Home modifications to make older lives easier.

Abstract

PHYSICIANS ARE TRAINED IN MEDIcine, but should they also learn interior design? In some ways, yes, say medical and other experts who believe home modification can reduce injuries and improve lifestyle for older patients, those aged 65 and up. While home improvement advocates do not mean physicians should become architects, they do say making suggestions to patients to modify their homes can improve their lives. Fairly simple changes may in some cases enable an elderly man or woman to keep living among friends and neighbors rather than have to move to an “assisted living” residence. “If the environment isn’t appropriate, injuries can occur that lead to major disability,” said Ronald Adelman, MD, codirector (with Mark Lachs, MD) of the Division of Geriatrics and Gerontology at Weill Cornell Medical College in New York City. “But we don’t teach physicians about these different areas regarding functioning and living well.” Cornell is acquainting physicians with home safety through Project GEM (gerontologic environmental modification), which its creators say is the only hospital-based program of its kind. Project GEM is headed by Rosemary Bakker, MS, a former interior designer who became aware of the problems facing many older adults through her mother’s experience with a hip fracture. Bakker is the author of Elderdesign: Designing and Furnishing a Home for Your Later Years (New York: Penguin Books; 1997). “I’m doing research, education, training, speaking, writing, and working with a broad range of organizations and individuals,” Bakker said in an interview. “We go to apartments and perform home assessments and see how to keep someone in their home for as long as possible through design.” When she conducts a home assessment, Bakker checks a variety of elements in the house or apartment to see if they need modification. For example, in the section on flooring, her checklist asks if there are wires across walking paths or under carpets; if area rugs are taped to the floor; and if the flooring is free from rips and holes. Once the assessment is complete, Bakker looks for resources to make the proper changes. “For example,” she asked, “did you know that there are low-cost or nocost services available in some places for income-eligible adults? There are agencies, particularly one called MetroPair, sponsored by the Metropolitan New York Coordinating Council on Jewish Poverty, that will install grab bars for free in your bathroom. MetroPair will do minor repairs, install dead-bolt locks, and put up window gates, where possible. It’s funded in part by the Department for the Aging of the City of New York.” She suggested that people might seek out—or perhaps set up—similar agencies in other parts of the country. Adelman said Cornell Medical College has begun to train medical students, residents, and postgraduate physicians to understand age-appropriate design in homes, hospitals, and longterm care environments.