Design solutions for mobility limitations to minimize injury

Mobility Limitations

Safety Flooring and Seating for the Elderly

Preserving the mobility of the elderly while simultaneously improving the safety parameters of their living circumstances are twin goals of equal importance. Indeed, the preservation and improvement of mobility in the elderly can have the effect of significantly enhancing the quality and length of life in later years. However, the need to ensure that these levels of mobility and independence are conducted within the confines of safe and advisable circumstances is tantamount. Thus, there is an array of factors to consider with respect to one's living space that speak to the necessity of special accommodations for the elderly or otherwise infirm.

Certainly, one of the most pressing, important and basic aspects of mobility is walking. For the elderly, difficulty walking can make even modest and simple tasks very taxing and potentially dangerous. The quality and nature of one's flooring is especially relevant to this circumstance, with the vulnerability to fracture and the threat that one might fall and be without the ability to contact a relative or emergency medical worker illustrating the need for a heavy emphasis on how flooring is selected and integrated into one's living space.

Accordingly, our research produces the finding that many of the fractures which occur and effect the elderly are as a consequence of floors which do not facilitate the needs of the elderly. Our research denotes that "poor flooring which is slippery and unsuitable footwear are other major factors contributing to the onset of fractures in the home, and the design of buildings should incorporate measures to minimize the risk of falls." (Minns, 1)

As Minns (1999) shows, a statistically significant number of the elderly individuals occupying hospital beds in long-term care facilities are being treated for hip fractures. This, the article argues, is most often because flooring in mainstream settings and far too many homes is of a substance which makes those with unsure footing more susceptible to the loss of balance or bearing. For the elderly, the consequences of a single misstep on such flooring can be catastrophic. Therefore, the flooring in the facility in question here would be fitted with a non-slip material, with hardwood, marble and many types of ceramic tile being eliminated from usability.

Beyond the surface material, cushioning is crucial, both for the shock absorption on the patient's feet and for its ability to cushion any potential fall. Minns describes a few methods, with two of them being particularly relevant to our needs. Namely, he describes the inset of a flooring structure where supports are arranged in a 'honeycomb' layout rather than traditional vertical and horizontal cross-beaming. (Minns, 2) He makes the argument that in spite of the costliness of building this feature into the flooring of an existing structure, it can add considerable to the absorption and give offered by the surface upon a falling body's impact. If this can be deemed cost effective and necessary in the case of our facility, the cost would be assumed through exploration of existing tax credits relating to such adaptations.

Another adaptation to flooring which would most certainly be adopted is that relating to the increased cushioning of the material used to cover the floor surface. The article contends that "the floor covering is a significant factor in the likelihood of a patient falling down and sustaining a fracture of the hip [Healy, 1994], and the type of floor covering in a very small trial [Booth et al., 1996] indicates that thicker carpet (7mm) gave a fourfold decrease in fracture incidence over a Vinyl floor." (Minns, 2) This fact is very encouraging for our needs, as it demonstrates a clear method for adaptation of existing flooring with a proven record of reducing critical injury relating to flooring that is too hard. This can essentially be done without the difficulties above-noted of removing or reshaping hard floors.

Beyond this, there are a number of steps which must be taken to ensure that existing surfaces which can be considered at least soft and absorptive enough to remain are reinforced against incident or accident. This will be especially relevant to carpeted or rug-covered floors, which can often be more moveable than one might desire. One article, published by Men's Health Center, offers the instructions to "fix carpet edges to the floor - avoid loose rugs and mats and make sure any uncovered floors are not polished too highly. Ensure all handles, railings and banisters are firmly fastened." (Health & Age, 1)

With respect to handles and rails, this helps to direct our attention toward how best to outfit transitional flooring between rooms. Railings and handles for level hallways is an effective way to provide extra support as one breaches the threshold of a carpeted room from the lower gradient of an uncovered surface. Wherever possible, however, transitional gradients will be avoided, with carpeting running through rooms at a uniform rise, reducing the need to prepare for transitional steps. Again, however, where transitions do exist, we would use banisters to help cross through doorways and thresholds.

In addition to the flooring, the facility in question will require seating which is especially design to meet the unique safety requirements of the elderly. The research here denotes that often specialized seating will be necessary in order to accommodate the many seniors who will spend significant portions of their day bound to a seat. As the research finds, in such instances, "a prescribed seating solution will help prevent/correct deformities, increase functional ability and improve sociability. Proper seating will also prevent pressure sores and may assist in improving a client's medical status by enhancing their swallowing and breathing ability." (Brennan Occupational Therapy, 1)

For these purposes, as with flooring, an issue of great importance will be the use of non-slip materials for the upholstering of chairs. Therefore, hard plastics are not recommended. Micro-fiber cushioned seats provide some degree of cushioning as well as the capacity for the needed variance in firmness and a non-slip surface that will allow residents to recline and even fall asleep in chairs without the risk of falling and incurring injury. (SS, 1)