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Universal Design Newsletter Housing Issue - Volume 14. No. 1 - Final Issue : Page 1

Universal Design News Volume 14, No. 1 January 2014 Final Issue A quarterly newsletter update from UniversalDesign.com Housing Issue Lighting: Not a UD Afterthought BY JENNIFER ECKEL Often when we think of Universal Design we envision no-step entrances, wide doorways and maneuvering space to make the home accessible for those using mobility devices. But for a comfortable and safe home environment, lighting is just as crucial. Good lighting supports our daily tasks and safe movement throughout the home. Visit us online at: www.UniversalDesign.com Contents 1 CAPABLE Empowers Aging in Place 1 Lighting: Not a UD Afterthought 2 Farewell from Universal Design News 5 Universal Design at Design & Construction Week 6 Circling Back with the Design Team Reg/Leg Watch ..............3 World Update.................7 New Products ................9 New Media ..................10 Aha! Moments.............. 11 Design Tip.................... 11 Calendar.......................12 Use a combination of overhead lights and step lights to reduce shadows on the floor. Photo Credit: Universal Design Tips: Lessons Learned from Two UD Homes Lori Powell, of Fogg Lighting, recommends a combination of natural, ambient and task lighting, referred to in the industry as “layering” light. Natural lighting can be provided by windows and skylights. Window treatments like shades and curtains can help to adjust the light and reduce glare. Ambient lighting provides overall illumination in a space, and it is often achieved with ceiling or wall-mounted fixtures and recessed or track lights. Task lighting is a more focused light that supports specific tasks, such as reading, grooming and cooking. Task lighting is often provided by recessed and track lighting, undercabinet lighting and portable floor and desk lamps. Before deciding on fixtures, take the time to look at how the space will be used and select appropriate solutions. Before the electrician arrives, the lighting plan should be in place to ensure that the fixtures installed will provide the type of lighting needed. See Lighting: Not a UD Afterthought, page 8 CAPABLE Empowers Aging in Place BY LINDSEY SCHERLOUM “I’m dying in this house!” one participant of the CAPABLE study (Community Aging in Place, Advancing Better Living for Elders) tells Jill Roth, her nurse, during a home visit. For many older adults aging in place is the dream, remaining in the community they know and in the house they have filled with a lifetime of memories. However, like almost 40% of older adults still living in their communities, she is experiencing disabilities that make normal activities of daily living extremely difficult. Since this woman, like all the participants in the CAPABLE study, lives in poverty, her home environment is just as disabling as her medical conditions. She has major electrical problems and a cockroach infestation, and the building adjacent to hers is abandoned. “Low income folks work hard all their lives and then when they are older adults they are suffering, and the gap between what their income provides and their environment needs is big,” says Sarah Szanton PhD, CRNP, the creator of the CAPABLE study, at the Johns Hopkins University School of Nursing. See CAPABLE Empowers Aging in Place, page 4

Lighting: Not a UD Afterthought

Jennifer Eckel

Often when we think of Universal Design we envision no-step entrances, wide doorways and maneuvering space to make the home accessible for those using mobility devices. But for a comfortable and safe home environment, lighting is just as crucial. Good lighting supports our daily tasks and safe movement throughout the home.
Lori Powell, of Fogg Lighting, recommends a combination of natural, ambient and task lighting, referred to in the industry as “layering” light. Natural lighting can be provided by windows and skylights. Window treatments like shades and curtains can help to adjust the light and reduce glare. Ambient lighting provides overall illumination in a space, and it is often achieved with ceiling or wall-mounted fixtures and recessed or track lights. Task lighting is a more focused light that supports specific tasks, such as reading, grooming and cooking. Task lighting is often provided by recessed and track lighting, undercabinet lighting and portable floor and desk lamps. Before deciding on fixtures, take the time to look at how the space will be used and select appropriate solutions. Before the electrician arrives, the lighting plan should be in place to ensure that the fixtures installed will provide the type of lighting needed.
As we age our eyes need more light; the average 60-year-old needs three times more light to read than the average 20-year-old. Indoors, bulbs with more lumens (higher light output) can be used to increase available light. More fixtures can be added as well, especially task lighting like floor and desk lamps with adjustable heads that focus light where needed. In the bathroom, providing two light fixtures along both sides of the mirror at eye level casts fewer shadows on the face than one overhead light, which can make grooming easier.
It is also important to increase ambient lighting in order to keep lighting levels consistent from one space to the next. Powell has found that, “People tend to try to solve the problem [of insufficient light] by using single, brighter fixtures causing hot spots and glare.” Hot spots act like spotlights, creating high contrast between light and dark areas. In order to respond to this contrast the eye has to make quick adjustments, making it harder to see.
Hotspots and shadows should be eliminated from floors and pathways. Dark shadows on floors can be interpreted by the mind as changes in level, which can lead to falls. The National Institutes of Health cautions seniors that six of 10 falls happen at home. Homeowners can reduce their risk of falls by eliminating deep shadows, lighting exterior and interior walkways, lighting all steps, stairs and level changes and reducing sharp transitions between light and dark areas.
“Exterior lighting in particular is often misunderstood. Many people think by putting a brighter bulb in their exterior fixture they are creating better light, but in fact what they are doing is creating a larger contrast between the dark night and the light,” explains Powell. “When lighting the exterior, several lower lumen output fixtures serve us better, making it easier for our eyes to adjust from dark to the light. Landscape path lights that just focus light down close to the ground can be a great solution.” Motion and light sensors can be used to automatically turn on exterior lights.
Interior nightlights can also be used to light the path from the bedroom to bathroom. Nightlights should give off a lower level light, or use dimmers, so that eyes can easily adjust to the light. Motion sensors can be used to automatically turn on nightlights when you get out of bed. As seen in Universal Design Tips, (see box at left) an LED strip can be placed along the baseboards of a hallway to light the way at night.
Glare from light fixtures and shiny surfaces can also hinder vision. Ambient lighting fixtures should include translucent shades to prevent direct view of bright bulbs. Likewise, cans for recessed lighting can be made deeper and undercabinet lighting can include a shield to block direct view of the light source. To reduce glare, non-shiny materials should be chosen for floors, walls and kitchen and bathroom counters.
The lenses of our eyes yellow as we age, giving everything we see a slightly yellow cast and reducing our ability to distinguish certain colors. Choosing lighting that is cooler along the color spectrum can help to compensate.
The type and locations of outlets, controls and electrical panels should also be considered early in the design process. In Universal Design Tips, the authors specified that the electrical panels be located within accessible reach range. This means working with the electrician to avoid the usual small closet or basement corner scenario. Deborah Pierce, AIA and author of The Accessible Home, suggests locating switches and outlets at consistent heights around the home so that a person with low vision can easily locate them. Faceplate covers that contrast with the wall color can improve visibility, while backlit switches can easily be found in the dark.
The very best lighting plans will be those that allow residents and guests to complete tasks and move around in comfort and safety. Lighting design professionals can review building and renovation plans to provide the best match for the homeowner and the space. Including lighting professionals in the design process early enough, will allow them to maximize the plan without wrecking the budget.

Read the full article at http://www.bluetoad.com/article/Lighting%3A+Not+a+UD+Afterthought/1601716/190821/article.html.

CAPABLE Empowers Aging In Place

Lindsey Scherloum

"I'm dying in this house!” one participant of the CAPABLE study (Community Aging in Place, Advancing Better Living for Elders) tells Jill Roth, her nurse, during a home visit. For many older adults aging in place is the dream, remaining in the community they know and in the house they have filled with a lifetime of memories. However, like almost 40% of older adults still living in their communities, she is experiencing disabilities that make normal activities of daily living extremely difficult. Since this woman, like all the participants in the CAPABLE study, lives in poverty, her home environment is just as disabling as her medical conditions. She has major electrical problems and a cockroach infestation, and the building adjacent to hers is abandoned. “Low income folks work hard all their lives and then when they are older adults they are suffering, and the gap between what their income provides and their environment needs is big,” says Sarah Szanton PhD, CRNP, the creator of the CAPABLE study, at the Johns Hopkins University School of Nursing.
In 2009 Szanton launched the CAPABLE pilot, modeled after the successful Advancing Better Living for Elders (ABLE) study done by Dr. Laura Gitlin in Philadelphia. CAPABLE combines the strategies of occupational therapists, nurses and building contractors in order to investigate how strength building exercises, creative problem solving and simple home modifications can address the needs of low income older adults, improve their functioning at home and reduce the need for expensive hospitalization and nursing home care among this population.
“CAPABLE doesn’t have the funds to repair roofs or replumb a house,” Roth explains, but simple interventions, the addition of a handrail on a staircase, or adding chains to a ceiling fan, can go a really long way.
The results of the CAPABLE pilot, published in 2011 and based on a sample size of 40 participants in Baltimore, MD, found that an average of four home visits from a nurse, six home visits from an occupational therapist (OT) and $1285 in household repairs could improve a patient’s ability to safely age in place. If these interventions could extend someone’s stay at home by as little as two weeks, then the CAPABLE program would demonstrate a cost benefit over the average $6000-a-month Medicaid funded nursing home. The current iteration of the CAPABLE study, funded through a Robert Wood Johnson grant, a National Institutes of Health grant and a cooperative agreement from the Innovations office at the Center on Medicaid and Medicare Services, is trying to prove that publicly funding these types of services will not only increase people’s quality of life by allowing them to safely age in their homes, but will also save government and taxpayer money.
CAPABLE’s three pronged approach coordinates occupational therapists, nurses and safety/access home modifications to tackle problems from multiple angles. “I don’t know how many times I’ve wanted to put in a grab bar,” comments Ally Evelyn-Gustave, an occupational therapist who has worked for CAPABLE since the beginning. “There are programs designed to help with home improvement, but the services are not coordinated. We put the services together.” The program’s home modification services are provided by a contractor and AmeriCorps apprentice from the Baltimore organization CivicWorks.
In addition to coordinated services, the real innovation of the CAPABLE model is its patient driven approach. Unlike the standard medical model, where a nurse and OT identify problems and prescribe solutions, the CAPABLE nurse and OT observe and ask how the patient is functioning on a day to day basis. “We go in and say, ‘what do you want to do day to day, and what is interfering with that?’ We do a lot of coaching, but the whole program is what the patient wants,” Roth says.
“When you’re working with somebody in their home,” Evelyn-Gustave adds, “it’s a very intimate relationship. People tend to open up to you about things they probably wouldn’t share in an outpatient clinic. They get more comfortable. The way this study is designed, it’s an ideal job for an occupational therapist because we work on improving people’s function, but it’s the participant that tells me what they think their issues are.”
The patients are asked to determine three goals that they want to address with the CAPABLE team over the next four months. As Szanton pointed out in an interview aired on PBS, “a lot of times this particular age group feel like they’re told what to do, and they kind of accept that. But this allows the person to speak for themselves and to use their voice.” Some patients have practical goals like getting into their basement, while others have psychological goals like finding time for themselves.
One woman wanted to address her insomnia. The woman had been sleeping on her couch for years, because pain and low vision kept her from safely climbing the stairs to her bedroom. The team joined strategies to teach her simple strength-building exercises, encourage her to take Tylenol to reduce pain, and install railings up her stairs and grab bars in her bathroom. Through these small changes, she is now able to enjoy better quality sleep in her own bed. By starting with a patient goal and working collaboratively, the CAPABLE team can not only come up with creative and personalized solutions, but also train patients how to apply these problem solving techniques for themselves.
The CAPABLE model reinforces that people already have the best sense of their own goals, and it empowers them to reach these goals by searching for new ways to meet their needs. At one of her last visits, Evelyn-Gustave asked a patient what she took from the CAPABLE study. “She said, ‘You guys have taught me so many things that I never would have thought about.’ On my second to last visit, something came up in her life, doing the stairs in her church. It was exhausting her.” When they talked about different strategies to solve that problem, the woman said that she had already talked with the deacon board, and since they couldn’t install an elevator she started looking to other churches where steps would not be an issue. “Yesterday for our final visit,” Evelyn-Gustave says, “she had found a church that didn’t have steps.” It was a simple solution, but it represented a shift in attitude, an awareness that she deserved a situation that was easier to manage and the confidence that she could find a solution. “So when they start to generalize the strategies,” Evelyn-Gustave says, “that’s when I clap my hands and click my heels.”
Though the larger CAPABLE study is currently underway, Szanton and her team are already envisioning how their methods can be replicated nationwide, so that the combination of simple home modifications along with lifestyle and mindset changes can improve the quality of life for low-income older adults and empower them to safely age in place as long as possible.

Read the full article at http://www.bluetoad.com/article/CAPABLE+Empowers+Aging+In+Place/1601717/190821/article.html.

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