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The Senior Home Assessment and Repair Project
History of the SHARP and R2D2 Center InvolvementThe Senior Home Assessment and Repair Project emerged from a specific community need, identified by the Layton Boulevard West Neighbors (LBWN). LBWN is one of Milwaukee's most successful community development corporations, offering distinct and important revitalization strategies for neighbors, businesses, and the entire community. The Layton Boulevard neighborhood is highly diverse and LBWN saw the need to maintain this diversity by assisting seniors to remain living in and be involved within the community. In order for this to occur, repairs and modifications were necessary in the senior citizens' homes. Leading the Layton Boulevard West Neighbors, Charlotte John-Gomez approached the University of Wisconsin-Milwaukee Community Design Solutions for participation. The R2D2 Center and UWM Occupational Therapy Department faculty, with its vast experience conducting home assessments emphasizing function, accessibility, and universal design, provided critical assistance to LBWN's mission of assisting seniors to remain in their homes. In addition, Dr. Noralyn Davel Pickens began this project with the R2D2 staff and has provided ongoing consultation. During early meetings with LBWN, other Milwaukee County and City agencies, and the R2D2 team, Dr. Pickens suggested approaching the group Rebuilding Together of Greater Milwaukee, which has substantial experience remodeling homes for seniors. Thus the collaborative effort among LBWN, RT, and the R2D2 Center became known as the Senior Home Assessment and Repair Project. Project MissionResidents living in the targeted Layton Boulevard community who meet a set of criteria stipulated by LBWN are eligible for inclusion in the Senior Home Assessment and Repair Program. Repairs and modifications completed on the homes will increase home accessibility, implement assistive technology, increase individual safety, restore the integrity of individual homes; and most important, improve the ability of residents to function in their homes, thus extending the longevity of their independent living and home ownership status. SHARP sets forth to combine occupational therapy home accessibility and universal design assessments with the missions of LBWN and RT to successfully modify and repair seniors' homes in the targeted Layton Boulevard community so this population can successfully remain a crucial component of this community. Before SHARP Modifications This photograph represents a stairway that leads from the main floor of a home to the basement. The stairs are made of unfinished wood and there is only one railing. An individual using the staircase is at greater risk of injury or falls due to the slippery wooden stairs, low contrast between the steps, and a single railing.
After SHARP Modifications This photograph features railings on both sides of a basement stairwell and grip-tape on the edge of each step. The double railings are large and wooden, enabling increased balance and stability of the user. The black, abrasive strips attached on the ends of each step are slip-resistant. The strips are composed of a gritty, textured material that increases tread and traction on the wooden steps. This feature also increases safety and decreases the chances of falls occurring on the stairs. The strips comply with accessibility standards and provide a good safety precaution for homeowners of all ages. Occupational Therapy Home Safety and Accessibility Assessment DevelopmentTThe primary role of the R2D2 Center is to conduct home assessments and provide recommendations to meet the mission of the SHARP project. To thoroughly assess the homes, the R2D2 staff sought to develop a comprehensive home assessment tool. The goal of each assessment is to enable the assessors to thoroughly evaluate each homeowner's needs in conjunction with the home's accessibility and usability while beginning to incorporate principles of universal design. Developing this assessment involved conducting a search to find every related home assessment, checklist, tip sheet, and informative document that has been created. Searches of the Internet, literature databases, and word-of-mouth resources generated numerous results. One of the searches produced a brief home assessment used by Rebuilding Together of Greater Milwaukee. By combining information gathered from visits as well as the search for assessments, checklists, tip sheets, and informative documents, the existing Rebuilding Together assessment was adapted to more fully encompass accessibility issues and begin to incorporate the principles of universal design. How the Assessment is UtilizedAssessment StructureThe assessment includes three main components: an introductory dialogue piece, general homeowner information, and a home assessment piece. The home assessment is broken down into several sections, based on the specific areas within the home (e.g. living room, bathroom, etc.). A variety of question types, including yes/no, fill-in-the-blank, and short answer are included within each section. A list of recommendations can be developed based on the answers. However, the step from the assessment answers to generating this list is not overt. This is where the skill and knowledge of the assessor is integrated with the assessment to personalize the recommendations and fully accommodate the needs of the individual. Using two AssessorsThe home assessment is conducted interview style with two assessors, which is beneficial for a number of reasons, the first of which is to enable a quicker and more efficient assessment. Generally, assessor number one asks the questions while assessor number two documents the visit. Some of the questions are observational in nature and the information can be obtained by simply viewing the specific areas within the home. This is most often done by assessor two while assessor one is talking to the homeowner. Second, when there is more than one homeowner (e.g. a husband and wife) it is beneficial to separate them and discuss issues with each individually. Experience has shown that when homeowners are separated, they are more open. Periodically, one of the homeowners will mention something about the other that he or she did not want to mention in front of the other. For example, during an assessment of a married couple, the husband had trouble with his vision but would not admit to experiencing any functional limitations within his home resulting from his low vision. However, his wife confided privately to the assessor a list of limitations her husband was experiencing due to his low vision. Involving two assessors during that visit assured a full assessment, thereby noting vital elements to help the husband with his day-to-day activities. Challenges Related to Universal DesignThe assessment focuses on accessibility and usability of a house. It takes into account the homeowner's current and future needs. However, the assessment and recommendations generated do not fully follow the principles of universal design. There are several reasons for this. The first is that the houses in the Layton Boulevard community are old. Largely because of this, the floor plans are most often extremely inaccessible. A second reason is the nature of the funding for SHARP. In order to fully remodel the houses following the principles of universal design, significantly more money and time per home are necessary to implement the necessary renovations. A third reason is homeowner acceptance. Most of the homeowners have lived in and owned their houses for more than 20 years. Most have meticulously furnished and decorated each room to their liking and most have preserved the integrity of the original features of their homes. As assessors, it is sometimes quite difficult to convince a homeowner to allow holes to be drilled in carefully preserved bathroom tile to install a much-needed grab bar, or to remove beautifully polished original doorknobs and replace them with modern, accessible lever door handles. To fully implement universal design, assessors would have to convince the homeowner to allow us to modify aspects of their home in which they may see no benefit. For example, a traditional bathtub is not universally designed. Many individuals are unable to use their bathtubs for a variety of reasons; for example, a wheelchair user dependent on transfers. A second example is a home recently assessed. An elderly woman living by herself was sponge bathing because she could not get into or out of her bathtub. Assessors attempted to convince the lady that with various modifications she could once again use her bathtub. She stood her ground and firmly refused. Finally, assessors discussed the possibility of installing a shower with modifications to suit her needs. She flat-out refused and said she did not want to "ruin" her bathroom and was fine taking sponge baths. Needless to say, assessors lost that battle. Such a situation provides an example of a power struggle between a homeowner and an assessor. How LBWN and RT Use Assessors' RecommendationsAfter the assessors generate a summary of their recommendations for home modifications, this document is submitted to LBWN for review. The items are prioritized and combined with other general home repairs that need to be implemented. The cost of each item is determined and the team establishes whether or not we must contract another company to implement any of the items. After looking at the total price, the highest priority items that can be implemented within the SHARP budget are proposed to the homeowner. Agreed-upon repairs and modifications are then implemented. SHARP Image GalleryImage gallery represents various implemented modifications that focus on accessibility. What We LearnedThe team learned that implementing the principles of universal design is more difficult than previously thought, for several reasons. Funding is limited because many do not fully understand and appreciate the principles of universal design. Furthermore, despite the intentions of those involved, assessors must realize that they are dealing with individuals' homes. Therefore, much of the work consists of building rapport with the homeowners in addition to explaining the need for various modifications. Part of the initial project goal was to begin implementing the principles of universal design. However, project team members are slowly realizing that the rest of the world has not yet fully begun to understand and catch onto the extreme benefits of universal design. The team hopes that as time moves on, the benefits of universal design will become more well-known and accepted. Many organizations and individuals are spreading the word and with the baby-boomer generation growing older, in a decade or so universal design may be commonplace. In the meantime, the project team will continue to push forward with its mission and slowly assist in helping and educating others. Project Team
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