What to do about Grandpa?
Living arrangements present a challenge for many families. Siblings debate who should be responsible for parents who can no longer live alone. Is it the one who lives closest or the one who is retired? As the children debate where the parents should live, Dad stubbornly digs his heels and refuses to consider moving. Just as teenagers can’t wait to leave home for freedom, grandpa wants to stay in his own home during his golden years. After all, he achieved the right to freedom after so many years of being responsible for children and work, right? So, what is the solution to “where should Grandpa go?” Many times the decision comes down to whose home is more accessible.
Rotating Living Spaces As an Accommodation
Rotating Between Homes
For some families, the perfect solution is to have Grandpa visit all the children. By rotating houses, Grandpa has an opportunity to visit with everyone for a while and not overstay his welcome anywhere. Such a solution works well for someone who likes to travel and doesn’t mind living out of a suitcase. However, for many, it has its drawbacks. If the parent has a house that needs care or pets at home, someone must tend to those. If Grandpa has confusion or other signs of dementia, changing locations frequently can worsen disorientation. When wandering is a risk, there is a significant danger of Grandpa getting lost or hurt as he moves around at night in unfamiliar spaces. Alternating homes also require moving “things” from place to place each time Grandpa moves, too, unless duplicate belongings exist in each location. Each time a move occurs, there is an increased risk something will be lost, broken, or forgotten.
Making Your Home Accessible
Moving Grandpa into Your Home
Before moving Grandpa into your home, consider his current and long-term care needs as you plan any remodeling or home repair projects. Think about how well he moves around and how accessible your home is for someone with mobility challenges. Will you need to make structural changes and move furniture around in the long run? Would this only work as a temporary fix, or could it be a long-term solution? Consider some of the following as possible accommodation needs:
- If Grandpa can’t get out of bed, he needs to elevate his head to eat. A bed that allows the head to raise and lower would be helpful, and a knee elevation to keep him from sliding down. Alternative: Stacked pillows or a bed wedge.
- If he becomes immobile, are the doors to the rooms wide enough for a wheelchair to comfortably move through?
- Can the bathroom accommodate a wheelchair for a transfer to the toilet?
- Can a shower chair fit into the shower? Can it also be used as a toilet?
- Do you need a ramp to get into the house? Front door? Anywhere else inside or outside?
- What type of privacy concerns do you need to address?
- Do you need to install more cable TV or satellite viewing options? What about wireless telephones?
- Consider emergency egress and 9-11 access. For example, how can a stretcher get to the location you will be using? In an emergency, can you help them exit safely?
- Are there any special considerations regarding temperature regulations, need for refrigeration, water temperature for showers, safety measures for locking doors or windows?
- Is the height of the bed safe? Will bladder or bowel control be an issue for mattress protection and sanitation?
- Are carpets or rugs on the floor a risk for falls?
- Do young children or animals live with you and pose a potential fall hazard either for rapid movement or leaving things lying around?
- Evaluate fall risks and access into and out of each room if Grandpa uses assistive devices.
- Painting doors in different colors is an excellent way to help people with dementia find their way around the house.
- Painting a door and surrounding walls the same color helps camouflage the exit to decrease the risk of dementia family members leaving through external doors.
Ramps Help with Accessibility into Buildings and Rooms
You might avoid going out in public, but you must access your home. Once you start using a mobility device to help you move around, you may find that you need accommodation for accessing your entrance or other parts of your home. There are many types of ramps that can help with that problem. We have both a permanent and a portable ramp in use.
We used a portable ramp for Lynn’s rollator and continued to use it when he began using a manual wheelchair. The portal ramp also worked well with the powerchair, but we decided to buy a sturdier model to accommodate the chair’s extra weight to last longer. If you consider purchasing a ramp, here are some pointers to consider first.
Tips for Buying a Ramp
Before buying or building a portable ramp, think about why you need one. For example, if you only need it periodically, a portable may be all you’ll need, but if you use it every day in one location, you might want to go with a permanent model. Once you decide, you’ll need both width and height measurements.
Which doors do you need to access?
- Measure each for the height of the threshold and get a ramp long enough to elevate one foot per inch of elevation.
- Measure the inside width of the door frame at the narrowest point. Does anything obstruct opening the door to its broadest potential? If so, consider that limitation in your measurement.
- Your ramp needs a “lip” on both sides for a smooth entrance and exit of the wheels.
The Americans with Disabilities Act requires that public facilities install a ramp for a 4.8 degrees slope.
- There must be a foot of ramp for each inch of incline. So, for example, a 30-inch rise requires a 30-foot ramp.
- At the end of each 30-feet ramp, you must install a 5-foot x 5-foot platform for a rest area or turn-around space.
- The ramp’s width must be 36-inches, and the ramp must have handrails that are 34-38 inches in height.
Accommodations Due to Immobility or Dementia
If your family member is transferring home from the hospital and is immobile, consider the following concerns.
- With immobility, you need to consider frequent turning. An abundance of foam wedges and extra pillows for positioning and comfort become necessary in such cases. Do we have enough or need to order more?
- If he’s incontinent (loses control of bowels or bladder), adult diapers, additional sheets, and incontinence pads must be available for frequent accidents.
- What type of equipment is needed to help with bed-to-chair transfers, toileting, showering?
- If you have a two-story home, will rooms need to be rearranged?
- How are you going to handle bathroom accommodations?
- What type of bathing arrangements are needed?
- Do items need to be moved to a lower shelf to reach them from his wheelchair? If so, which ones and where do the misplaced items go?
- Is there a risk of him wandering away? Does he need a GPS alarm button to wear?
- Do you need alarm systems for the home or a GPS-type tracking device if he wanders away?
- What safety devices do you need in the home?