Hi there, and welcome back to Aging Together! September is Fall Prevention Awareness Month! In this article, I provide a recap of a Q&A session I had with an aging-in-place architect. Aaron D. Murphy shares expert insight into aging in place, home modifications, fall prevention, and the importance of building your ForeverHOME with your future in mind.

The following conversation has been summarized for clarity. You can listen to the full conversation on the podcast!

Pooja (Host): Aaron, thank you so much for joining me today!

Aaron (Architect): Thank you for having me. I’m excited to talk to you.

What inspired you to specialize in designing homes for aging adults?

Two different light bulbs over a decade apart. 

The first one I was actually at the University of Washington in architecture school in Seattle. My grandmother was five foot nine traveling the world, playing bridge, playing cards at a master’s level, loving retirement. When I got out, four years later, she was 5’2 trapped in a hospital bed, and didn’t know Grandpa’s name. For her, it was osteoporosis and Alzheimer’s. But what I noticed, at 22, I don’t really want to know about Grandma’s hygiene, or bathing, or anything medical. But a split-level home was broken for her. There were stairs everywhere. Stairs from the car up to the main floor. Another set of stairs to get to the shower, back down for the laundry. A house like that did not work for somebody with an ability change.

My second lightbulb, ironically, buying a car off Craigslist, 10 years later. Two 63-year-olds bring me a car. Whose is this? It’s Mom, she’s 92. Well, where does she live? Finally gave up the keys, she lives in the assisted living place down the road. I said, I’m doing a little homework. Do you mind if I ask, don’t answer if it’s too personal. What did that cost you? $150,000 out of pocket and $10G a month. 

My jaw hit the floor. That’s where I went, “Oh my gosh, there is a humongous housing gap when it comes to changing ability.” So if we’re living twice as long as we lived in 1900, shouldn’t we be designing houses different?

Can you tell me a little about your relationship with occupational therapists? How their practice and aging in place architects kind of work together. I know you mentioned that you frequently work together with OTs, PTs, and  a whole gamut of professionals. How does that play into your role and your work?

If you go to the bank and you’re in a wheelchair, you can still go to the bathroom there. That doesn’t exist for housing right now. I can go to a book and know where to put blocking behind a wall to put a grab bar in according to the ADA as of 1990, which was a fantastic first start to the rights of all.

But, I can’t tell you if you’re left side strong [or] right side strong. Did you have Parkinson’s in your family? Are you shuffling your feet? Women tend to be stronger in the legs. Men tend to be stronger in the upper body. That’s the OT. That’s what I need an occupational therapist to do when we’re doing home assessment, or when we’re designing a house that considers everything that you might need to the best of our ability at the time.

When you’re planning ahead, 70% of what I design really falls into the term universal design. Just better for everybody. Better for the four year old, better for the 84 year old. But the rest of what I do, and in architecture I refer to this, I think it’s a book I read in college, called Problem Seeking. And by asking enough questions, peeling the onion, getting to real truths, including your dreams and your fears, well, now we know who you need on the team and how we can put more brains for a better solution together at the table.

What are some key myths and facts related to homes and fall prevention? (I’m thinking about how people sometimes feel that function/safety and aesthetics can’t be combined, etc.) What are some key design principles that you consider when designing a ForeverHOME for aging adults?

Good design disappears – that’s step 1. If it’s done right, you don’t notice. You just notice it works. We can use color and light and material transitions to tell your brain about safety without needing yellow bumps on the floor and red stripes on your countertop. We’re not turning homes into hospitals.

What are some of the most common areas you address when thinking about fall prevention and home safety? How do you incorporate some of those universal design principles that you spoke about in relation to accessibility or usability for a wide range of individuals, kind of like you mentioned, okay, mom has osteoporosis and dementia, but dad has Parkinson’s. How are we going to work on this together to then now create a home that is safe for both of them?

70%, I would turn universal design. 30%, I want that occupational therapist, or I want to talk to the doctor. I also want to talk to your financial planner. There are pivot points that all corners are intersecting, and there’s no push without a pull, right? So we do need the big picture.

When it comes to the home itself, whether we’re designing your last house, cool part about an architecture firm, nobody really calls you until after 40 because they bought a spec house first and second. That’s what they sell, right? And so I can say to you, any chance this huge investment you’re about to make that you’ll live here in 30 years, they say yes.

Great. Well, then you’re going to be 70 in this home. Let’s talk about aging in place. So that’s where we get into some of your basic answers: wider hallways, wider doorways, thinking about turning radiuses and mobility devices that may come into play in the future.

I mentioned hallways and doors. Most falls happen in the bathroom. That’s really where I want to look for extra space if we’re modifying a home.

The cool part about an empty nester, you and I both know bedroom three is for the grandkids, bedroom four is collecting Christmas presents for them and a vacuum cleaner. So these houses that we empty nest out of have space to reimagine you living there forever, and that can include an elevator.

If I talk to you about spending 50 grand on an elevator or 50 grand on five months in assisted living – you’ll stay in the conversation.

What are the most common or highly recommended home safety/fall prevention recommendations you see for older adults/new home construction for aging in place out there right now? What’s in the market?

There’s a huge rise in the zero-threshold shower. Creating more of a wet room, European concept, without a curb. Just because that’s one of those places – if your feet aren’t working, that’s a trip and fall waiting to happen.

Sometimes we can do double wall construction if we want sound privacy, because a pocket door goes into a cavity. Now, I’m not a huge fan of the finger pulls – that can be weird as dexterity and and hand strength changes. But what I do like about a pocket door – most falls do happen in the bathroom, and I learned that, that two foot six inch wide door that always swings in to a five by eight standard spec house bathroom? When you fall, you’re blocking the door. That costs the EMT 90 seconds to get the door off when he’s trying to save your life. Would you consider making that easier on him? Most people would, but bathroom is where you’re gonna start.

Touchless faucets or faucets that are levers, not knobs. Light switches that are paddles, not the finger grab. Even the height of switches and outlets matters. If you think about being of a different ability, wouldn’t matter if you’re a little person, wouldn’t matter if you’re a kid, wouldn’t matter if you’re shrinking like I already am at 49, our dimensions change when our body changes. And so what we need and where we need it has to go with that.

What are some of the common challenges you face when you’re designing for aging adults and how do you overcome them?

I think the biggest challenge, quite honestly, is the psychology of acceptance. They come to me as an architect. They know that I have sound advice from experience and licensure, and they probably know that I have a fiduciary responsibility to give them the best advice.

The psychology really is about being an active listener, being empathetic. If you’re in sales in any way, if you own a business, you only sell two things: making a dream come true, or making a pain avoided. Beyond that, no one’s listening. What’s in it for me? You have to explain it in a way of what’s in it for them.

The dream of what could be. Sometimes you have to use a little bit of the fear of what could happen if you don’t, but that’s always a fluid sales discussion, right? But if I’m not listening, and you don’t feel like I’m hearing you, we’re done talking, I’ll never even get to the sale.

Are there any resources, guidelines or tools that you recommend for individuals who are interested in learning more about aging in place design or finding professionals to help them create their ForeverHome?

If you’re just going to go to Google, AARP is a great place. They have what’s called the Home Fit Guide. Really smart checklist that’ll get you started thinking, and they kind of own that space at a national level for all people 50 plus.

What is one takeaway you’d like the audience to consider as it relates to fall prevention, home safety, and either building or finding your ForeverHOME? 

Somebody goes to the hospital every 11 minutes because of a fall. Don’t be the person that says I’m not a statistic until I am one.

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At Caregiver Consulting & Healthy Solutions, we are dedicated to helping you navigate aging together. This blog page is for everyone: whether you are an older adult looking to age in place, a caregiver seeking support and guidance, a young or middle-aged adult planning for the future, or simply someone interested in learning more about the aging process. I hope you’ll join me on this journey. Let’s navigate aging together.

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To get in touch with Aaron D. Murphy or to find out more about ForeverHOME, visit his website, Facebook or Instagram page.