An expert explains how Universal Design can help make homes safer and more functional for older residents.

Thailand’s elderly population is growing rapidly. By 2025, the country is projected to become a fully-fledged aged society. And that is going to be something of a burden for the workforce, forcing them to care for their aged parents.

In response to this, the government, the private sector and local communities have worked hard to create an age-friendly society and launched several programmes including senior housing complexes and smart homes for the elderly in a bid to enhance the quality of their lives.

However, family members are still the primary caregivers for aged parents and older relatives. For a variety of reasons, caregivers may choose to care for their older adults at home as long as the situation is safe for everyone. To reduce the workload and stress, they might modify their home to make it safer and more comfortable for older residents. And adopting some principles of Universal Design could provide the answer.

“Well, Universal Design is not strictly for the elderly or the disabled as most people tend to think. Actually, it benefits everyone, regardless of age, ability and life status,” says Assoc Prof Trirat Jarutach, head of the Center of Excellence in Universal Design, Chulalongkorn University’s Faculty of Architecture.

He explains that Universal Design is the process of creating environments and products that can be usable for all people, to the greatest extent possible, without the need for adaptation. On top of that, these ideas promote a more inclusive environment for physically challenged individuals.

According to him, this inclusive design is based on principles of equitable use, flexibility, simple and intuitive features, information communicated effectively, minimisation of hazards with error, low physical effort and appropriate size and space for approach and use.

“So, we can apply some of these rules and add some Universal Design features in order to improve safety in and around the home for older residents. You know, having a safe space at home can reduce the risk of falls,” the professor says.

According to statistics from the Department of Disease Control (DDC), one third of older people suffer a fall each year. Falls are leading cause of fatal and non-fatal injuries in the elderly. In Thailand, more than 1,000 older adults die from falling each year – that’s an average of three persons a day.

Risk factors for falls include illness and chronic disease, poor eyesight, a decline in physical fitness, certain medications and environmental hazards.

Assoc Prof Trirat adds that more than 85 per cent of falls among older Thais in their homes are due to environmental causes, according to the statistics compiled by the DDC under the administration of the Ministry of Public Health.

“Slippery floors, uneven surfaces, different floor levels, stairs that are too steep, a bed that is too high, poor lighting, lack of safety equipment and obstacles – these can jeopardize seniors’ safety at home,” he says.

According to him, the most dangerous areas of the home for seniors are the bathroom, the staircase, the bedroom and areas that connect inside and outside spaces.

“Many seniors slip or trip and fall while they are trying to manoeuvre from the inside to the balcony or to a laundry area in the back of the house or to a garage due to the height difference between two floors. You need to fix it (the height difference) to make the spaces safer,” Mr Trirat says,

For the bathroom, he suggests installing slip-resistant flooring and adding grab bars beside the toilet and shower for extra support when sitting and standing. A shower chair will let older adults enjoy their shower without having to worry about falling. A non-slip mat can help prevent falls as well. It’s also a good idea to change the direction of the bathroom door opening as this gives more room inside the bathroom and makes it easier to enter and exit.

“Trips are as dangerous as slips, so remove trip points like thresholds wherever possible. A bathroom door with a raised threshold can easily cause an elderly person to trip and fall,” he says.

The academic adds that the rise of each stair should ideally be between 10 and 16 centimeters. Handrails are a must, on both sides of the staircase if possible. Lighting is also critical.

“Older adults usually walk more slowly and with shorter steps. We should make stairs the proper height to make them safe and convenient for them.  Make sure that the general lighting is bright enough to light the stairs. Try to keep the floor space clear so that things do not obstruct walkways,” he says.

Also make sure that the bed is the appropriate height, the expert says. Beds that are too high or too low can cause seniors to fall. It’s wise to add a grab handle to secure support while standing.

“If a cane or walker is needed, it should be kept near the bed when not in use. When senior adults get up from bed, let them sit on the edge of the bed for a few minutes with both feet flat on the floor. This will give their blood pressure time to adjust. They will feel less dizzy and their balance will be good before standing,” Mr Trirat says.

When it comes to improving the living room, he suggests using warm colours like yellow and gold which can make seniors feel comfortable, while creating a joyful living environment.

“You can have the wall painted an inviting golden shade and use bright yellow accent pillows in the living room to create a cosy ambience and promote alertness,” he says.

All doorways and hallways should be wide enough to comfortably let a walker and a wheelchair pass through.

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Universal Design truly benefits everyone

Dr Nart Fongsmut says adding Universal Design features to her residence has helped keep her mother safe while giving her peace of mind.

“My 84-year-old mother has had several falls in the past two years when she lived in her own traditional Thai style house in Soi Ekkamai. It was quite dark inside and had different floor levels and a steep staircases. I offered to remodel her home to make it safer but she refused my offer,” she says.

Dr Nart has decided to give her own condominium unit in Nonthaburi province a makeover adding some Universal Design features. Among the upgrades are grab bars, comfort height adjustment for the tables and the chairs and other senior-friendly furniture items and aids. These features have been added without turning the unit into an obvious assistive living space.

She has also invested in remote safety and health monitoring devices with specialised sensors that can be used to detect emergencies like fires or falls.

“The devices can alert me to potential health or safety issues of my mom from a few or thousands kilometres away. Now I have a helping hand and peace of mind, thanks to new technology and the absolutely good design.” Dr Nart says.

Creating safe and inclusive public spaces for all

In addition to safe homes, it’s equally important to create public spaces that are suitable for active older persons, Asst Prof Trirat notes. He urges state agencies, the private sector and communities to improve buildings, outdoor spaces and facilities to ensure that they are inclusive, welcoming and supportive places that can actively protect and promote older people’s rights.

“Environments that are good for older adults can be good for everyone,” he says.

A 2016 study by Chulalongkorn University’s College of Population Studies showed that hospitals (40%), district offices (30.8%) and department stores (12.5%) in Bangkok care able to provide a safe, welcoming and accessible spaces for older adults to actively use them.