Tuesday, March 27, 2007


We have lived in our home for 20 years and have never had a railing installed at our front entrance. There are only two steps, and they are not usually difficult to climb. Last year I slipped on black ice when I stepped out and ended up in the front garden on my back, fortunately with no injuries. My husband arranged to have a railing installed last week and I am glad for the increased safety it provides. Besides that, it looks nice.

Many of my patients end up unable to return to their homes after an injury or illness due to accessibility issues. I have a patient who had a stroke a number of years ago and still lives in a walk up apartment with 28 steps. She is now even weaker from another illness and her discharge is being delayed due to her inability to do those stairs. She and her husband are reluctant to move from the place they have lived for 40 years and at their age, it will be a difficult move.

Some of our long term patients could go out on a pass to the homes of their families at special times if only they could get in. The trend in newer housing developments is towards smaller lots and higher houses, often with three very inaccessible levels. Bungalows sell at a premium price around here as aging baby boomers look for a suitable home to get older in.

It doesn't take much to increase a person's difficulty doing stairs. My husband broke his ankle a few years ago playing hockey, and like most men, had no difficulty with crutches. Most women struggle with crutches due to lower upper body strength. Whenever I do a community visit, I habitually count entrance steps and look for railings and other safety features. Stair lifts and home elevators are available, and while they are pricey, may be cheaper than moving.

We are all getting older and good health and mobility is something we cannot take for granted. Best to plan for the future before we are forced to move at a difficult time.


  1. Oh my--you nailed it. Our aging inspires greater caution.
    I have an aunt who is 75 who goes down the stairs in her house backwards, so she won't fall. I am grateful for her caution.

  2. I empathise with you. That is what not in our hands. My below article rightly points out the need of universal design in all our homes for security, unversality, userfriendliness and safe to use designs.

    Universal Design addresses widest possible audience

    User-friendliness is a unique selling point – be it instruments or kitchen stores, homes or public places, personal vehicles or public transport, as it addresses widest possible audience. You'll be surprised at the everyday products that are easier to grip, walk on, lift, push or pull and open and customers just like them. Are not these inspired by Universal Design?

    Accessible or universal design is not only for the elderly and disabled, many experts now say universal design is simply a better and more thoughtful way of designing for all ages and conditions- addressing diversity of needs.

    With the improvement in medical facilities and life expectancy, a larger Indian population is graying. Recent researches have confirmed that the average life expectancy of Indians by 2050 shall be 70 years and above. Why don’t we the young generation thinks of planning for our later years and also for our parents. Why do we allow our homes to remain so unfriendly to elderly homeowners or for their disabled members?

    Constant trudging up and down stairs, forced stooping to retrieve pots and pans, slippery bathrooms and tubs and dimly lit rooms are but a few of the issues the disabled and elderly deal with on a repetitive basis, so shall we if we don’t wake up now.

    There are encouraging signs of emergence of a design approach called universal design popularly known as UD in the West. Universal design holds that homes and many home products should to be designed for ease of use for a larger audience. Yet universal design doesn't necessarily mean higher cost in renovations, nor does it mean giving up fine esthetic design in favor of functionality.

    But not many home designers and product makers in India yet are enthusiastic about universal design and fewer who are, themselves not convinced about the concept as they still feel that the concept does not conserves space and increases costs. With the mandatory provisions of non-discrimination in the Indian Disabilities Act-1995, at least the inclusion of accessible designs can be seen in public places and built environment to a far greater degree than is found in most homes.

    If we love our parents, I am sure we do, why don’t we think of room makeovers? What you require is just to include low (or no) thresholds between rooms, handrails in hallways, baths and shower stalls, elevated kitchen counters with sufficient knee space to bring sinks closer, and transition from knobs to levers that open with a nudge rather than a twist for now. For example, if we remodel a bathroom, we might consider universal design elements in terms of non-skid rugs or flooring, handrails in shower stalls and along tubs, wider shower doors with minimal thresholds, showers with seats, levered faucets, elevated toilets rather than squatting types, and brighter, motion activated lighting.

    Lets plan our tomorrow for we are capable today. Tomorrow we shall have to depend on the younger generation who may have their own priorities.

  3. KGMom- I have a number of patients who find it easier to go downstairs backwards due to bad knees. It takes more muscle control to walk downstairs or downhill than up. I hope she has a railing!

    Subhash- I don't see that you are linked to advertising. Your comment does bring up good points whether in India or Canada.

  4. Even though I am 21 at the moment, your blogging has always encouraged me to think about the future. When Michael and I have a house, we want to build (or renovate) it so that we are be able to live in it till the end of our lives hopefully.

  5. I agree with you wholeheartedly. I live in a ranch style home but it has a very steep driveway - and I mean VERY steep. Then there are about 12 steps up to the front door. In 20 years we'll need an electric chair lift to fetch the mail.

    I broke my ankle in 05 and had surgery. I had a very hard time with crutches but within a week or so, I managed quite well and gained a lot of strength, but never attempted stairs with them.

    It's scary.

  6. Jaspenelle- You don't have to be old to have a mobility problem. Any anyone can visit you, even old relatives like your aunt ;-) if your home is accessible. I hope you an Michael find what you are looking for soon.

    Mary- Like I said to my niece...you don't have to be old to have a mobility problem. Your broken ankle would have been a good lesson on structural barriers. Hope it is well healed. Twelve steps up to the front door! That should keep you fit.


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