I have spent a fair bit of time on this. The wife and I are both late 50s with the kids gone, looking at what our next/ last home needs to have. I am sure I have overlooked some stuff.
FWIW I am a 25 year RN, I have been working with shut-ins, the homebound, for the last 5 years or so. Home Health Nurse in US parlance, that would be a 'district health nurse' in the UK. The wife and I are both in good enough baseline health to expect most likely both of us will be using walkers before we kick the bucket, and a 50-50 shot for either of us to be wheelchair bound before we get to go home to Jesus.
The main break point I see is 'independent at home.' That is one spouse working, the other able to be at home alone for extended periods. The four things I have seen over and over are for the one at home to be able to get from the bed to the bathroom to the kitchen and to a vehicle. We are looking for a 3 bedroom/ 2 bath ranch, all one level, with enough room in the garage to build a ramp at 1:12 slope and still fit a vehicle.
The fundamental problem with most bathrooms in the USA is the toilet is too close to the bathtub. Once you (I, we, the patient, whatever) ; once 'you' need a walker to get into the bathroom, and a shower bench to sit down on before you slide over the bench into the tub, the darn throne is too close to the tub.
For the bath, if we start with a tub, throne and double vanity we could probably drop to a single vanity, move the throne over away from the tub and move on. If someone has a big stroke and needs a slider transfer bench for both the commode and the tub this won't be enough room.
Certainly this is a moving target. I have plenty of patients so hard to move that it is just easier to bring in a third party to give them a bed bath, compared to using a crane to pick them up and then roll the crane into the bathroom, these folks are usually not safe to leave at home alone for several hours in a row. Folks in powered wheelchairs too, usually, but not always, just more efficient to provide a bed bath rather than transfer in and out of the tub.
So for independent at home we are looking for the following- but I am real curious to know what I might have overlooked.
1. 3/2 ranch, all one level. Master bedroom and two offices while the wife and I are still independent. Could provide a room to a live in caregiver in the future if needed.
2. 1:12 slope ramp, preferably in the garage for all weather usability, for vehicle access by wheelchair or walker.
3. outdoor patio or deck wheelchair accessible from main level
4. one ADA bathroom, aka the tub and shower bench wheelchair accessible
5. large enough kitchen to get in there with a wheelchair, open the fridge, grab prepared food, heat it in a microwave while still in the wheelchair, and then a spot at the dining table to roll up to.
Nice things would be
1. a sink in the bathroom with no vanity under it so a fella could brush his teeth or shave without having to twist a whole lot.
2. Minimum 38" (3-2) doors throughout. I like 3-6 (42") doors better for wheelchair use. I don't know how many thousands of dollars I have been paid in the last 5 years taking care of skin tears on the backs of the hands of folks whose doors are really too narrow for wheelchair use, but it is too many thousands. I got a nice boat, but I don't like profiting from preventable stuff.
This is where you guys come in. In 25 years of practice, the number of patients I have met with a life goal of moving in to Shady Acres Rest Home is zero. Zilch. Nobody wants to go. Our bathrooms are too small, our doorways to narrow, and our homes have too many stairs. I have a reasonable number of folks on my census who can get from bed to bath to kitchen, but they can't get to the garage and instead need the fire department to come carry them out of the house, and then come back to carry them back in after they go see a doctor.
I did look at buying a wheelchair accessible minivan a couple years ago, probably 2019 or so. I can't make the money work. Even staying within the ethical limits of my job and just advertising on facebook and craigslist without my name on it, getting a chairbound individual into the minivan takes time, and time is money. If I was paying a driver $15/ hour with no benefits and keeping the vehicle in a heated garage so it would last, I would have had to charge $200 or so round trip to take one individual round trip to one doctor appointment. And good luck finding a good driver willing to work on call for $15. How long does it take you to get into the cab and shut the door when you are travelling? Do you buckle your own seatbelt? In a more moderate climate I could dispense with the heated garage, but the problem remains that each fare needs a roundtrip, not a one way.
Appreciate your thoughts here, many of you have aging parents and may very well have seen something I haven't.
FWIW I am a 25 year RN, I have been working with shut-ins, the homebound, for the last 5 years or so. Home Health Nurse in US parlance, that would be a 'district health nurse' in the UK. The wife and I are both in good enough baseline health to expect most likely both of us will be using walkers before we kick the bucket, and a 50-50 shot for either of us to be wheelchair bound before we get to go home to Jesus.
The main break point I see is 'independent at home.' That is one spouse working, the other able to be at home alone for extended periods. The four things I have seen over and over are for the one at home to be able to get from the bed to the bathroom to the kitchen and to a vehicle. We are looking for a 3 bedroom/ 2 bath ranch, all one level, with enough room in the garage to build a ramp at 1:12 slope and still fit a vehicle.
The fundamental problem with most bathrooms in the USA is the toilet is too close to the bathtub. Once you (I, we, the patient, whatever) ; once 'you' need a walker to get into the bathroom, and a shower bench to sit down on before you slide over the bench into the tub, the darn throne is too close to the tub.
For the bath, if we start with a tub, throne and double vanity we could probably drop to a single vanity, move the throne over away from the tub and move on. If someone has a big stroke and needs a slider transfer bench for both the commode and the tub this won't be enough room.
Certainly this is a moving target. I have plenty of patients so hard to move that it is just easier to bring in a third party to give them a bed bath, compared to using a crane to pick them up and then roll the crane into the bathroom, these folks are usually not safe to leave at home alone for several hours in a row. Folks in powered wheelchairs too, usually, but not always, just more efficient to provide a bed bath rather than transfer in and out of the tub.
So for independent at home we are looking for the following- but I am real curious to know what I might have overlooked.
1. 3/2 ranch, all one level. Master bedroom and two offices while the wife and I are still independent. Could provide a room to a live in caregiver in the future if needed.
2. 1:12 slope ramp, preferably in the garage for all weather usability, for vehicle access by wheelchair or walker.
3. outdoor patio or deck wheelchair accessible from main level
4. one ADA bathroom, aka the tub and shower bench wheelchair accessible
5. large enough kitchen to get in there with a wheelchair, open the fridge, grab prepared food, heat it in a microwave while still in the wheelchair, and then a spot at the dining table to roll up to.
Nice things would be
1. a sink in the bathroom with no vanity under it so a fella could brush his teeth or shave without having to twist a whole lot.
2. Minimum 38" (3-2) doors throughout. I like 3-6 (42") doors better for wheelchair use. I don't know how many thousands of dollars I have been paid in the last 5 years taking care of skin tears on the backs of the hands of folks whose doors are really too narrow for wheelchair use, but it is too many thousands. I got a nice boat, but I don't like profiting from preventable stuff.
This is where you guys come in. In 25 years of practice, the number of patients I have met with a life goal of moving in to Shady Acres Rest Home is zero. Zilch. Nobody wants to go. Our bathrooms are too small, our doorways to narrow, and our homes have too many stairs. I have a reasonable number of folks on my census who can get from bed to bath to kitchen, but they can't get to the garage and instead need the fire department to come carry them out of the house, and then come back to carry them back in after they go see a doctor.
I did look at buying a wheelchair accessible minivan a couple years ago, probably 2019 or so. I can't make the money work. Even staying within the ethical limits of my job and just advertising on facebook and craigslist without my name on it, getting a chairbound individual into the minivan takes time, and time is money. If I was paying a driver $15/ hour with no benefits and keeping the vehicle in a heated garage so it would last, I would have had to charge $200 or so round trip to take one individual round trip to one doctor appointment. And good luck finding a good driver willing to work on call for $15. How long does it take you to get into the cab and shut the door when you are travelling? Do you buckle your own seatbelt? In a more moderate climate I could dispense with the heated garage, but the problem remains that each fare needs a roundtrip, not a one way.
Appreciate your thoughts here, many of you have aging parents and may very well have seen something I haven't.
