Guest Blog: Tub tips for aging in place

file000975936314Bathtubs are a mixed blessing for those of us who wish to age in place. From the time we’re young, soaking in soothing hot water is associated with relaxation, stress reduction and quiet contemplation. There’s nothing like a good soak at the end of the day, as my mother always said. But as our mobility decreases, and we become less and less steady on our feet, the traditional bathtub with its high sides and slippery surfaces may become less user friendly. In fact, it may even become down right dangerous! For those older adults who would like to continue to enjoy a bath even though it has become more challenging to do so, and for those who have been prescribed bathing as a recommended part of a therapy program, selecting a safe, cost-effective and aesthetically pleasing accessible bathtub can seem overwhelming. There are just so many choices. In this article we will look at some basic tips on how to choose the right bathtub for your long-term bathing needs.

First it is important to understand that bathtubs are generally more expensive to install than a shower, and any option that requires the use of a contractor will not be cheap. According to the website homeability.com, accessible tubs may be defined by: the door type (no door, inward, outward, upwards or sideways opening doors); the entry style (walk/step-in, slide-in, lift-in); and whether the user sits or lies down inside. Below are some options to help you to refine your search:

Option 1: A “walk-in” tub: Just as the name implies, a “walk-in” tub features a side opening that swings either inward or outward and the bather walks into the tub through a very small opening by stepping over a low threshold while the tub is empty. If you are steady on your feet, this tub type reduces the chances of falling as the low threshold eliminates the need to step over the raised tub side of the traditional 30” x 60” bathtub found in so many Canadian homes. To use the tub, the bather sits on a built-in seat, closes the door, and adds hot water. The advantages afforded by this tub-type include the very low entry threshold, the molded raised seating within the tub, and the aesthetic appearance of the finished product. Of the options discussed here, this is the most aesthetically pleasing. However it is also the most expensive as units can cost between $7,000 – $20,000 to install. Why so costly? Because the contractor must remove and discard the old tub, new equipment must be purchased, and installation may require plumbing upgrades, a new tile surround and new flooring. Also consider the renovation hassle as the installation of this type of tub can take from several days to several weeks, leaving you without access to the bathroom during that time.

And then there’s the bathing experience. Bathers must enter the tub when it is empty so that the door may be secured properly. Filling and draining times can take 10 minutes or more (these tubs hold between 40 and 80 gallons of water). This can mean a very cold start and finish to your bath. Bathers are required to sit rather than recline leaving shoulders and chest exposed. And finally, for taller users, closing the door can be difficult as the space within the tub is generally very tight when sitting down.

Option 2: Modifying an existing tub: The “tub cut” alternative is particularly well suited to situations where one or more in the household wish to bathe while others wish to shower. For this option, a contractor cuts a door into the side of an existing bathtub (tub cutters can accommodate any type of tub material from cast iron to plastic) creating a low threshold for entry. The door insert may or may not swing but when sealed allows and the tub to be used as a regular bathtub. This is a much more cost-effective alternative than the walk-in tub (prices for modification start at around $1,500 and work is completed the same day) but the end result is not as aesthetically pleasing. Anyone who visits the home will immediately know that the bathroom has been modified. And many of the same issues that confront the walk-in tub user will also apply with the tub cut. This tub type also presents an additional safety hazard as the bather must raise and lower themselves into the water. Grab bars will need to be installed to ensure safety. The bottom line: the tub cut option is probably best suited for people who prefer to shower.

Option 3: Motorized bath chair: This is by far the most inexpensive, safest and easiest of the three options discussed here. The motorized bath chair is placed inside your existing bathtub. At the push of a button, the seat lowers the bather down into the water and it raises them back up at the end of the bath. There are a wide variety of tub chairs on the market, ranging in price from $200 to $500 or more (Amazon.ca has a good selection). Look for a motorized chair that ensures there is sufficient power to both lower and lift the bather before beginning the bath. Best of all, there is no need for a contractor or for any alternations to made to the bathroom. The chair can be removed and taken with you to a new location or when the time comes to sell the home.

In summary, before buying, do your research. Ask friends who have been through the experience what they have found works best, do a web search to see what others are saying about specific products, and whenever possible, try to use the product first hand before making your investment. For a more comprehensive overview of bathing solutions, including images, visit homeability.com.

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Mary Jane Carroll is a professor in the Bachelor of Interior Design program at Sheridan College. She developed a specialized post-diploma program at Sheridan called “Aging
in Place Design Specialist”. Mary Jane was published in “Universal Design: Creating Inclusive Environments,” and has presented her papers on Universal Design in England and the USA.

Business of Aging: Aging Simulation Suits

Aging simulation suits are becoming more popular because they can be used to emulate the physical and sensory limitations that may be experienced by individuals as they age. This allows the user to gain a better understanding of how aging may affect an older adult’s ability to successfully navigate their physical environment and perceive their physical surroundings. When used in a structured way by business owners, this insight can help them dispel their assumptions about aging to develop better products and services for older adults.

safe_image.phpWhen we consider the physiological changes that most commonly occur with increasing age (e.g. sensory impairments, reduced mobility, decreased strength, etc.), it is easy to imagine how the suit can be used to evaluate existing environments. An article entitled As Baby Boomers Age, Is Architecture Failing Them highlights how one architecture firm uses aging simulation suits to ensure that an aging population can successfully negotiate the commercial buildings they design. By focusing on how ‘baby boomers interact with buildings’, the firm was able to identify specific design elements that needed improvement such as ‘lengthening the landings on escalators to allow [the] user to regain balance’.

Another practical use of aging simulation suits is the Working With Seniors: A Primer for Health Care Providers program at The Michener Institute for Applied Health Sciences in partnership with Baycrest. This program provides healthcare students with simulation experiences to gain ‘first-hand perspectives and experiences of the challenges that seniors often encounter during medical appointments’.

When used strategically, aging simulation suits are effective tools that enable users to consider ways of making environments more accessible for older adults. It is, however, vitally important to remember that not all older adults age in the same way and that the changes simulated with the suits are not indicative of the challenges faced by all older adults. This is why the upcoming Business of Aging Global Network Greater Toronto and Hamilton Area (GTHA) chapter meeting, hosted by the Centre for Elder Research, will feature a tailored experiential workshop that not only uses aging simulation suits, but also explores participants’ beliefs and attitudes about aging. (See flyer for details.) The simulation, when paired with the introspective exercises, can help users make the best use of aging simulation suits, improving their products and services for individuals of all ages and abilities.

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Guest Blog: Age-Friendly Community – A Quest for Connexion

By Mark Venning

At a time when we seem to be building an increasing number of senior living communities, ranging from adult lifestyle condo concepts, to retirement residences, assisted living housing and other variations of older age based centres, one can be left asking how this fits into the broader concept of age-friendly community. The original intent of the report 2007 Age-friendly Cities Guide produced by the World Health Organization (WHO) included a section on housing options, making several recommendations that address, among other things, the issue of affordability and adaptable design.

indexOne of the other key elements in this WHO masterpiece is respect and social inclusion, which also contains the promotion of
inter-generational interactions. Yet when
I look at this rash of construction for senior
living I wonder: how much are we inadvertently perpetuating social exclusion? There is obviously a market for all this building, some of it a little “upmarket” for everyday people, but the spirit
of age-friendly design asks for much more from us as a community.

People do want options, reflective of a wider range of views on how they to want to live in later life. A new narrative must frame how communities are to be designed, while considering specific incremental life stage needs of older people, alongside the shared needs of all generations – remembering that positive social interaction is a major contributor to the healthier lives of all generations. By 2030, when the early millennials start turning 50, will they look at the construction options of this early century as serving their needs in the same way as todays’ seniors market?

The evolution of cities is every generation’s project – function, form, flow and the fabric of human interaction. Over the next fifteen years, the percentage of persons older than 65 will be significantly higher and thus the need to adapt the urban agenda to a workable inter-generational model for an aging population is a key opportunity.

In a quest for connexion, there is a hope-inspired trend emerging that integrates into this building boon – the development of urban ‘intergenerational community hubs” or “zones”. In the UK, the Oxford Institute for Population Ageing posted a blog in August 2015, titled “Intergenerational Contact Zones- What and Why?” which is a very good start for understanding this trend. It truly supports the WHO Age-friendly initiative.

Where else but in Vancouver BC would you find a wonderful Canadian example of this trend – the Frog Hollow Community Intergenerational Hub. And last month, there was a feature story in Metro News about a Greater Toronto Area collaboration between a 27year-old design student from OCAD and his 67year-old neighbour who together worked on a proposal to redevelop an underutilized elementary school in Vaughan which could turn into an intergenerational community hub. Other examples exist, but this is enough to make the point.

Now, here is a hometown opportunity. The Sheridan Centre for Elder Research, based in Oakville, is uniquely positioned, with its “possibility making” approach, to further promote this age-friendly quest for connexion as it already is by its very nature, part of a true intergenerational contact zone. Sheridan College is home to a young creative population of students who can be easily encouraged to join this conversation on designing a stronger age-friendly community.

Further still, I would encourage my fellow members of the Sheridan Centre for Elder Research Business of Aging Global Network to stimulate interest in this topic by having a facilitated discussion at a future meeting where students join us to explore the options for the future of housing and community design – 2030 style. Perhaps together, we could the re-phrase this as designing “age-inclusive community”.

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Mark Venning works with not-for-profit and business leaders, providing presentations, research and advisory services on the Business & Social Aspects of Aging Demographics – and 1:1 with business executives “leaving the corporate crow’s nest” to explore Entrepreneurship in Later Life. www.changerangers.com

Guest Blog: The Prevalence of HIV/AIDS Among Older Adults

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By Mandisa Sifelani

I have always enjoyed working with older adults, so coming to the Centre as a practicum student was exciting for me, but also it was to challenge myself. Challenge myself in the area of research. As this is a skill I had been learning in my classes, I was eager to put theory into practice, and what better place for me to practice, than at the Centre for Elder Research.

As my interest has always been in older adults, the issue of the prevalence of HIV/AIDS among older adults caught my attention. There is a lot of dialogue and open discussions surrounding HIV/AIDS in general, however, there is not much focus on the aging population, and there needs to be. In some way, older adults have become “the forgotten” generation.

According to Statistics Canada, the rise in HIV/AIDS cases among older adults is rising, and so is that of sexually transmitted infections (STIs). Too often older adults are sidelined and are not being tested for HIV, because their symptoms are associated with ageing. This is according to the Community AIDS Treatment Information Exchange (CATIE), who also state that low knowledge and testing can lead to a diagnosis of HIV in older adults, which may rapidly progress and make it difficult to treat.

Older Persons living with HIV/AIDS experience a “double jeopardy” of HIV stigma and ageism, where they perceive ageism in accessing AIDS service organizations, and HIV stigma in accessing non-HIV services (Public Health Agency of Canada, 2015). So because of this “double jeopardy”, how can older adults living with HIV/AIDS be supported in their quality of life? Here are some steps that can be taken;

  • Educate older adults
  • Educate families, caregivers and physicians
  • Facilitate workshops on prevention and safe sex practices for older adults
  • Be inclusive of older adults in approaches and strategies to a better quality of living with HIV/AIDS.

Furthermore, I have to mention how the use of technology (iPads, Laptops, Smartphones and computers), can be a great asset and tool for older adults to use in finding online resources, (literature, support groups, agencies), which not only increases their awareness about HIV/AIDS, but it keeps them in the “loop” on what is new in the medical field. Additionally, the use of technology, can connect older adults with their physicians through online dialogues/consultations, plus interactions with family, friends, and other older adults living with HIV/AIDS. Which is a key factor in ensuring that they do not succumb to isolation and loneliness, which plays a significant role in the lives of those living with HIV/AIDS.

To gain more insight on this growing social issue, an article entitled The graying of HIV: 1 in 6 new U.S. cases are people older than 50 highlights the growing number of older adults in the United States, which parallels with Canadian older adults as the growing numbers are similar in our own backyard.

In conclusion, I can honestly attest to how my time at the Centre has truly brought theory into practice. In my role as a practicum student I have been able to partake in a couple of projects, which have all aided me in seeing community research in action. My love for research has grown, and with the support of the research team at the Centre, I will always be grateful for the learning opportunity and experience.

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Mandisa Sifelani, B.S.W, is an M.S.W Candidate, 2016 at York University, currently working at the Sheridan Centre for Elder Research as a practicum student. Her major focus of work has been on older adults and aging, and until recently how the inclusion of technology can be an asset in helping to curb isolation and loneliness with the aging population.