About Brady

Brady is a student of MSc. Computer Science at Uppsala University, Sweden.

Designing for the Elderly in a Universal Design Context

Discussed here are methods of how a flat (or apartment) can be designed in order to accommodate an old person from an early stage to a late age (allowing for possible impairments).

Home design considerations for the elderly are generally specialist for that age group. Once an individual enters old-age it is commonplace that their home will require both an extensive and expensive refit for the owner to adapt to the weakening state of their body. Failing that, the other option is that they move to an apartment with the correct facilities (retirement community).

There are a number of factors to consider for the development of the body of an aging human being. The suggestions are split, room-by-room, into the main factors influencing the design:


Mobility and strength

  • Widespread
    • Wide doors
      • Width to allow access for conventional wheelchairs to enter.
      • Also allows access for individuals that can be classed as extremely obese.
    • Doors not carrying huge weight
      • Heavy doors may be harder to open at an older age, due to the physical body weakening.
    • No steps
      • Anyone is able to enter the apartment, no matter what possible impairment.
      • A level floor design makes every part of the apartment accessible.
    • Open plan
      • where it does not invade on privacy, making less obstacles to go through increases accessibility.
  • Entrance
    • Lift access to door of apartment for buildings more than one storey
      • As mobility decreases during aging, taking flights of stairs becomes increasingly difficult. If an individual weakens to the point of not being able to pick up their feet appropriately, then a lift will come in to greatly assist being able to enter and leave the apartment; similarly, should a person develop an impairment restricting use of their legs and a wheelchair is needed.
    • Sensor-activated entrance locks
      • For persons with diseases such as ALS or Parkinson’s, a sensor activated lock will save having to align a key into a small slot without total control of their arm movements.
  • Bedroom
    • Bedside table
      • Offers support for getting in and out of bed.
    • Storage and managing space
      • Not overcrowding the space within the room; enough room given to move around (consideration for walking frames and wheelchairs).
      • Closet storage being at mid-level, with easy pull-down rails to store items higher but to access at the same level.
  • Bathroom
    • Shower
      • A shower should be considered over installing a bath, as it is step-in step-out with no lifting of body weight required.
      • Basket for wash items hung at mid-height on the shower to avoid stretching to the floor and shifting balance.
  • Kitchen
    • Storage
      • Not overcrowding the space within the room; enough room given to move around (consideration for walking frames and wheelchairs).
      • Cupboard storage being at mid-level, with easy pull-down rails to store items higher but to access at the same level.
    • Appliances
      • Placing voids below the work surface instead of using it all for storage allows access for people in wheelchairs to cook and use the sink, other appliances situated on the work surface, e.g. toaster, kettle, coffee machine.
      • Switch for cooker hood extraction fan at mid-level.
      • Waste disposal unit. Less carrying out the trash, less heavy lifting and trip hazards.
  • Lounge
    • Furniture
      • Not overcrowding the space within the room; enough room given to move around (consideration for walking frames and wheelchairs).
      • Placing furniture within proximity to grab on to, to reduce risk of a dangerous fall at an elderly age.
    • Appliances
      • No trailing wires. No trip hazards.

Perception

  • Widespread
    • Large high-contrast door handles with locks at mid-height
      • Larger door handles at high contrast compared to the the finish of the door make the object clearly visible assists for reduced vision, a common impairment developed at old age.
  • Entrance
    • Making apartment numbers more visible
      • Larger, high-contrast number signs to the apartment can assist visibility.
      • Braille signs accompanying the number sign.
    • Sensor-activated entrance locks
      • No issues with finding keys.
      • No issues with aligning the key into a small slot.
    • Large prickled entrance mat
      • If house customs are that shoes are to be taken off before the rest of the house is accessed, having a distinct entrance zone which gives sensory feedback is the most indicative of separating these areas.
  • Bedroom
    • Contrast furniture with floor
      • Using a high difference in color contrast from the floor surface presents objects more readily in the room. This can be especially useful to people with yellowing vision, cataracts, glaucoma.
  • Bathroom
    • High contrast toilet seat
      • Using a high contrast toilet seat from the rest of the toilet and floor surface makes finding the toilet seat a great deal easier even with deteriorating eyesight.
    • High contrast shower step
      • Using a high contrast step from the rest of the shower and floor surface reduces the amount of falls it can produce substantially by becoming more visible.
    • LEDs with a temperature sensor in the wash basin tap changing the color of the water whether it be hot or cold. Could avoid scalding if the person has nerve damage.
  • Kitchen
    • High contrast sideboard
      • Using contrasting appliances and kitchen utensils to be easy seen when placed upon work board.
      • Could be made digital, creating augmented border around items.
    • Different grips
      • By using different textures on utensil grips, it is easier to recognize whether the person has indeed picked up the correct utensil.
    • Backlit oven
      • Clearly see how the state of the food being cooked.
    • Transparent toaster
      • Make sure the toast isn’t burnt.
    • Kitchen sink
      • LEDs with a temperature sensor in the tap changing the perceived color of the water.
  • Lounge
    • Speakers placed near the seating
      • With gradual hearing loss there is a tendency for the elderly to have the television or radio on excessively loud so they can hear what is on. Speakers placed near the seating reduce the noise level requirement for the seated to hear.

Cognition

  • Widespread
    • Recognizable objects
      • Objects that are hidden or are disguised as part of something else can create confusion upon memory loss. It is better to keep something simple and recognizable.
  • Entrance
    • Self-locking door
      • Door is locked from the outside, but can be opened from the inside.
      • Alarm if the door is left open for a long amount of time. Useful with memory loss.
    • Video intercom
      • Shows who is outside the door on the buzzer being pressed.
      • Safety conscious as the elderly are more at risk of fraud and doorstep burglary.
  • Bedroom
    • Window blinds on a timer
      • Using window blinds on a timer can help against confusion of the current time, particularly useful in parts of the world with midnight sun.
      • Helps maintain healthy daily rhythm.
  • Bathroom
    • Self-flushing toilet
      • Flushes on the user getting up. Keeps toilet hygienic if the user forgets to flush.
    • Water-level sensing bath and wash basin
      • If a bath or wash basin is closing to be over the limits of its capacity, the water stops. The person could be preoccupied with something else or simply have forgotten.
    • Electrical sockets do not provide power if water is being used or can be measured to be in use from the basin/bath
      • This is safety conscious planning and will stop disaster from happening if there is some cognitive lapse disassociating the relationship of electricity and water.
  • Kitchen
    • Oven turns off after an hour of non-interaction
      • Light turns off in cooker. Alarm indicates cooker has gone off.
      • This is to avoid fires by slip of memory or other cognitive issues.
    • Water-level sensing sink
      • If the sink is closing to be over the limits of its capacity, the water stops. Saves flooding the kitchen if the resident moves on to focus on other things and forgets about it.
  • Lounge
    • Reducing the amount of remote controls.
      • Less remotes, less things to learn and remember.
    • Doorbell notification on the television
      • If the doorbell rings the TV indicates someone is at the door. It could even display the video intercom feed.
      • Tries to indicate the experience of watching the TV show as separate from something that needs to be dealt with in the real world, i.e. “the door bell sound is not part of the television programming”.

Listed here has been an attempt to introduce universal design of an apartment, which is supportive  to the resident throughout aging and developing potential impairments.

As a person ages it is common to deny the weakening state of the body; a home with the features described here would provide the confidence to show that the person’s life as they know it is still accessible and does not necessarily need to have drastic changes to adapt to their aged or impaired state.

The suggestions and reasonings put forward have been thought-out to give as little stigmatization as possible whilst providing support in areas of difficulty found in a standard flat built today; all of the ideas were considered with an aesthetic design basis in mind. There is ample room to improve apartment facilities without making the residence look institutional, but instead making them perfectly modern and conventional.


Recommended reading:

Stigmatisation regarding loss of hearing

Having a disability such as loss of hearing introduces a significant amount of stigmatisation. Those having a hearing impairment in many cases encounter acute emotional and physical disorders without use of an aid. Those with an aid are often then stigmatised for having a visible indicator announcing that they carry this impairment.

Especially amongst the old, there is a trend of viewing that having a loss in hearing is a social disgrace. Many fear the stigmas having this disability, and may decide not to wear their hearing aid. Others may simply not purchase one at all. Fearing stigma may result in denial of any hearing issues.

A 2010 study looked into the constituent pieces that fuel the stigma behind loss of hearing (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2904535/). The findings were three major contributing factors:

  • altered states of self-perception
  • ageism
  • vanity

that is to say, the perception of self-image, negativity aimed towards older people, and perception of one’s appearance are all contributing factors transformed by elements of society and the media.

Changing a person’s perceived self-image can be difficult. Alterations, such as developing a loss of hearing may be hard to accept. Some in the study did not want to admit their disability, or that their body was in decline, and faked having correct hearing.

“I don’t think I wanted to admit I really had a problem…and feeling dependent on hearing aids. And also, embarrassment, because it would make me less of a man.” [quote from the study]

Hearing aids, as reported in the study, additionally were said that they represented aging. This was declared by both persons with the hearing loss, and persons without. One went as far to say they felt their authority diminish when seen with one.

“I think people see a cane or a hearing aid or a walker or gray hair . . . anything that’s a statement of aging and weakening as strongly negative.” [quote from study]

Society and the world of marketing remains very youth focussed, for example it is considered beautiful to look younger. From this standpoint, aging and negativity go hand in hand; not wanting to look old is seen as natural. Persons in the study would often keep the conversation short in order to reduce the stigma of using an aid.

Further to imagery in society, there were grave vanity concerns expressed by the participants of the study. Wearing a hearing aid was seen as an unattractive. It would often be removed or, at the very least, hid under hair to avoid drawing attention to it.

“Yeah, I don’t like the idea of popping hearing aids into my ears and going out into the world. I’ll feel like everybody’s staring at me [saying] ‘Acck…look at him, look at him! See he’s gotta wear hearing aids and I don’t! Ha ha ha!” [quote from study]

If a stigma is so large that people actively go out of their way to not use their assistive equipment, then the problem is something that desperately needs to be tackled. A perception of hearing aids having this stigma greatly influences the acceptance of the disability, the decision to get hearing tested, purchasing hearing aids, and using them.

The selling-strategies employed in advertisements and marketing for hearing aids reinforces fears. The main point being sold in regard to hearing aids are how small they are or how invisible they seem. This supports the perception shown by people in the study that hearing aids are unsightly, increasing the stigma on larger aids that are easier to notice. While providing a solution that may make some people fearing stigma with hearing loss purchase a hearing aid due to the hidden qualities of it reducing the stigmas of having one, it does not help remove the stigma that fuels the purchase.

Overcoming the stigma related to loss of hearing and having to wear a hearing aid is not straightforward. Ideas in the study from participants included less negative coverage in entertainment, for actors to have visible hearing aids and not to find it a hinderance or be stigmatised for wearing one. For entertainment media not to show the people with hearing aids as old, or a difficulty for the other characters to deal with would be an initial step away from hearing loss carrying a stigma and broaden the normality bracket.

It is essential to change the feeling of negativity about hearing aids to one which is of awareness and not seen to attribute shame or branding on the individual wearing it. The ability to communicate and involve oneself as one ages is of benefit to everyone. Forgoing this in fear of the stigma of having one should not enter one’s mind as a consideration.

Research into the use of hearing aids consistently reports advantages for mental-health, emotional and physical states for persons with loss of hearing.*

Marketing hearing aids on the premise of them not being seen, rather than the worldly benefits of being able to hear properly takes the stigma to absurd levels. An individual with hearing loss should not have to worry about labels being placed on them on wearing a hearing aid, however this is how the current situation presents itself.

* http://deafness.about.com/b/2011/09/05/get-a-hearing-aid-save-your-brain.htm

“I know how to do it”

Taking from the Disability, the Truth television programme, a recurring topic was that of misconception about people with impairments.

“I know how to do it” makes reference to Curtis Palmer, a young man who requires the aid of a wheelchair in his everyday pursuits. In his words, he aims to convey a common situation that arises where able-bodied people offer to help him enter and exit his car; Curtis is fully able to do this himself.

“One thing that I think people need to learn is that when I’m getting out of my car, if I’m at the supermarket or something like that, I don’t need any help, it’s cool, I got it.”

Curtis is highlighting a habitual response from people upon seeing him with his impairment in a position he is more than capable handling. There is a prevalent misunderstanding that he, and other persons having a disability, needs assistance at all times of the day.

Countering this instinctive and misguided view of a righteous response to assist a person with a disability on first-sight is an issue requires resolution. The problem is experienced on a regular basis.

Curtis is not alone, throughout the course of the video other people with disabilities discuss their realities with handling misconceptions.

Joanna Dominick is a person in Disability, the Truth who also comes across with issues of people actively speaking to her with pity, which is another preconception able-bodied persons often have toward the disabled. Joanna is perfectly content with what she does in life and as she explains in the video:

“I was in the supermarket the other day and this lady came up to me and said, ‘Wow look at you, all by yourself and doing your grocery shopping’ and I wanted to say to her ‘Yes, I am 28’”.

There is a clear lack of understanding from the general public about the lives lived by disabled persons. It has thus become a necessity to instill the impacts disability has – especially in regard to disability being seen as something that debilitates every aspect in the life of an individual, which is false in its purest form.


A possible approach to addressing this issue is introducing a system in which to educate people on how to properly handle situations involving persons with disabilities.

This could be a government scheme within companies and schools, employing visiting mandatory workshops on correct etiquette and situational responses with disabled people. Through the adoption of such methods, we remove exposure of persons with disabilities to minimal levels; in essence, it does not require extensive advertisement nor the role of a spokesperson.

However, this does not change social attitudes.

If some set schema was introduced for widespread public notice, i.e. the medium of television, it would be better ingrained in the mind of the general populous. No spokesperson would be necessarily required, as an example, computer-generated anthropomorphised characters enact the  issues to be enlightened on their behalf.

Despite the lack of a spokesperson, this approach can produce an exhibited status for persons with a disability and may garner unwanted attention towards the disabled community. Exposed status may provide a platform for scrutiny and further stigmatization. Utilising a medium such as CG-characters serves to reduce placing the disabled in the spotlight, however this also comes with its own issue. Providing indirection between the recipients of the message and those that it refers to introduces a disconnect. This disconnection principle, which can be used to great effect in creating an emotive association with the audience, carries the possibility of removing subject-relation with the intent of the imagery. That is, non-relation to concerned party, the disabled community.


There are multiple ways of tackling the issue of misconceptions on people with impairments, but it is irrefutably a problem that needs to be addressed. It produces unease amongst both the disabled and able-bodied. Occasions are distinctly possible to occur whereby a disabled person has refused to receive assistance, which has offended the helping party (out of thinking they were only doing good). A situation such as this is likely not a rare occurrence, and, aside from opinions on arrogance, may provoke a resentful feeling in the person trying to help such that they begin to care less about disabled persons in general.

Education is the greatest tool in overcoming apparent misconceptions on disability.

In a global society that is increasingly in favour of equality, measures must be taken to explicate the correct manner in which to act correctly respecting people with disability. Not all attempts will be successful – as such task does not happen overnight; however, given time, public understanding will improve.