Modifying Stairs For The Elderly

When I was an Occupational Therapist (OT), I read about the upcoming surge of retiring Baby Boomers. They’ve often lived in their homes for decades and now many want to age in place. This new phase of life requires making their house safer as they grow older. This is especially true if they happen to live in a two story or multi level home. The main culprit here being the staircase!

So, the question then is what is involved in modifying stairs for the elderly population? There are products you can purchase such as stair lifts, treads, lighting. There are things you can do like modifying handrails, install lights and of course, modify the rooms so to avoid the need to use the stairs.

The 6 main methods for what home modifications you can make for seniors are:

• Move the person to a main floor bedroom if possible
• Install or tighten handrails
• Put lighting and non-slip material on steps
• Install a stair lift for those with poor mobility
• Keep steps and landings free of clutter
• Reduce or eliminate the need to use the stairs

Aging In Place In A Multi Level Home

One of the biggest problems with aging in place in a two story home are STAIRS.

I remember working with an 85 year old patient who had come to rehab after a fall on his staircase in his home. He was over 6 feet tall and wore size 12 shoes. Normally he used a cane when he walked, otherwise his mobility was very good for his age.

He was very fortunate because he only suffered a broken ankle and multiple bruises.

“Research by the national Centers for Disease Control and Prevention shows that home modifications and repairs may prevent up to 50% of all home accidents among seniors, including falls that take place in these older homes.” — AgeSafeAmerica.com

When I arrived at his home to do a safety assessment, I could see that he and his wife had already made some modifications. They had added grab bars in their shower and a shower chair. And, they had modified the steps leading from their garage to the kitchen so that they had low risers. They had also removed all the loose rugs throughout their home.

It was really wonderful to see how proactive they were because honestly, I often had to argue with my patients about the changes that needed to be made!

But one area that they had neglected was making changes to their staircase.

When we assessed how he would use his stairs, it was clear to see why he fell. The depth of each step could not safely accommodate his large feet! We solved the problem by installing rubber mats on those stone steps, installing double handrails AND instructing him to walk up and down the steps sideways.

Yes, it would take him longer but it was safer and much better than another trip to the hospital and more rehab.

Home Modifications for Older Adults

As an OT, I used to do home assessments often. It was my job to check and ensure that my patient could go home to a safe environment. And not only did their home need to be safe, it also needed to accommodate them if they were now using a walker or wheelchair or other mobility device.

Recommendations often included modifications to the home. Some were changes that were easy to make, although some were structural. I would also provide a list of tools and/or equipment such as stair lifts, raised toilet seats, grab bars, medical alert devices, etc.

I admit there were times when the home environment really wasn’t suitable for the patient any longer, making it very difficult to convert it to what they now needed. Often financial restraints would prohibit them from moving, so we did the very best we could with what we had.

Here are some problems and solutions for dealing with older adults living in two story homes.

Problem: Master bedroom and bathroom is upstairs.

Solution: If the homeowner simply cannot use the stairs then the solution is to move the bedroom down to the first floor. Hopefully there is a bathroom on the main level, if not, some remodeling may be required.

A wonderful solution for wheelchair bound patients (and even for those with severely poor mobility) is the use of a portable indoor shower. Yes, there is such a thing. It’s a great option for 2 story homes that only have a half bath on the first floor.

Besides the issue of mobility problems, having a first floor bedroom is smart for several reasons:

1. Escape routes are easier to access in case of a fire or other problem.
2. If no one else is using the upstairs — electricity and heating costs can be lower.

Problem: Slippery steps

Solution: If the steps are wood or stone or any other type of smooth material, they can be slippery. Rubber soled shoes are the best type of footwear for seniors but not everyone will want to wear them.

Another solution is to use rubber treads on each step and landing. These days they come in a variety of styles and designs. The caution you need to take is to make sure that they will not lift up or get caught up if the homeowner is using a cane or other walking device.

If possible — on wooden steps I would recommend to glue or nail down the rubber treads for added precaution.

Other solutions include:

• Carpeting the staircase
• Installing a chair lift

Problem: Poorly constructed handrails or lack of handrails

Solution: It’s always best to have two sets of handrails, one on either side of the stairs if possible. It’s simply safer and usually an easy solution.

If the handrails are poorly constructed or in need of repair, of course I would recommend to my patients that they get a handyman to fix the problem(s). The cost to fix this problem is much less then the medical cost if they fell.

The homeowner should be able to put all of his or her weight on the handrail and feel secure. They should also be able to wrap their hand fully around the top of the handrails.

Problem: Poor vision

Solution: For those seniors with poor vision — it’s strongly recommended to install step lights. There are many different varieties for indoor and outdoor steps. They can be added to each step and landing or can be built in.

Problem: Trouble lifting legs

Solution: The standard height of each step may be too difficult for some elders and for them, there are 4 solutions.

1. Alter the height of steps — using guidelines for Low Riser type of stairs. These are most often used outdoors in public places but if your home (and budget) can allow for them, they are an excellent solution.
2. Modifying Staircases with Stair Aides — but if there are any cognitive problems such as Dementia or Alzheimer’s — it’s not recommended to use stair aide blocks as it may be more difficult for the home owner to remember how to use them safely.
3. Stair Lifts are the most common solution for those who have physical difficulty getting up and down stairs.
4. Elevator — of course most homes cannot accommodate (or afford) an elevator, but it is an option if you can do it.

Problem: Decreasing frequency of using the stairs

Solution: Oftentimes someone living in a two story home finds themselves going up and down the stairs multiple times a day. Of course, if the objective is to reduce the possibility of falling on the stairs, you want to reduce the number of times you have to use them.

Here are some tips on how to do that:

• If the home security system only has a panel on the main level, it’s recommended to add a second panel upstairs (in the master bedroom if possible).
• Keep several bottles of water upstairs.
• Stash away some crackers or granola bars, etc. upstairs.
• Purchase a second set of cleaning supplies (if you do the cleaning) and keep them upstairs. If need be, purchase a second vacuum cleaner for upstairs.
• If possible, install a laundry chute upstairs and hopefully you will be able to connect it to the laundry area.
• Being safe means not taking chances. It’s mandatory to enforce the idea that carrying things up the stairs is NOT safe. If the homeowner MUST carry small items upstairs — a good way to do that is by wearing a backpack or an apron with pockets, etc.

Getting Financial Help

Major renovations such as moving a bedroom downstairs or installing a full bathroom with safety features on the first floor can be costly. But, the majority of the time only minor changes will have to be made and these can be more affordable.

There are over 400 federal, state, non-profit and private organizations in the United States that offer programs that provide financial assistance for older adults.

For home modifications and equipment — you can fill out the form at PayingForSeniorCare.com to see if you qualify and what programs are in your area.

Related Questions

Are Carpeted Stairs Safer?
Yes, carpeted stairs are generally safer for older adults than solid wood or stone or any other slippery material. Fully carpeted stairs are the best option because it is less likely that someone could trip on them and the padding installed under the carpeting can help to cushion a fall, if it happens.

Are Stair Treads Safe?
Yes and frankly, they are often overlooked as an option for improving stair safety in a house. if carpeting is not an option, stair treads are a less expensive alternative to making steps safer.

Are Stair Lifts Safe?
In general, yes. There are issues to consider such as the cognitive level of the user (i.e., can they understand how to use a chair lift?), the type of lift you choose and the options that are on the product. Read more about safety issues and other information about stair lifts.