Learn from Daniel Elliot an occupational therapy as he talks about home modifications that can make homes safer for individuals with physical limitations.
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Katherine Cocks0:02
Hi, my name is Kathy. I've been a geriatric nurse for over 10 years. Many times when I would meet with family members of aged loved ones, they didn't always know what to do. I started this podcast knowledge for caregivers, to assist them with practical suggestions as they assist their own loved ones age with dignity and grace.
Katherine Cocks0:29
Well, I want to welcome my listeners back. And today I'm talking to Daniel Elliot. He is an occupational therapist. He was inspired to get into how to make your homes accessible because of his own accident. Daniel, welcome to the show. I am now curious, what kind of accident did you have? And how did that affect how you saw designs in the home?
Daniel Elliot0:53
First of all, thank you so much for having me on. Kathy. That's a great question. And that's sort of the genesis for where I am today. In 2014, at the time I was before being an occupational therapist, I was a Jones Beach lifeguard. And one day, the waves were really rough that day, but we still had people in the water and I had to go in and make a rescue. And upon diving in, I ended up hitting my head. What happened was, everything went numb, I had fractured two vertebrae in my neck, and they burst into my spinal cord. So I had some temporary paralysis. Luckily, I was able to be stabilized and airlifted to the hospital where I had to undergo surgery, they did a fusion surgery. So they took out some of those vertebrae and put in a plate and some bone growth factor so that it could heal. But after the surgery, I was certainly really weak, trouble walking, trouble getting around and things like that. I had an amazing rehab team and they they got me a lot stronger from where I was when I got into the hospital. But I wasn't nearly as strong as before the accident. Despite being able to walk somewhat, I was in a wheelchair, mostly, I was getting ready to go home. But one of the major concerns was that my house was completely inaccessible. It had two steps in the front, and then a 90 degree turn and five more steps and another 90 degree turn. Despite me just wanting to get home so bad, there was no way for me to get it up those stairs because I wasn't up to that yet. There were no resources or options, talking to the social workers in the rehab team to make my home accessible at the time. So there was really no way for me to get home. Luckily, I was able to slowly make my way up the steps with some additional help and get into my house. But the experience of working with the rehab team is what made me become an occupational therapist and pursue that career. Having experienced myself the inability to get into my own home. And that lack of accessibility is what made me so close to home modifications, I just became an OT started doing home modification consulting as well, not only to address home accessibility, but also to address safety function and the other things that tend to impact older adults specifically.
Katherine Cocks2:57
That's true how it affects older adults, but it's not always older adults because I had toe surgery and they sent me home on crutches. I fell trying to get up my one step and I sent my husband to get a nice scooter because I said I am not going to be able to do crutches. You don't have to necessarily always be older, just a minor surgery and crutches and you're having trouble on trying to navigate your home. We actually work with kids as well who have disabilities and really anybody who it's not always about the person, it's about how they interact with their environment, there is an issue it's addressed. So you're absolutely right. So first, I want to say from an occupational therapist point, what are some home modifications that I call kind of low hanging fruit, some of the things that would just be a little easy for people maybe to do as they have mobility issues, or even if they break a leg and they're on crutches or something like that before they're get into a major project
Daniel Elliot3:49
. Some of the most common ones is making sure that those area rugs and things are taped down. Another big one is lighting in the home. If you're moving around at night or going to the bathroom at night, a big reason that you can bump into things and lose your balance is due to low light. I've always recommended motion sensor lighting, there's plug in lighting that goes into the wall and there's even motion sensor LED strip lighting, which actually looks really great. And as soon as you get to the area that you're going to be walking in in a dark pathway or hallway, it's going to detect your motion. Some of the other things are grab bars and placement of grab bars, seats in the shower, handheld showers. Those are smaller things that either require little or no installation, but can really make an impact on safety.
Katherine Cocks4:35
When you talk about grab bars. I've been in some homes and I don't like them is the suction cup ones. What are your feelings on those suction cup grab bars because I've just seen them come off so easily.
Daniel Elliot4:46
I've gone into homes where I see those two and I cringe because those are absolutely not recommended. What happens is the the moisture after you shower or just in a bathroom in general seeps into the suction area and it can make Get loose. The unfortunate part is it won't come off, it'll just be loose. So the next time you use it, because that moisture under there, it's going to slip. So you're going to have all your weight on it, and it's going to completely fall off, we always make sure to tell people, but that's definitely not a good solution.
Katherine Cocks5:15
I'm glad you said that. Because I just I'm not an occupational therapist, but I don't like those I tell my caregivers, you check that thing yourself before you let somebody else grab it. But I agree with you, I definitely don't like this and I tell people, hey, 150 bucks to get somebody professional install a grab bar is a lot better than a broken hip.
Daniel Elliot5:33
Absolutely. And the thing about grab bars, too, is even when they're professionally installed, and you have those aluminum or chrome ones, people don't always like the look of those either. But there are so many amazing manufacturers and vendors that are now creating these grab bars and even other safety equipment that can match the aesthetic of your home. So it doesn't have to look like a hospital either, you can get a purple grab bar, one that's brass or wooden polished like something to really match the character of your home. So that's always a really great option to go over with people.
Katherine Cocks6:02
So that's really interesting to know, because I've never seen any that match the home. So I'm glad to see that I do see a few people are starting to get nice grab bars that kind of look like your towel rack. Because I say please don't grab your towel rack. I've seen too many of those pulled out of the wall. And I'm sure you have to like, okay, there's a big hole, somebody grabbed the towel rack on that. So you can even get grab bars that can serve dual purposes. Correct?
Daniel Elliot6:25
Yeah, exactly. So they're dual purpose grab bars, or they're called incognito grab bars, they have towel rack grab bars, they have grab bars that look like shelves that go in the shower. And they have grab bars that also hold toilet paper rolls as well. So you can really blend them in and they hold 250 plus pounds of force as well.
Katherine Cocks6:44
When it comes to the other issue. You talked about steps getting in the home or that one step in the garage. What do you see as usually kind of a general solution, I know every home would be different and you have to evaluate it. But what are some general solutions for people, they're looking at maybe a couple of steps.
Daniel Elliot7:03
The first step, no pun intended is to analyze sort of where the person is at right now. If it's someone who otherwise has decent balance, but it's just worried about safety, maybe you're adding an additional hand railing. And you're also adding some extra lighting as well. And maybe a grab bar that allows you to pull yourself up into the rest of the home. That's something that we would want to promote. Because we don't want to completely take that person away from using their stairs, if it's somebody who's really having a hard time, depending on the rise to the entryway, there's ramps, there's outdoor stair lifts, there's even vertical platform lifts as well. And you can even do some really interesting things to residential doorways or doorways in anyone's home as well and make them automated and control them with your phone. There's a lot you can do with an entryway. It's just a matter of where the person is at and what they need and how they can function with that entryway. And that's how we look. That's the lens we look at when we look at modifications as well, in any place in the home.
Katherine Cocks8:02
That is really interesting. I have never seen the one where you can use your phone to just unlock and open your door. That deadbolt is connected to your phone. And then also the automatic door opening mechanism as well that you can connect to your phone. Some older people might have trouble with some of that. But it's definitely an option that I was not even aware that technology was out there. If someone was like, Hey, I'm thinking about remodeling my bathroom. What are some things that they should really think about? Like I'm already 57? If I'm going to remodel I'm already going to think if I'm aging in here, how do I want to remodel my bathroom because to me the bathroom is always water shower, just slick floors is always such a dangerous place. So if somebody was already thinking about remodeling and they're thinking, I might bring in my parent or I'm going to age in place, what are some things that they should think about or ask their remodel person to do?
Daniel Elliot8:53
Yeah, absolutely. What's really interesting is the trend in design is going towards zero step entry shower. So let's say you have a tub and a vanity, you know, typical high toilet, things like that. What I would recommend for a full remodel is to actually create what's called a wet floor or a wet room where there are drains within the shower and also an additional drain outside as well just in case water gets out of there but completely curbless you can walk right in you can put glass panes in front of the shower area, which always look really nice. You can add those incognito grab bars or stylish grab bars. Having a handheld shower. Usually the handheld showers come with a rain head shower as well. So you can make that remodeled shower area book really nice. The other thing you can do is add a wall mounted sink. That way there's about 27 inches of knee clearance. Let's say you wanted to sit down and do some of your self care activities while you're sitting at the sink. Again, they also come in a lot of different stylish designs. And then the last one would be probably upgrading the toilet to something that's anywhere from 17 to 19 inches high.
Daniel Elliot10:00
I personally think 19 inches is a little tall, but 17 inches should be just right. And they even make now what's called personal hygiene toilets that have been a features in them as well. Wash and dry features and, and all those other things. And the last thing is with the entryway, pocket doors or barn doors look absolutely beautiful. And you can also widen the doorway to anywhere from 32 to 36 inches. And then lastly, having automated lighting so that when you walk right into that bathroom, the lights turn on, or walk right over to the shower area, the lights turn on as well. And one thing I forgot about the shower area is since you're remodeling, you can actually put blocking in behind the wall when you go to tile. And that blocking can hold a folding shower bench. So they come in like teak and all different types of designs, they can fold down, or they can fold up when you're ready to use them. That's sort of like how my brain would work. If someone was like, let's remodel my bathroom and make it totally safe. One more thing I would recommend is some of the tile that they make is prone to being slippery. But in the shower area, use something called mosaic tile or tic tac tile, which is smaller, you're going to get more surface area and less chance of slipping as opposed to like a large tile that can be really slippery.
Katherine Cocks11:16
The things that you're saying, I'm imagining in my head, I'm not much of a designer type person. But it sounds to me like it would do nothing to bring down the value of your home and looking like a hospital. But it would actually bring up the value of your home because it's safe for anyone to use. But it's also very stylish. Yeah, absolutely. So that's something that we really focus on too. We work with a lot of people who've been living in their home for 10, 20, 30, 40 years, and they really have a connection to that and like the memories that they've made there. So we want to make sure that whatever changes they're making, they're proud of it. And another thing I'll say is, even though I went over all these different changes that would go on in the bathroom, those are all functional and safety designs, the person who's remodeling their bathroom can still pick out their tile, they can pick out the, you know, types of fixtures and the shower head and everything like that. So they can still have a lot of choice over how they want it to look.
Daniel Elliot12:12
When you look at the other issue that I see to be a problem is doorways. And no matter what we try to get the smaller Walker, the smallest wheelchair, sometimes it's just hard getting through doorways. How do you approach that type of challenge?
Katherine Cocks12:27
Yeah, so when a clinician goes in and identifies that somebody doorways too narrow, it's usually because they're using a certain type of wheelchair or just like you said, Cathy, their Walker is too wide. This is where the clinical piece and the home improvement piece really mesh well together. And it's something that as a clinician, we have to make sure that we are within our scope of practice for making the recommendation. But the contractor is also there to make sure that the doorway can actually be widened. So depending on what's outside of that doorframe, will determine if the doorway can be widened or not. Normally, if there's space next to the doorway, or there's wall space, you can open up the doorway, you can let's say there's or a saddle up between the doorway, you can have that lowered as well. And you can play around with what kind of actual door you want as well, whether you want to do a pocket door, a barn door, or a sliding accordion door. But one of the things to consider is wires or plumbing or things like that are in the wall next to that door. And that's where the contractor comes in and, and how we work with them to make sure that these functional changes can happen.
Katherine Cocks13:36
Because I would imagine that doorways can be a little more of a complicated piece because holding beam or different things in that doorway or pipes that can make it a challenge. When somebody really is determined to age in place, what are some of the most complicated type of home modifications that you would do,
Daniel Elliot13:57
the people that I've worked with and that we've worked with that are the most complicated, or where we put the most effort into is, you know, those unfortunate situations where somebody has gone from maybe completely independent to now requiring maximum assistance. Because really no changes have been made to the house, maybe they have eight steps to enter the home and the bathroom is small and absolutely nothing is set up for them. So now we're looking at all of these different areas at one time, based on this person's changing condition and trying to address all of them and manage that whether we're talking to people techs that are responsible for the track systems in the ceiling, or for a vertical platform lift that requires a specific stair lift tech or platform lift tech to do. And then you have your installers and general contractors to do some of the other interior work as well. But if something like that occurs, find the right people, which you know, we've worked with all of those types of people and you break it up into different projects based on making sure that that person can not only access their home, entering and exiting, but also function as well.
Katherine Cocks15:03
I've kind of asked a lot of questions on what I've seen. And I've definitely learned a lot from you. So was there anything else as far as like home remodel that I didn't cover that you thought was really important? I think I would say at jukebox health, would we really focus on some of those common sense home modifications, they're really simple things that are going to make a big difference in safety. So I'll give you an example of a really common project that we might do is we get people calling us because mom or dad is falling at night in the bed, and the bedroom actually happens to be one of the most common areas falls occur. A really common home modification project that we would do is adding a bed rail, adding motion sensor lighting between the bedroom and the bathroom, lowering the door saddle between the hallway and the bathroom, making sure the lighting is good in the bathroom and some grab bars. And that's a rather inexpensive project to do. But it's going to certainly reduce their risk for falls. And just to add to that there's been some really amazing research out of Johns Hopkins and USC on home modification studies, they found a 50% reduction in falls improvement in up to seven different activities of daily living, and even a 15% readmission reduction rate to hospital. So it's amazing to see all the research out there around home modifications and to be able to put it into practice.
Katherine Cocks16:27
When you talk about bedrooms. The main ones I've seen are like some new slide under the mattress, is that the one you're talking about? Or is there some type of something you're building with a bedroom?
Daniel Elliot16:36
Yeah, so bedrooms, they come in half length or quarter length, so the person can still you know, bring their feet over the edge of the bed. And then there's full length as well. If the person is ambulatory or walking to the to the bathroom at night, or even just getting out of bed, and walking wherever they need to go, typically will recommend a quarter length bedroom.
Katherine Cocks16:56
This has been so informative to me. I know you said you're with jukebox. But go ahead and give us your the company of how people can contact you. If they're interested in getting an evaluation from you. I know you say you sort of do a free home assessment, see what they need, see what you guys can help with. So tell us about all of that. And then we'll close up the show.
Katherine Cocks17:16
Yeah, absolutely. So jukebox health connects clinicians and health care with home improvement. We make those common sense changes in the home. They're driven and clinician LED. And what happens is the family is going to get a report of all the different options and solutions that they can make to their home. All the labor and materials pricing is included. And jukebox will fulfill those products and also schedule the contractor. So we're really a full service company that can take you know families a to z in terms of solving some problems in their home. And you can find us at www dot jukebox health.com You can also email me at Daniel@jukeboxhealth.com We have a LinkedIn page and a Facebook page.
Katherine Cocks18:02
I've been doing this 10 years but I definitely learned some new things that I'm really excited about and I really appreciate you being here.
Katherine Cocks18:10
I hope you have enjoyed this podcast. If you have found it helpful, then share it. If you wish to contact me for consulting services you can reach me at www.kathysconsulting.com. Remember, our content is meant for informational purposes only, and not to replace the advice of healthcare professionals.