After the Fall

During a family vacation this summer, my 88-year-old mother stumbled and fell as she walked between two houses we had rented. No one saw the fall—she shouldn’t have been walking unaccompanied, but try telling her that. A neighbor who happened to be leaving for work helped her up and brought her to the door. We called an ambulance and got her into a reclining chair, which seemed to help with her pain while we waited.

To our relief, an X-ray at the ER revealed she had not broken any bones, but she had strained and bruised the muscles in her lower back. We left with instructions to administer Tylenol (1,000 mg three times per day), and to apply ice, 20 minutes on and 20 minutes off, for the next 48 hours, then switch to heat. Fortunately, our vacation spot was close to our mother’s home, so we spent the next few days and nights there while trying to make arrangements for her rehabilitation.

Obstacle Course

During that time, it quickly became clear just how poorly prepared my mother’s home is to accommodate someone with her type of injury. As with most homes, many of the obstacles are in the bathroom. To begin with, it’s too small (less than 5 by 8 with a hall closet taken out of one corner), and someone in a wheelchair couldn’t even get through the door. The poorly arranged fixtures allow no room to maneuver with a walker—something my mother now uses as part of her rehab—and no space for a caregiver to provide assistance. 

Getting into the tub requires standing on one foot while lifting the other 15 inches or more to clear the edge of the tub, then shifting your weight to the floor of the tub, which may not have a nonslip surface or mat, and repeating the action with the other foot. That’s easy for most healthy people, but to the very young, the very old, and the injured of any age, it can be painful and difficult—an accident waiting to happen. Getting out is even more dangerous because you’re wet and the tub and the bathroom floor may be slippery.

While watching my mother during a dry run demonstration of how she gets into the tub, I was horrified to discover that she steadied herself by grabbing the two least-stable objects in the room: the sliding shower door and a metal towel bar of the kind that is attached by a concealed bracket and a tiny set screw. How could we not have thought about this during the 15 years she has lived alone? (I immediately purchased and installed a suction grab bar. It works remarkably well and is a good solution when traveling.)

Getting on and off the toilet is another ordeal for someone with a lower-back injury. And the bathroom is just the start. Why do we put the laundry in the basement when the bedrooms are on the first or second floors? Why does entry to most homes require navigating stairs with wobbly guardrails on tenuous surface mounts? (Any stair is impossible to navigate alone for someone using a walker.) The list goes on and on.

My mother’s age is a contributing factor, but not the determinant one; anyone at any age with a similar injury would have encountered the same challenges my mother faced. For me, her experience reemphasized the importance of designing homes and home remodels in a way that anticipates the needs of occupants whose physical capabilities may change, whether due to age or illness or injury. 

This dictum answers to many names—aging in place, universal design, living in place, design for life—but whatever you call it, the concept is nothing new to most remodelers. But it’s easy to push it into the background when a client’s budget, aesthetic sensibility, or reluctance to acknowledge the need gets in the way. 

I hope this story about my mother’s fall is a wake-up call. If you don’t know about universal design, learn; if you do, learn to implement it before someone falls. After the fall is too late.