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Differing Abilities

As  we age, certain physiological changes ensue. The age and the rate at which these  changes occur differ from individual to individual. Some of the characteristics  of aging adults that make universally designed living accommodations desirable  are:

Changes in Vision

  • Yellowing of the  lens
  • Opacity of the  cornea
  • Weakening of the  muscle controllers
  • Crazing of the  cornea
  • Flattening of the  lens (farsightedness)
  • Loss of  sensitivity to intensity of color
  • Loss of  sensitivity to blue and other “cool” colors
  • Less ability to  discriminate between closely related colors
  • Slower adaptation  rate to light-to-dark conditions
  • Loss of ability  to discriminate fine detail
  • Loss of ability  to discriminate closely related distances, such as curbs and steps.

Changes in Hearing

  • Presbycuses or  selective frequency hearing loss, especially in the higher frequencies
  • Losses in the  ability to distinguish low-volume sound

Changes in Strength,  Flexibility, and Mobility

  • Loss of strength  in the lower extremities, causing a “drop” to chair surfaces when sitting
  • Less ability to  bend the knee joint to an acute angle in order to position the center of gravity  over the heels for egress from a chair
  • Greater reliance  upon arm strength to lift the center of gravity from the seated surface and  stabilize the body for transition from standing to sitting
  • Longer seated  durations, yet earlier onset of discomfort owing to tissue loss over the ischial  tuberosities
  • Graduation  transition from normal walking gait to a “shuffling” gait, whereby the aged  adult thrusts feet forward out from under the center of gravity

Related Factors to Consider  in the Design of Living Space

  • “Tremor”  experiences in early morning and at end of day
  • Loss of grip  strength in palm from 95 pounds in youth to as little as five pounds
  • Loss of  “pinching” strength, or tip prehension strength in the fingers, from 30 pounds  to zero pounds in extreme cases
  • Greater need to  use whatever appendage of the environment presents itself for stability when  walking, climbing, or changing position
  • Early onset of  fatigue on inclined walkways or ramps
  • Need for armrests  on dining chairs that fit below table surface, with solid back support, because  aged adults do not lean forward when dining, but use the backrest of chairs for  support.

Disability Problems with  Potential Solutions:  a Quick Reference Guide

Mobility

Problem:

  • Reliance on a  wheelchair
  • Joint  inflammation resulting in lack of movement
  • A person can  easily move around in a space but needs to sit and rest periodically

Solution:

  • Utility carts for  transporting large items
  • Easy access to  sink, electrical outlets etc
  • All purpose work  surface at comfortable height
  • Cabinet and  countertops that allow sliding of items
  • Raised toilet  seats

Balance Impairments

Problem:

  • Walking
  • Carrying things
  • Bending over
  • Getting in and  out vehicles

Solution:

  • Lavatory with  open knee space
  • Easy to reach  storage
  • Accessible  heights that would require little or no lifting/lowering

Uncoordination

Problem:

  • May result from  fatigued muscles
  • Symptoms include  spasticity, tremors, weakness, and impaired sensation
  • Safety is the  most pressing issue

Solution:

  • Positions that  promote better motor control
  • Equipment that  stabilizes objects

Strength

Problem:

  • Muscle strength  decreases with aging and various diseases

Solution:

  • Energy  conservation and work simplification
  • Small work  triangles
  • Reduce steps
  • Promote  individuals to pace themselves

Sensation

Problem:

  • Sensory  perception decreases with aging and various diseases **See further description below

Solution:

  • Enlarge visual  cues for Braille
  • Mirrors to check  difficult to see areas
  • Use other sense  to compensate

Perception/Cognition

Problem:

  • Color, depth  perception changes over time and in various diseases **See further description below

Solution:

  • Color
  • Contrasting  materials
  • Use of organizers
  • Single function  controls
  • Dual cues to keep  person focused

Sensory-Perceptual Systems That  Change with Age:

Vision

The normal  aging of the eye involves many changes. The cornea becomes flatter, the scler  (white of the eye) becomes yellowed, and the pupil decreases in size. The lens  becomes less elastic and more rigid, and also yellows slightly. The end result  of these changes can include:

  • impaired depth  perception
  • color blindness
  • decreased ability  to focus on close objects (presbyopia)
  • reduced ability  to adjust to light
  • cataracts
  • glaucoma

The amount  of light that reaches the retina of the average 60-year-old is only one-third of  that seen by a 20-year-old. Because the changes occur gradually over a long  period of time, many individuals do not realize the extent of their visual  limitations.

Hearing

Presycusis,  a type of neurosensory hearing loss, is the most common cause of hearing  impairment in the elderly. Presycusis was originally thought to result  exclusively from age-related changes in the cochlea (inner ear). It is now known  that environmental factors also contribute to age-related hearing loss. Like  age-related vision changes, those changes that occur in hearing are gradual and  not always recognized or acknowledged. It is important to stay alert to signs of  hearing loss such as:

  • frequent requests  to repeat information
  • complaints of  hissing or ringing in the ears
  • failure to react  to sounds coming from behind
  • reduced  comprehension when surroundings are noisy

The  inability to understand the spoken word because of reduced hearing can lead to  suspiciousness, anxiety, agitation, and paranoia, even in individuals who do not  suffer from dementia.

Taste

By age 70, it is estimated that  two-thirds of the taste buds in the mouth have “died.” Perception of sweet  tastes declines, causing many older people to use more and more sugar. Flavors  decline in their distinctiveness, which encourages the use of extra salt to  “bring out the flavor.”

Sugar and  salt become potential health hazards when used to excess, leading to late onset  diabetes and high blood pressure.

Smell

The sense  of smell also declines with age. Our sense of smell can be crucial in warning us  of fire or toxic hazards. The ability to discern certain odors can also bring  pleasure and spark memories.

Touch

Many  elders are at risk for falls because of a number of disorders that cause changes  in the peripheral nerves and proprioceptors, thereby reducing feeling and the  ability to recognize the position of the limbs. Numbness or loss of sensitivity  is a common complaint.

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