Life-Span Design of Residential Environments for an Aging Population

PLENARY ROUNDTABLE III: LOW-TECH APPLICATIONS AND RETROFIT

OVERVIEW

Today's older adults, as compared to their parents, have access to many more independence-enhancing technologies. Unfortunately, many people do not use these technologies to their full potential. Plenary Roundtable III focused on ways to encourage functionally limited older persons to use low-tech devices and simple environmental designs that can help them live independently. The roundtable's presentations and subsequent discussion explored reasons why older people who could be aided by such products or devices might not be making appropriate use of them. Several of these reasons included 1) poor product design due to lack of detailed anthropometric and sensory measurements, and limited product testing, and 2) lack of knowledge about available products.

Sara Czaja, from the Stein Gerontological Institute in Miami, Florida, presented "Enhancing the Home Safety of the Elderly: Technological and Design Interventions" (this volume). James L. Fozard, of the Baltimore Longitudinal Study of Aging in Maryland, delivered a paper on "Sensory and Perceptual Considerations in Designing Environments for the Elderly" (this volume). David Levy, of Hennan Miller Research Corporation in Ann Arbor, Michigan, discussed "Design and Problems of Aging" (this volume).

PRESENTATIONS

Enhancing the Home Safety of the Elderly: Technological and Design Interventions
(S. Czaja)

Czaja examines information, design, and dissemination issues that affect the use of "low technology" (simple devices) in the home or affect the use of home modification options to help functionally limited persons live independently. The author identifies the need for 1) additional information about the problems older people are likely to encounter at home, and 2) information regarding the appropriate use of existing technologies. Also, she suggests the development of better design guidelines for housing and recommends a strategy for disseminating information to the public about existing technologies. The following items highlight some of the specific information, design, and dissemination data the author believes are needed to improve independence-enhancing technologies:

data on tasks that are problematic for older persons, and the types and frequencies of the difficulties these people encounter;
data on the functional requirements of specific home tasks, products used in the performance of these tasks, and characteristics of the environments in which these tasks are performed;
information about the functional (physical and cognitive) capabilities and limitations of older adult populations;
data regarding the appropriate application of existing products to older users, and data that allow the matching of products and technologies to specific tasks and persons; and
strategies for effective dissemination of information regarding availability, cost, and appropriate application of technologies for older adults.

Sensory and Perceptual Considerations in Designing Environments for the Elderly
(J. Fozard, F. Schieber, S. Gordon-Salant,and J. Weiffenbach)

This paper looks at age-related differences in the ways people see, hear, taste, and smell -- sensory and perceptual experiences -- and reviews ways to alter the environment or a person's behavior to improve sensory functioning. Some of the changes that can be made include glare reduction, sound proofing, food seasoning, and odor enhancement.

Additionally, the paper identifies a need for specific design guidelines/recommendations that reflect a consideration of the physiological changes that affect older people. The authors discuss a number of simple but highly effective ways to overcome sensory and physical limitations. For example, in the case of hearing limitations, signal intensity can be increased, the contrast between the signal and background noise can be increased, and the amount of background noise can be decreased so that sensory signals can be more easily detected. Some very effective design efforts are based on these kinds of ideas-for example, large-print type, magnifiers, and recent developments with hearing aids and telephone amplification devices.

Design and Problems of Aging
(D. Levy and C. Malcolm)

Levy and Malcolm offer a review of research needs and design principles, and ask thought-provoking questions that if answered will lead to improved product design. The authors believe that design must reflect the needs of an aging population in functional and aesthetic ways. Below are highlights of some of the research needs, principles, and questions raised in the paper.

RESEARCH NEEDS

Establish a closer integration between aging research findings and product development.
Establish anthropometric data on everyday tasks and activities of older people (anthropometric refers to measurement of the human body to determine differences in individuals).
Demonstrate the connections (or "interrelationships") among the cost of long-term care insurance, a safe environment, and health/functional capability.
Develop a better understanding of the impact of the environment on caregiving in the home.
Establish design criteria to assess the work of designers.

The research needs listed above reflect some of the key shortcomings of current research efforts. Without appropriate research, designs are likely to be based only on assumptions about user needs and desires.

DESIGN PRINCIPLES

Bias-free: designers should create products that do not require complete functional ability to use them; these products should be useful to a wide range of people.
Well-mannered: designers should create products that take into account the way home lifestyles and work situations change for people as they age.
Provactive: designers should create products that allow activity and discourage passivity.

At the very least, design solutions should be useable, cost-effective, flexible, affordable, and acceptable to older persons.

QUESTIONS

What potential does new technology hold for the design of products for older people?
Is federal money available to fund comprehensive anthropometric studies of older people in their daily activities?

DISCUSSION

Discussants considered reasons assistive devices and environmental supports are not being used to their maximum potential. They identified several reasons related to design or research information needs, including lack of 1) sensory or anthropometric measurements, 2) design criteria, 3) product fit evaluation, 4) information about retrofitting options, and 5) information dissemination strategies. A common theme that ran through the discussion was lack of funding sources for necessary research, implementation, and dissemination.

SENSORY AND ANTHROPOMETRIC MEASUREMENTS

Discussants concluded that anthropometric data on older persons, standards, and guidelines for sensory-related products, such as illumination levels, are needed. Although a wealth of data exists about the aging process, information is scarce about the implications of aging for the performance of everyday tasks and activities.

Limited knowledge exists on the anthropometric and biomechanical characteristics of older adults, the discussants said. They agreed on the difficult of specifying what designs should look like if knowledge regarding the characteristics of the design population is lacking. Often designers base their designs on what they think the user wants or needs because they have little empirical data with which to work.

DESIGN CRITERIA

Discussants agreed that, all too often, products are designed to be functional but may not necessarily be aesthetically pleasing or appropriate. The group recommended the development of design criteria - standards by which effectiveness and appropriateness of designs can be measured. The group concurred that specific products are not going to be used if older people see those products as stigmatizing or fail to find the products useful.

PRODUCT FIT EVALUATION

In the effort to create new and better designs and to develop retrofit standards and guidelines, the discussants believed that it was important to incorporate into the process the needs and preferences of the user group. To ensure that design solutions are effective, discussants recommended testing and evaluating products with the intended user group. Such a course of action would include:

interviewing older adults regarding their needs and preferences,
observing them in the performance of tasks, and
evaluating their interactions with devices and environmental components

Also, the discussants suggested that researchers should conduct multidisciplinary studies on the appropriate application of products for specific users. This would involve developing a system, including designers, products, and users, by which specific devices could be matched with individual needs. For example, the availability of special bathtubs does not imply that all older people need to have these tubs installed in their homes. User testing is critical; a number of products being marketed as designed for the elderly or to assist the elderly have not actually been tested or evaluated with older populations.

INFORMATION ON RETROFIT AND REDESIGN

Discussants suggested that retrofitting existing spaces and products could be very effective for several reasons. First, older people are more likely to use things with which they are familiar, and improving a familiar product increases the chances of its being used. Second, the cost of retrofitting is usually less than the cost of replacement with a different product. Finally, retrofit solutions are usually more immediate because they typically do not involve the development and production time associated with new designs. Unfortunately, despite the advantages of retrofit options, many people are not aware of them, nor do many know how to have their homes retrofitted.

INFORMATION DISSEMINATION OF EXISTING PRODUCTS

Discussants noted the absence of strategies to ensure that as many people as possible benefit from the variety of assistive devices already available. A myriad of sophisticated computer and simple technologies exists that can aid independent living, but potential users are not aware of them. In many cases these devices are underutilized or the appropriate products are not matched with the appropriate people. The group agreed that many older people could lead better lives if they learned about the kinds of devices and designs that could help them.

Discussants also agreed on the need to develop effective ways to let older adults know what is available aid where and how products/devices can be obtained. To this end, they endorsed the idea of educating health-care professionals -- physicians, nurses, and social workers, among others -- about what is available to make life at home easier so they can share this information with their patients and clients.

Finally discussants encouraged educating older people and their families about what devices are available and how they should be used. Products have limited utility if they are not used properly; in fact, improper use can lead to safety problems.

RECOMMENDATIONS

The session concluded with recommendations that encourage the use of assistive devices and environmental supports to their maximum potential. These recommendations focus on housing design and retrofit, new research needs, and dissemination of existing in formation

HOUSING DESIGN AND RETROFIT

In general, more attention needs to be paid to the needs of older people living at home. Despite the increase in residential developments for the elderly and other types of new housing being proposed by architects, a large number of older people will continue to remain in their own homes. Therefore, it is critical to concentrate efforts on identifying and developing affordable adaptations for existing home environments.
A system is needed for examining and evaluating the homes of older people to identify and prevent potential problems.
Evaluation of existing products and retrofits is essential to deten-nine what works and what solutions are optimal.
Policy issues require attention. For example, government or insurance companies could offer reimbursements or savings to individuals if they retrofitted their homes to make them safer and more manageable.

Research Needs

New research and data -- for example, data on the anthropometric characteristics of older adult populations -- are essential.
Models are needed to encourage and permit better matching of specific available aids or retrofits with individual needs.
More interdisciplinary efforts are required in research.
Greater commitment is needed from business and industry in promoting products and housing for older people and supporting research efforts.

Dissemination of Existing Information and Products

Strategies with a nonmedical approach to marketing products and devices will assist in removing some of the stigma attached to the use of assistive devices. These strategies include developing better designs as well as teaching older people that using such devices only means they are performing tasks differently from other adults.
Older people need to be taught how to express their needs to product designers and manufacturers.
Designers, architects, and builders need access to logically organized, available information on products and research findings.
Strategies should be developed to get information to seniors and health-care providers about available design options and retrofits.
Potential funding sources should be educated about the relevance of anthropometric research to good product design.

CONCLUSION

This session's message is: pay attention to how older adults can live independently in their own homes. Solutions must be cost-effective, feasible, and acceptable to older adults. Although computer and robotic technologies can be very effective in improving the quality of life for older people, these types of technologies are not affordable for everyone nor are they appropriate for some types of living problems. Similarly, although architects and corporations are developing exciting new living environments for older people, it is unlikely that all of the nation's elders will relocate to these facilities with these types of environments.

Therefore, design efforts should be directed toward developing simple, low-budget devices and identifying ways to retrofit existing homes. This includes developing new and better products and assistive devices, as well as finding ways to modify existing environments and products. Efforts also involve communication among researchers, designers, and health-care professionals, and the education of older people, family members, and service providers. Strategies should be developed that allow individuals to age in place.

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