Safe at Home

DC's Office on Aging Pilots a Program to Keep Seniors Injury Free

Toilet Riser and Handles

Aging in place has become a priority with the rapid changes occurring in the District. Many families worry about their elderly loved ones losing their homes, but there is an additional concern when it comes to the senior population. Falling in or around the home can lead to serious repercussions physically, financially, and emotionally. In July 2015 the Safe at Home (SAH) Act was introduced during a session of the DC Council by councilmembers Charles Allen (Ward 6), Anita Bonds (At-large), and Jack Evans (Ward 2). The purpose was to establish a home modification grant for qualifying low-income seniors and adult residents with disabilities to make safety improvements to their homes. Seniors who own homes or renters with their landlord's permission can now qualify for up to $10,000 in home upgrades. The bill also allows an SAH tax credit for people who foot the bill on their own (50 percent of the modification cost or $5,000, whichever is less).

Needs Assessment

The Safe at Home program is a pilot. An occupational therapist will visit the home to evaluate individual needs. The therapist will do up to seven assessments including vision, strength and balance, cognition, and medication. Tori Goldhammer, program manager for the SAH program of the DC Office on Aging (DCOA), explains that the initial setup is “a little combination of an interview and visit; getting a little bit of information about their medical history and what the senior's goals are. We don't go in places in the house where they never go. If the most important thing to them is taking a bath then we focus on that.” Based on the evaluation SAH will purchase small items such as bath mats, lamp remote-control systems, and furniture risers. Larger installations such as stair lifts, grab bars, or ramps can be done by contractors who are trained to work with seniors. “Having an occupational therapist evaluate the homes with the seniors should help them feel very comfortable that they are being taken care of,” adds Goldhammer.

Common Falls Not So Common

It is a myth that falling is a natural part of the aging process, but the statistics don't reflect it. According to the Center for Disease Control, 2.5 million older people are treated in emergency departments for fall injuries annually. One out of five falls causes serious injuries or head trauma. Seniors are particularly vulnerable to fall injuries due to factors such as balance problems, poor vision, muscle weakness and foot problems, and medications that can make them sleepy or dizzy. Head trauma can be a very grave issue for seniors who take blood thinners.  Elderly people with cognitive issues such as dementia are at an elevated risk of falling. In fact, 60 percent of elderly people with cognitive impairments fall annually. Some studies suggest that people with gait abnormalities have an increased risk of developing dementia and cognitive decline.

Falling, whether it results in injury or not, can also take its toll on mental state and quality of life. When older adults fear falling they tend to avoid social activities and stay indoors (over half of falls take place at home). This can lead to increased physical decline and depression. Social interaction wards off depression, and exercise can strengthen bones and protect people from injury, so staying active is critical. The best defense is for seniors to get educated about fall risks and prevention. The DCOA offers fall prevention training periodically throughout the year.

Funding Fall Prevention

Prevention has proven to be much more cost effective than treatment. A stair lift costs on average $5,000. Compare that to the price of one year in a nursing home for a patient who never recovers from a fall (in excess of $100,000) and you have the argument for a funding program. The funding for SAH has been carved out of a larger effort, the Single Family Residential Rehabilitation Program (SFRRP), which provided dollars for home improvements. AARP Legal Counsel for the Elderly collaborated with AARP DC and other advocates to work with the Committee on Housing and Community Development headed by Councilmember Bonds. The groups persuadedthe council to allot money for individuals who need smaller items and do not seek to apply for large dollar amounts.

Since final council approval, DCOA has received hundreds of calls asking for help. In just a few months close to 40 projects have been approved and completed. Rochelle Bobroff, senior attorney for AARP Legal Counsel for the Elderly, says SAH has been essential. “I have personally talked to seniors who say their bathrooms are not on the same floor as the kitchen or bedroom. So if they have a walker or a cane, going up and down steps is a real risk. They managed it yesterday but will they manage tomorrow?” Investing in SAH projects for seniors yields excellent returns: “It's money well spent for the District and a quality-of-life improvement for the seniors.”

What SAH won't cover are big-ticket items that are more structurally related such as buckled floors or damaged walls. The funding is for low- to moderate-income seniors. Individuals aged 18-59 with disabilities are also welcome to apply. “There is an income requirement. The idea is, this is not for the District's millionaires. But low- to moderate-income families who don't have $5,000 to put in a stair lift can get the help they need,” adds Bobroff. SAH is a pilot to measure the need for this type of program, so there will be a push to make it permanent. Given the current interest and volume of applications submitted so far, Safe at Home might be safe for good.

For more information about Safe at Home call202-638-0050 or visit the DC Department on Aging website,

Candace Y.A. Montague is the health reporter for Capital Community News.

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