Aging in Place

Don Fenn was sitting in his Toronto office in 2003 when he received a phone call from the police in London, Ont.

“Does anyone you know drive a white Chevrolet convertible?” the constable asked. Fenn immediately recognized it as his mother’s car, and the officer continued. “We found it in the middle of an intersection between Oxford and Waterloo, and we found your business card in the glovebox.”

The next few hours were a whirlwind. Fenn quickly called his dad in London to check in, and discovered that his mom, who was living with Alzheimer’s, had simply left to run some errands. She must have become confused at some point, and Fenn’s dad, who was her primary caregiver, eventually found her walking down a nearby street.

Later, Fenn and his family met with his mother’s medical team in London, and it was decided that Fenn’s mother needed to move into a care home.

 “It was a tough day for me, and for the rest of my family,” he says.

Being the closest to home out of his siblings, Fenn became the “designated driver” for his parents’ health care, which, in turn, kickstarted a new life mission for him. Fenn knew many people, including his parents and his friends’ parents, who wanted to stay in their homes as they aged but needed access to information and support in order to age in place safely.

In 2004, after decades spent working in media and marketing, Fenn founded the communications company Caregiver Omnimedia, which focuses on providing vital information about aging in place, in terms of home care and modifications for individuals and their caregivers.

“I knew very quickly that the biggest problem we had with family caregiving was information,” Fenn says. “That was why I wanted to form this company. I wanted to ramp up communication and move things forward.”

Fenn partners with occupational therapists (OTs) across the country to expand the reach in helping other family caregivers. OTs work one on one with people with mental or physical deficits and their caregivers to find solutions to barriers in their everyday lives. Through a consultation process, OTs, along with renovation contractors, go into homes and help make plans to modify a space for people who want to continue to live at home and are seeking accessibility.

Marnie Courage is a Winnipeg-based OT and CEO of Enabling Access Inc., and she says that aging in place involves melding safety, security and happiness for everyone in the home.

“Aging in place means a lot of different things to a lot of different people,” says Courage. “But it means having access to the health care and social support that you need to live safely and independently in your home or community for as long as you wish, or are able. This is both for the individual and the caregiver.”

In addition to Caregiver Omnimedia’s consultations and workshops, Fenn started a home modification council that is working to streamline the aging-in-place process for individuals and their caregivers. Currently, OTs, renovators and home builders are all hired individually, but they’re moving forward to formalize a process for families so everyone is on the same page for the individual’s needs. His vision is a “network across the country” to help family caregivers modify their homes in order to create safe and accessible spaces for their aging or disabled loved ones — and there are a lot of people looking for this help.

According to the Canadian Mortgage and Housing Corp., 85 per cent of aging baby boomers would prefer to age in place, even if there were changes to their health.

Margot Schulman has also been working to help family caregivers modify their homes through her interior design firm, Schulman Design. She started the Calgary business 22 years ago, after completing her degrees in interior design and gerontology. Even then, through her early work in care homes, she noticed that people were wanting to age in place, but the right spaces weren’t being built.

Schulman’s brother, Dave, sustained a catastrophic head injury after a bike accident when they were in their early teens, so she says she learned very early how building design affects accessibility.

“Watching how these homes were designed, I just saw Dave’s life shrinking,” she says. “I didn’t want his life to just be about the day-to-day, waiting for care. What I realized is that buildings have such an impact on how people feel, how they work and how they interact. I realized that the feeling of well-being and the feeling of being at home are non-negotiable for life.”

Schulman says people’s homes should reflect their values and personal histories, so that people living with dementia can have a sense of personal choice while still staying safe. The goal is to increase inclusivity in every building.

For example, Schulman recommends the simple remedy of removing cupboard doors or installing glass or metal mesh inserts in cabinets in the kitchen for those who love cooking and still have the capacity to help. It removes the question of where the mixing bowl is, and offers visual cues to keep the person engaged.

“We know that if someone is using their hands, then they’re using their brain,” Schulman says. “We want people to feel engaged in their day in a way that sparks joy.”

Of course, safety is a paramount concern for home modifications.

Fenn, Courage and Schulman all agree that safety is a main interest while working on home modification solutions — and it’s not without cause. A 2014 report from the Public Health Agency of Canada states that falls result in 85 per cent of injury-related hospitalizations for seniors, and more than one-third of seniors who are hospitalized for a fall are discharged to long-term care — almost double the amount who were living in that kind of care when they fell.

Simple changes, such as putting handrails on the wall of frequently used routes, can help to keep a loved one safe. More advanced modifications can include lights leading the way to the washroom, automated floor lights in the hallway or smart homes that set off an alarm if a door leading outside is opened.

With Enabling Access Inc., Courage has found that washrooms and front entrances are the two main places that need modifications. Many homes in Calgary have a few steps leading to the front door, so she has suggested including a second handrail or melding a ramp into the landscaping so that it’s both aesthetic and functional.

Additionally, grab bars, non-slip floors and wheelchair-accessible showers can be seamlessly incorporated into contemporary designs.

In a home where one person is caring for another with dementia, all three experts agree that, in addition to safety, compassion and empathy are essential for aging in place.

 “I think it’s the same for everyone,” says Courage. “Home is where the heart is. Our longer-term memories are often connected with the senses surrounded to the home: the smells, the sights, the feel and the sounds. We should all have that security of home.” [ ]

Home Modification Tips from the Experts: