We know that the first of the three major marketing segments for aging in place solutions and strategies, if we look at them in order, is aging in place without urgent needs (the other two being progressive based conditions and traumatic change needs). This sounds fairly simple and straightforward, but it’s very easy to overlook the nuances here. What exactly is an urgent need and what isn’t? If it’s not urgent, can it still be something that needs to be taken into consideration for a design solution? That would be yes.
Generally, an urgent need would be described as something that is noticeable, such as someone using a cane, leg brace, prosthesis, walker, wheelchair, white cane or service dog, oxygen, hearing assistance, or other physical presentation indicating a need of some type. There is no single type of an urgent medical need. It just means that we can recognize that the person with this type of limitation is apparent to us. We don’t know the extent of their limitation, the overall impact on their lifestyle, how it may intensify or subside, or how it might develop over time just by looking. All we can observe is that something is going on that we need to consider in our design recommendations and that we need to get an occupational therapist or other medical professionals to assist us.
So does a person without urgent needs mean that there are no physical, sensory, or cognitive needs? It means that none are apparent. Does it also mean that we don’t have to get a HIPPA release form signed to involve an occupational license in the assessment process? Not necessarily, We might want to anyway, but that’s not a definite. We would have to know more first. No urgent needs suggest that we can approach a requested remodeling project without any regard for any non-visible or hidden physical limitations that someone might have other than what they volunteer. However, this is quite risky from a liability standpoint and from the perspective of satisfying the requirements of our clients.
There’s a big difference between no “urgent” needs and no needs at all. Most everyone has some needs, and the older we get, the more that those needs increase. Just in the normal aging process – although there is no precise age at which a person can expect to experience any of these conditions – a person can expect reduced vision or vision concerns, issues with their height and reach, and hearing decline.
In terms of vision, it becomes harder for people to read fine print, to distinguish between two or more items of basically the same color or hue (“figure ground”), and to see well at night or in darkened rooms. It requires considerably more light to read or distinguish objects because the iris in the eye does not dilate as much as it did when younger, making it harder to see well in darkened areas. Depth perception can create issues when walking or stepping between two unlevel surfaces. Cataracts can form that creates a fuzzy vision until it is corrected. There are other eye diseases and conditions that can be present also. Glare and visual over-stimulation are two issues that may not be readily apparent but can present uncomfortable reactions and potential safety concerns for people who experience them. While not age-related, color-blindness is a condition that several people experience that can have an effect on how they relate to their living environment, and this is not obvious to an observer.
Then, there’s a natural decline in hearing that occurs as the high and lows diminish and we are left with the midranges. Also, it can take longer for the brain to process the sound waves into electrical impulses and then recognize them as spoken words. It’s not as instantaneous as it was a few decades earlier. That and the toll that loud music, urban sounds, and other ambient noise has had on our hearing and it’s not surprising that older people don’t hear as well as they used to, as they want to, or that they let on that they do. They often mask or compensate for weaker hearing.
A fact of aging is physical shrinkage where the spine actually compresses. It’s not uncommon for people to shrink an inch or two – possibly more. This means that what they customarily have been able to reach in the kitchen, bedroom closet, or bath may by slightly out-of-reach for them now.
None of these conditions are urgent, but neither are the ones to be ignored in the design stage. Knowledge of the typical aging process will enable us to be aware of subtle changes in ability and to design for them. Again, occupational therapists will be invaluable in helping make such determinations.