Multiple sclerosis keeps Debbie Russell-Hoeber at home most of the time. Her journey with the disease started 16 years ago with foot drop and hip pain. She’s since moved, slowly, into a walker and, a couple of years ago, onto a motorized wheelchair.
“I’ve learned to adapt,” she said. “I don’t want to live in some rehab center.”
Russell-Hoeber, 59, of Hamburg, is among the three of four Americans over 50 who long to live out their days at home, regardless of their health. Nearly nine of 10 people ages 65 and older feel the same way, according to AARP.
It isn’t always easy – a home health aide is a regular companion to Russell-Hoeber – and it can become costly. But families willing to make changes, both big and small, can make a good go of it.
“People don’t want to think proactively but having things in place eliminates so much stress and strain on people,” said Jill Eppolito, a physical therapist, certified aging in place specialist and owner of Accessible Home Solutions in East Amherst. “The other part about being proactive is you have more choices available to you and you can do it over time.”
You can roll with the changes that aging brings by making a home more accessible, regardless of age.
“All of the things we’re talking about that are safer and better for seniors are safer and better for all of us,” Eppolito said.
Russell-Hoeber and her husband, Mark Hoeber, live in one of a few dozen tidy houses on a side street in their village. The front yards on the block are modest in size, the driveways fairly narrow. She aims to stay here for as long as humanly possible. She hates to admit it, but she spends too much time watching reality TV shows about spoiled housewives in top American cities. She likes ABC sitcoms, too, and football. But hanging out with her two most constant companions, a Golden doodle named Brooks and a Cavachon named Raven, often brings the greatest joy to her days.
She and her husband bought their house in 1994, when she was pregnant with their son Jordan, now 21. The couple remodeled soon thereafter, putting in new laminate floors, widening entryways and building a walk-in closet in what needed to become a first-floor bedroom – all steps that have proven a godsend these past few years. “A lot was already here before I got MS, so we kind of lucked out,” she said.
Russell-Hoeber worked in medical billing for about 30 years. She was diagnosed with MS in late 1999. Five years later, as her gait weakened, she fell and broke her left wrist. In the later part of her career, she handled her duties at Sedona Holistic Medical Centre in Hamburg using a walker. She went on disability in 2009. The family since has added an electric vertical platform lift off the back porch so she can get out into the driveway and a new wheelchair-accessible van. She and her husband have looked over the years at a series of steps they could take to make their home more accessible. Eppolito has helped.
Many choices that make daily life more manageable for those with limitations cost less than $100, Eppolito said. Others can costs hundreds of dollars, while ramps and some home remodeling jobs can run into the thousands.
For about $300, Eppolito can do a home assessment and design a plan that allows for more ease of movement throughout a house. Residents then can find contractors on their own or choose from a list Eppolito recommends.
Too expensive? Consider the alternative: One in three people age 65 or older will fall this year, most of them in their homes. One in five will need medical care. That will run an average of $35,000 – $7,700 of which will come out of pocket, according to the Centers for Disease Control and Prevention.
Life can get much harder for those resistant to change after a fall or serious illness, Eppolito said. That’s why she recommends a closer look at the following.
Those who need just a little help with the stairs should consider railings on both sides, properly pitched and installed. Each step should be uniform in height at least 11 inches in length to step down upon. The back of each step should be closed so a foot can’t slip through a set of stairs.
Entrances, hallways, stairways and places where tasks are performed – to cook, read or pursue a hobby – should be generously lighted.
“I prefer a minimum 36-inch-wide door, inside and out,” Eppolito said. “We prefer lever-style handles and hardware versus the knobs that you have to grip and twist.” Interior doors should require less than 5 pounds of force to open; exterior doors, a maximum of 8 pounds. You can get an extra inch or two in a doorway by adding hinge extenders.
“A smooth, durable, hard floor is great throughout,” Eppolito said. Tile, hardwood, laminate or vinyl are best. “There are no tripping hazards and if a person uses a walker or a wheelchair. They can move from room to room very easily without having to navigate over thick, plush carpet.” Area rugs can be a tripping hazard, especially for those with an inconsistent or unsteady gait.
Russell-Hoeber has a powerlift chair in the living room and a small TV tray that holds her remote control, reading material and her medications, the latter of which are in dated pill boxes.
“Many bathrooms are tiny but you can be creative and make more space,” Eppolito said. The first-floor Hoeber bathroom once had a free-standing bathtub and a separate shower stall with sliding doors and a 4-inch curb on the bottom, both of which became impossible for Russell-Hoeber to navigate. “I can’t imagine her trying to get around in that bathroom,” said Julie Stebbins, one of her home health aides, with Health Force Home Health Care Services
RESOURCES TO MAKE HOME SAFER
Erie County Caregiver Coalition
Provides links on its website to help caregivers in a variety of ways, including with health care questions, home safety assessments, advanced care planning, transportation and proper nutrition.
aging.ny.gov; (800) 342-9871
A starting point for those looking for caregiving services, including the Erie County Department of Senior Services or outlying county Offices for the Aging, as well as a variety of support for families dealing with loved ones of any age who have a range of physical and mental health conditions.
Network in Aging of WNY
University at Buffalo-based agency of professionals devoted to promoting safe, healthy aging. Includes links to a variety of agencies including home health care information.
Accessible Home Solutions
Private East Amherst company serves the region with aging-in-place planning.
COST OF FALLS
Aging in Place resources at Buffalo & Erie County public libraries
Because devices that can help those with limitations change at a rapid rate, many books can become obsolete within a few years, said Renée Masters, a registered nurse and outreach librarian based at the Central Library. Here are some books and websites she recommends that can provide valuable information.
“The Illustrated Guide to Assistive Technology and Devices: Tools and gadgets for living independently,” Suzanne Robitaille
“Dressing Tips and Clothing Resources for Making Life Easier,” Shelley Peterman Schwarz
“Making Life More Livable: Simple adaptations for living at home after vision loss,” Maureen A Duffy
These provide access and direction to a variety of useful resources. Visit the library website at buffalolib.org then click on Subject Guides. Choose the Disability Resources and Caregiving guides.
AbleData (abledata.com): Provides comprehensive information on products, solutions and resources to improve productivity and ease life’s tasks. AbleData is funded by the National Institute on Disability, Independent Living, and Rehabilitation Research. It is part of the U.S. Department of Health and Human Services’ Administration for Community Living. It does not sell products nor endorse any nongovernment websites, companies or applications.
Family Caregiver Alliance (caregiver.org/choosing-assistive-technology
AgingCare (agingcare.com/products): A commercial site that offers links to resources for a wide range of needs designed to help people live independently.