A number of design standards from assisted living facilities that can be adapted for the home include the following:

Floors
Falling is the number one cause for older individuals to be hospitalized and eventually moved to a rehabilitation center or assisted living residence. Carpet with a tight, firm weave and thinner carpet pads reduce the possibility of falling. Never, under any circumstances, use throw rugs. For large area rugs, remove any side fringe. The less floor surface changes, the less chance of a fall.

Stairs
All living spaces should be on one floor including laundry room, bathroom, and bedroom. Climbing and descending steps is difficult for strength, balance, and depth perception. If steps are required, whether the number of steps is two or ten, install handrails on both sides of the stairwell.

Doors
Door thresholds should be flat. Raised thresholds are a tripping hazard and an obstacle for walkers and canes. A raised threshold also makes every room inaccessible for wheelchairs.

Storage / Shelving
For general storage, remove all high shelves and keep items at eye-level or lower. This includes pantries, linen closets, and cabinets. Keep in mind, reaching also causes falling.

Hardware
For “graspability” purposes, change all door, cabinet, and faucet hardware from knobs to levers. This will give the individual a better grip when trying to turn on or off the faucets or open and close the doors.

Bathrooms
Many falls occur in the bathroom and for that reason it is one of the most dangerous rooms in a home. By installing handrails by the bathtub, toilet, and sink the risk of accidents are greatly reduced. Towel racks, if grabbed for support, will come loose or detach from the wall, so it is advised that they be removed. Use the handrails instead. The largest hazard is the tub, as most individuals fall forward getting into it. While most homes feature some sort of tub, maybe even an oversized soaking tub, consider installing a stand up shower instead—and remember to include a seat in the shower. If a shower is not possible, secure the tub with a sufficient number of handrails.

Kitchen
If the stove controls are behind the range, replace with a model where the controls are to the front and need to be pushed in to turn. Place the microwave on a counter, not up on a shelf. Again, reaching causes falls, and removing hot plates or bowls from an elevated position could cause hazardous spills and potential burns as well.

Windows
Windows—particularly those where reaching is required—can be difficult to push up and pull down. Casement windows, or those with a crank, are easier to open and close because of the “graspability.”

Creature Comforts
A must for older individuals: a phone in every room of the house. Or ensure the individual has a mobile phone on them at all times. Phones are a lifeline for help and a phone in each room—or on their person—reduces the chance of falling when rushing to pick up. Programmable thermostats also add to the comfort of the home. For those who like to change the temperature frequently, find a program that is easily understood or one that you can adjust remotely. In addition, ceiling fans should have long chains or be turned on and off with a wall-mounted control.

Furniture
Furniture can make a big difference in the comfort of a home—it can also be potentially unsafe. Make sure chairs have arms, and that those arms are hard-surfaced or have foam padding for ease in getting in and out. Skip a tie-on chair pad, which can slip and cause a fall. Also, consider getting rid of the coffee table and ottoman—which turn into obstacles —in favor of smaller end tables.

Brian G. Minnich, AIA, LEED AP, is a Project Manager and Architect, Rubeling & Associates, of one of the mid-Atlantic’s leading architecture and interior design firms. With over 30 years in business, Rubeling & Associates specializes in assisted living and healthcare as well as education, religious, corporate office, campus spatial master planning, and local government projects. For more information, or to contact the author, please visit Rubeling.com or email This e-mail address is being protected from spambots. You need JavaScript enabled to view it. .