Home Assessment
Renee Vandenberg is a 59-year-old woman that lives in a two-story farmhouse with her husband and 3 children. She works as a bookkeeper, horseback riding instructor, and the head of a new company that produces health products for animals. In her free time, she enjoys riding horses, gardening, and spending time with her family. Over the years, she has had multiple injuries and diagnoses, including a fractured ankle, right rotator cuff repair, cataract surgery, COPD, atrial fibrillation, and most recently, a subluxated clavicle with nerve pain down the arm as the result from a car accident. Renee mentioned she currently has a little trouble with stairs and is concerned she will not be able to function safely in her home in its current state. She does not plan to use the upstairs or downstairs portion of her home.
The Home Safety Self-Assessment Tool (HSSAT), created by students from Buffalo University in New York, was used to evaluate Renee's home. The first item was to evaluate the entrance to her home and garage. There is a concrete pad in the garage and leading to her house, and then a set of stairs leading to the doorstep. My concern is that the concrete is cracked, which could pose a tripping hazard as she gets older and may need a walker. In addition, she has to go over about a 4-inch threshold to get inside her home. There is also no grab bar by the doorway should she lose her balance. Ideally, she wants to have the garage attached to the house with 8- inch steps with railings leading inside to avoid snow and ice. However, this would only happen if she and her husband can afford it. I researched the cost, which ranges anywhere from around $17,000 - $100,000. If this is unfeasible, I suggested building a ramp with railings from the house to the garage. This could be a low-cost option for her, as her husband does some building. I educated her and her husband on the ADA guidelines for ramp height, width, and placement of the railing. I also suggested that she consider fixing the concrete by either replacing it or raising it. After some research, I found that raising it is cheaper initially, but replacing it lasts longer and saves more money in the future.
On the exterior of her home, she also has a deck that stands about 20 inches from the ground, which lacks both steps and a railing. I encouraged her to build a set of stairs and a railing around the porch while she and her husband are able. In addition, there is also gardens surrounding the front and left side of the house. She eventually wants to build a raised garden so that she doesn't have to kneel while planting or weeding her garden.
The interior of Renee's home is open style with doors to the porch, bedroom, bathroom, and family room. The rooms are separated by Latin plaster walls and some dry walling. In her entryway, there are 2 6- inch thresholds, one leads to the kitchen and the other to the living room. There are 2 sets of stairs leading to the basement with no railings. In addition, coats and shoes line the left side of the stairs, which are potential safety hazards. She mentions that only her husband goes down the stairs when checking the furnace or water heater. Since there is limited space, I suggested a hanging shoe rack and installing a railing, which are both low-cost. Since the entryway is made of concrete, she wants to pour concrete in order to level her house.
Another issue is the presence of a front load washer and dryer in the entryway. Not only does it reduce space, but she has trouble using them as it increases stress on her neck and back. She eventually wants a top load washer and dryer to make this job easier. There is enough space near the entryway where she could put them side by side.
The living room has furniture lined around the walls with plenty of space in the middle. Chairs sit in front of a roll top desk in one corner, which is right next to the piano. A table sits in the other corner with a small television set above it. A hallway is in between the table and piano. The floor is wooden, which makes for a slip resistant surface. The large, bay window lets plenty of light in the house, and the light switch is in an accessible place. Most of the entrances to the other rooms are wide enough for a walker to fit through. The major issue I noted was that an antique cabinet with sharp corners partially obstructed the entrance to the entryway. Eventually, Renee wants to get rid of the television. I told her that when she does this, she could move the table and put the cabinet next to it. This would create more space to get around with an assistive device.
The kitchen was another area of concern. It has good lighting, and there are plenty of windows. However, in its current state, she has to reach down and up over her head into cabinets which could cause her to lose her balance. There is also a middle island that limits space to maneuver around, preventing easy access to the fridge, dishwasher, and oven. Once her children move out, she plans to get rid of the middle island altogether. She also wants to reorganize the kitchen so that the things she uses often is at midlevel. This would also mean getting rid of dishes. I suggested that she considered getting a step stool with handlebars and wide base in case she has to reach overhead.
The bathroom is relatively small, with a tall cabinet to the left and the counter to the right. It has a step over tub with a grab bar on the sill, which Renee says she has used to get in the shower and to use the toilet since she broke her ankle a few years ago. She also has a shower chair from this time. In the future, she wants to install either a walk-in shower or one with a door. I mentioned that a walk-in shower may be best if she wants to live here for the rest of her life, but one with a door would be a good option if she doesn't. For now, I suggested adding grab bars and a rubber bathmat inside the shower to reduce her fall risk. Other suggestions included an elevated toilet seat so that she could easily stand up from it.
Finally, the last area assessed was her and her husband's bedroom. This is a 10 x 12 space, featuring an open-faced closet with overhead cabinets, a queen-sized bed, and a 3 x 5 office space. Within 2 feet of the door, I noticed her dresser is to the left and the closet to the right and there is only 1 ½ feet of space between. There is too little room to rearrange anything, which is okay for now. However, once her children move out, she wants to move into the family room. This is about 1.5 times larger than her bedroom. She is currently reorganizing her things into a closet, which will eliminate some clutter. The closet is also large enough to fit her dresser, which would also increase floor space. I also noticed the edge of the carpet was curled up by the entrance. She stated that she wanted to take the carpeting out to expose the bare wood floor, which would eliminate a trip hazard.
Overall, Renee's home needs considerable renovations if she wishes to continue living here. She is aware of changes that should be made and has given lots of thought about her options. Many of the problems I noted do not need to be fixed now but should be corrected in the future. It helps that she has her children and husband to help her with shoveling snow, reaching the hard to get items, and other tasks. The changes to be made is to be determined by how long she plans to live here and her ability to take care of herself.