Americans with Disabilities Act (ADA) in Senior Living Resources: Pierson and Fairchild, Ch. 12 O’Sullivan text, & US Dept. of Justice, Disability Rights Section Heather Braden, PT, MPT, PhD, GCS

Objectives Identify workplace accommodations for seniors who are still in the workforce Identify public accommodations in stores and transport for seniors Recognize home accommodation needs for seniors Discuss and assign a home evaluation for a senior

Federal Statutes ADA requires that goods/services available to the public be available to persons with disabilities Violations result in fines/injunctions with court orders requiring defendants to make their business more accessible to persons with disabilities ADA protects those w/ AIDS, cancer, MR, learning impairments, deafness, blindness, traumatic brain injury, and others

Workplace Assessment for Seniors in the workforce (some folks never retire) Title I: Employment- may not discriminate for disability in hiring or promoting if person is otherwise qualified for job Reasonable accommodations for employees are requested w/out undue hardship on the company The essential functions of the job must be met Adjusting & re-arranging equipment, providing readers/interpreters if a vision/language impairment, modifying work schedule, AD such as large print or amplifiers, accessible restrooms & doorways. Parking size, surface, entry with illumination, platform, access to eating area, elevator, refreshment machines

Federal Statutes in the Community Title II: Public Service- may not discriminate re: public transportation 6 minute video describing benefits of ADA re: transportation http://www.iidc.indiana.edu/cpps/ada/celebrations/adavideos.asp#dbtac-psa Title III: Public Accommodations- access to restaurants, hotels, stores, theaters “Universal design” when building to minimize re-modeling needs Public facilities require equal access for those with disabilities Remove structural barriers Install ramps, widen doors, sufficient parking space, grab bars, restroom with w/c access, phone and fountain heights, cut out curbs Public transportation access, crosswalk indicators, parking spaces, entry to buildings, access to counter tops & checkout areas, aisles, emergency exits 4 minute video- town in TX that needed to improve ADA compliance in certain areas http://www.youtube.com/watch?v=ygtq74bmehs&feature=related Universal design= stepless entrances, wide hallways/doors, level transitions b/t rooms w/ no thresholds, nonslip floors, lever door handles, rocker light switches, single-handle sink faucets, no-step shower access

Universal Design of public facilities Steps <7 inches tall and >11 inches deep w/ handrails extending at least 12 inches beyond top & bottom of stairs Steps with tactile warning strips to alert person a change is coming 5’x5’ area at doors 34” doorway width and lever style door handles Choose firm furniture with double arm rests and upright backs Non-slip, level floors w/ matte finish to reduce glare

Home, Nursing Home, Assisted Living Assessment Sidewalk, driveway and garage (detached?), approach to entry w/ steps, porch (lighting?), threshold height Access to electrical outlets, light switches, access to call lights/phones, access to smoke detectors, emergency exit, heating/cooling controls Access to sink, tub/shower, medicine cabinet, protection from hot water pipes from w/c level Access to clothes, closet, bed height Home Evaluations can be via video taping or in person

Assignment: Home Assess/Evaluation ADA W/C Accessible “Home” Choose a senior citizen 70+ y/o and complete a home assessment. Their home may be a local nursing home, ALF, senior care center, or residence. Bring a tape measure. Check out w/c or walker from DPT Program Office if need be. Utilize the ADA w/c accessible home specifications and HOME ASSESSMENT form. Assess the home recommending WHEELCHAIR LEVEL or WALKER LEVEL needs. Turn in Home Assessment as instructed by deadline.

W/C Accessible Specifications at Home (see ADA w/c accessible home handout) Garage- 10 feet height w/ direct access to house Sidewalk – 36 inches (in) minimum Doorway- 32 inches minimum Ramp- 1 inch rise for every 12 inches run/distance Hall width- 32 inch minimum, 40 inch preferred Threshold- ½ inch or none Electrical outlets & phone access- 18 inch from floor Switches- rocker type switch, 40 inches from floor Door handles (lever) & Windows- 36 inches from floor Floor- firm w/ no rugs Cabinets, Outlets, Microwaves access- 36 inch depth clearance in front and to reach

W/C Accessible Specifications at Home (See handout for w/c accessible home) KITCHEN U/L-shaped floor plan with 5’x5’ turning radius Counter top, sink height, range height- 30-34 in from floor & knee clearance of at least 26-30 inches Electric stoves w/ controls on front or side Dishwashers elevated 6 in w/ front controls Side-by-side frig is needed Counter top microwave is needed Use glide-out cabinet shelves to improve access to storage areas

W/C Accessible Bathroom Toilet- 16-18 in from floor, grab bars needed Roll-in shower- 5’x5’ or regular shower- 3’x3’ w/ grab bars; tub seat, hand held shower head, & adhesive strips to minimize slipping on the tub/shower surface likely needed Sink- 34 in max from floor (bowl depth slope front to back) and insulate pipes to prevent burns Thermometer to test water temp prior to bathing Grab bar 24-30 inches long attached securely

W/C Accessible Bedroom Bed height- 18-22 in, space for w/c transfer Closet- slide doors, rods adjustable to 48-52 in max from floor with wall hooks and shelves around 45 inches Dressers- 36 in from floor w/ 36 in “reach and access” zones

Adaptive Home Features -Disability Connections, 2011 Install hinges allowing door to open and drop back in line w/ frame for extra clearance Remove trim around inside of door adding ½ inch Remove hand rims off w/c Mount adjustable mirrors above stove so can see into pots from the w/c Buy a “reacher” to turn off burners Use shelf liner to open jars/bottles Buy large handled cutlery for arthritis or s/p CVA Buy oversized, lit key pads for phones (do not pre- program 911)

Adaptive Home Features (continued)……. Mount battery operated lights in closets or pantries (if no light exists already) Place hats, gloves, scarves, etc in baskets easily reached to avoid top shelves Place a cut tennis ball over door knobs for comfortable grip and turn or use longer lever handle Choose keys with large, round tops and apply rubberized, color rims for easy identification Add tassels, large loops or cords to zippers so arthritic fingers can dress successfully Rearrange furniture for wider walkways for canes and walkers

ADA SUMMARY PTs are experts of functional movement analysis. Be prepared to assess and recommend adaptations for your patients’ daily needs. If a pt’s current living environment is not feasible to remodel, be prepared to recommend alternative living quarters based upon pt’s needs and safety.