as flush as possible and outright removing any threshold bumps or unneeded saddles (often common between rooms with hardwood flooring) is particularly important as many seniors tend to drag their feet due to mobility issues or have visual acuity problems and are thus more prone to tripping over slightly raised thresholds. If there is a change in surface level than there should be a color and texture contrast at the threshold to act as a visual warning.
 
When it comes to changes in floor levels, anything over 1/4" (6mm) should generally be avoided. Transitions between 1/4" and 1/2" will require beveled slopes to properly traverse (with a ratio no greater than 1:2 for safety). Changes in level greater than 1/2" (13mm) will require a gradual slope to overcome (such as the installation of a small interior ramp).

Hard Floors vs Carpeting

Hard surfaces for flooring include such types as hardwood, bamboo, tiles, stone, linoleum, vinyl, rubber, and cork. Overall these styles of flooring are easier clean, more sanitary & hygienic, with lower maintenance required (as they can generally be swept or mopped and will not require shampooing or the use of an expensive deep cleaning vacuum). They tend to be more durable than softer surfaces such as carpeting and thus last longer before requiring replacement.

Hard floors are easier to traverse (especially with mobility aids such as wheelchairs, scooters, and rolling walkers which require a firmer surface for their wheels to spin properly) and pose less of a possible tripping hazard, yet tend to have far less cushioning and shock absorbance if someone should fall. Hard flooring also tends to be more initially expensive to install as opposed to carpeting.
 
In comparison, softer surfaces such as the various styles of carpeting are generally less expensive to initially install and are viewed as more comfortable and easier to stand on for extended periods of time with less stress placed on the feet (as long as the depth of the carpet doesn't start causing balancing issues). Carpeting is also warmer and tends to be particularly popular within bedrooms in cooler climates (especially as seniors tend to be more sensitive to colder temperatures as they age).
 
Carpeting also has more cushioning and shock absorbance during falls and is thus less likely to cause injuries than certain harder surfaces. However, the carpet itself tends to pose more of an initial tripping risk, especially when it comes to high-pile or plush carpets. Carpets also tend to be harder to traverse for those with mobility aids, particularly wheeled ones.

​In addition, carpeting is less durable requiring more frequent replacements than harder surfaces as well as being higher maintenance and less sanitary & hygienic due to all the dust, dirt, and other particles this type of surface tends to attract. This can be a particularly bad drawback for those seniors with more severe allergies or other respiratory issues as well as those who lack the health & dexterity for repeated carpet cleanings.

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