I use drug store reading glasses when the light is low, the type is small or the print to paper contrast poor. When the light is good I do not need the glasses. My ability to read has to do with my eyes but it is also a function of the other factors.
The situation is true of much about disability. This thinking is called the New Paradigm of Disability. Ability is seen as a function of the environment, the tools and the person. It is interaction. Adjustments to any factor impact the whole. If there are no steps, the inability to climb steps is not disabling. The steps are a problem that can be changed. The inability to climb steps is cured so to speak.
I wrote about this previously, but I want to take the topic a bit further.
Another Concept for this discussion is Compression of Morbidity. You might say it is about the good life. We all have an impression of the good life we look forward to. We each have different vague or concrete notions in our mind’s eye. We also have, maybe even stronger, impressions of the aging life we do not look forward to. Compression of Morbidity is about lengthening the good life and compressing the bad life into a wee bit at the end. It refers to ‘not a bad way to go” which is what we say about someone ‘lucky’ enough to get pretty old and die quickly without long painful and miserable periods that stress our families, our wallets and our good nature.
Another concept in this discussion is Environmental Press. I have known of the concept for years but never heard it so clearly as expressed by my friend Patrick Roden. The link is to his website, aginginplace.com and his explanation.
Environmental Press refers to the client-environment fit. If the environment is too hard (too much press) the individual cannot do for themselves or may be endangered. If the environment is too soft (everything done for you -too little press) the individual loses self esteem, motivation and zest for life. A well tuned environment (just the right press) uses our abilities maximally, uses other resources optimally and enhances self esteem.
So…how do home modifications, good universal design spaces, figure into the discussion? A well designed home keeps you from being injured, may allow you to return from an incident sooner and safer, helps you be as independent as possible (BE all YOU can BE), allows caregivers to do their jobs safely and uses the resources (human, financial, medical) you need to call upon as well as possible. That means you feel good about yourself, draw down your financial resources as slowly as possible, call upon your friends and family only when needed.
Effectively, the right home moves the Threshold of (Dis)Ability – the point at which we cannot do, manage, pay for or engage services or activities easily or as independently. On a large scale the amount of resources needed can be reduced substantially. Seen in this way, policies that recognize and promote home modifications should be a big part of the answer to the health and financial crisis some people predict as the ‘silver tsunami’ comes of age.
What policies? Job training for veterans and others to modify homes. Tax breaks, reduced financing costs, reduced permit fees, permit and inspection expediting, density adjustments or just plain mandates for Universal Design construction practices. These are not new ideas…some are used for solar installations, others have long history in community development practices. These ideas are not going to solve all the health, housing and care crises looming over our next thirty years. Nothing will solve it all at once. Every bit counts.
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I am interested in learning more about Aging in Place and Universal Design. I am a native Washingtonian, and spent 25 years living in Bethesda. The last 10 years my husband and I have lived in Venice Florida. My husband is quite disabled, and unable to move from bed to wheelchair without use of a Hoyer lift, which we have. We have made some modifications to home and lifestyle and will have to find more in the future. I have joined Institute for the Ages, of Sarasota County FL, and find the concepts about aging that I have learned so far are very interesting and encouraging. Judith Zangwill