Addressing Information Needs in Housing Design

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Addressing Information Needs in Housing Design

• Dr C. Bridge
• The University of Sydney
• Faculty of Health Sciences

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Policy planners thinking

• High staff turnover --gt Need to recover and
  recycle intellectual property in order to balance
  the huge investment in training
• Need to ensure that all stakeholders are on the
  same page and up to date --gt Need to create a
  common pool of information
• Modification mistakes are difficult to undo --gt
  Need a sustainable and resilient cultural shift
  towards a more evidence based practice
• Need to create greater efficacy in outcome for
  clients --gt Good design is not just common sense
  so education and research critical
• Enormous pool of knowledge their --gt So already
  out need to locate and share knowledge as a means
  to sustain a more reflective practice
• Most people want to do a good job and most
  services are geographically diverse so are not
  competing --gt Need to create a community with a
  common purpose in order to bridge the
  Funder/Provider and Service split

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Body of evidence for changes to include people
with disabilities

• There is considerable unmet need for good quality
  accessible housing.
• There is a growing body of evidence for
  effectiveness as an intervention.
• Random Control Trials
• Pre-post test studies
• The accumulating evidence suggests that
• modification or good design can delay the onset
  of functional loss and
• may be an effective strategy for preventing home
  accidents such as falls especially among older
  persons.

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Causation versus selection effects in housing
research

• Causation argument
• the direct effects of particular features such as
  no steps, wider doors etc. on particular
  populations must be empirically observed and
  measured to be implemented
• Versus
• Selection argument
• disability and illness result from poverty and
  restricted choices re locality, quality and
  amenity

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Nexus between housing and provision of care in
the home

• A secure home base underpins community and health
  based care.
• Good quality housing reduces health and care
  costs.
• Community based care through formal and/or
  informal means has the potential to provide large
  savings to Government.
• Housing and tenure types do impact the magnitude
  and the cost of community care.

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Environmental impact on human function over the
lifespan
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Creating a gradient for housing change

• Creating a PUSH effect requires regulation,
  training, monitoring and co-ordination across
  industry players
• While
• Creating a PULL effect requires incentives,
  best-practice exemplars with care toward
  aesthetics and effective marketing.

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Clearinghouse Project

• The HMinfo website was launched in November 2003.
• To create greater capacity within the Home
  Modification sector leading to improved
  residential housing outcomes for older people,
  people with disabilities and their carers
• The HMInfo project provides a centralised and
  accessible online vehicle for collating,
  analysing and sharing information likely to
  improve home modification practice outcomes.
• To achieve this it works in partnership with the
  Home Modification service sector, peak
  organizations (both disability, ageing and
  construction) and State and Commonwealth
  government policy makers.

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Technology as a tool for capacity building
innovation

• A million dollars in computer infrastructure for
  Home Community Care (HACC) funded services
  including home modifications was rolled out in
  2003
• Currently 80-90 of the (HACC) Minimum Data
  Collection is electronic.
• All HACC Home Modification and Maintenance
  services in NSW now have access to World Wide Web
  technology

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Embedded as a part of the Human Services Network
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The Flow of Information
Designers, builders and/or Tradespersons (Practit
ioners students)
Home Modification and Maintenance Information Cle
aringhouse Research team Academics students
Administrators Policymakers
Occupational Therapists (Practitioners
students)
Consumers Carers
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Timber DeckingSystematic Review

• No known published COF for timber i.e normal
  ambulation. let alone abnormal gait, wheelchairs
  etc.
• COF has linear relation to gradient as gradient
  increases COF decreases.
• Water, ice, mould rot known timber issues
• Variety of timber profiles and coating systems
  available but no data on efficacy
• Coated timber composites, steel mesh or brushed
  concrete products being recommended in preference
  to reeded timber.

Source Bridge. C. 2003
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Tile Coating Systematic Review

• A study into the friction requirements for people
  with mobility impairments was found, people with
  mobility impairments require a surface COF 0.6
  for level surfaces and 0.8 for ramps (Buczek et
  al, 1990)
• Smaller tiles provide greater COF due to the tile
  to grout ratio
• Unglazed tiles have a significantly higher COF
  than glazed tiles
• The COF of a tile that has had a coating applied
  was similar for both glazed and unglazed tiles

Source Whitfield, K Bridge, C. 2004
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Grabrail Diameter Systematic Review

• Power or cylindrical grip generates maximum
  gripping force (Achea, 1979
• Dusenberry, 1996 Fothergill, 1992 Pauls, 1985)
• There is an optimal diameter for maximum grip
  force. This occurs when the wrist and forearm are
  aligned the thumb and index finger are forming
  a 'C' when grasping the grabrail. (Achea, 1979
  O'Meara, 2004 Pauls, 1985 Templer, 1992).
• Grips spans that are too large or small or
  inappropriate shapes may reduce grip strength
  (Hedge, 1999 O'Meara, 2004).

Source Cameron, J. Oram, L. Bridge. C. 2005
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Grabrail Orientations Systematic Review

• Lateral orientation causes asymmetry and
  increases the compressive forces of the hip, the
  ankle and knee on the same side of the body as
  the rail (O'Meara, 2003).
• Horizontal grabrail may increase ankle torques
  where a vertical grabrail may decrease these
  torques.
• Hip torque is reduced with the use of a grabrail
  (Bahrami et al., 2000 Ongley, 1999 Roland,
  1996 Schultz et al., 1992).
• Each orientation places the arm in a different
  position, which causes the joints to move
  differently.

Source Seton. H. Bridge. C. 2005
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Alerting systems Systematic Review

• Flashing lights are more efficient than static
  lights. Flash rate should be minimum of 1Hz and
  maximum of 3Hz.
• White light is more effective than coloured
  light.
• Strobe lights are most effective but could not be
  reliably depended upon to consistently wake deaf
  people sleeping
• Within a room or large space the person should be
  no more than 15m away from the light signal.
• Only rooms that have a circumference of less than
  15m can be adequately covered by a single strobe
  light centrally located.

Source Lee, F. Bridge. C. 2004
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Home wayfinding lighting Systematic Review

• An adequate level of illumination for an ambient
  lighting system to enable safe movement through a
  building is 20 40 lux (Standards Australia,
  1990, 1998 Watson, 2002).
• A low level of illumination (0.05 1.0 lux) was
  sufficient for a lighting system to enable safe
  mobility, provided that the lighting system
  creates a high contrast with the background
  environment (Aizlewood Webber, 1995 M. Wright
  et al., 1996 M. S. Wright et al., 2002)

Source Pitch. M. Bridge. C. 2005
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Aggressive and self-injurious behaviour
Systematic Review

• Features such as smaller room size, type of
  lighting, finishes and aesthetic features and
  fewer exposed mechanical devices have been linked
  to less physical aggression and less stereotyped
  behaviour, participation in activities, positive
  interaction and choice (Thompson, Robinson,
  Dietrich, Farris, Sinclair, 1996).
• Features with a history of being damaged by
  people with cognitive impairment need be made
  durable, for example, windows, walls, doorframes,
  toilets, faucets, etc (Close Horner, 1999).
• Features that neither overload nor limit but
  instead provide a limited choice based on the
  needs and wants of the individual e.g providing
  two wardrobes, one with obvious affordances
  containing one or two outfits and the other with
  reduced affordances stores the remainder of the
  clothes (Fleming, Forbes and Bennett, 2003).

Source L. Hodges, C. Bridge, M. Donelly K.
Chaudhary 2007
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Hot Topic Summaries address niche products and
legal liability

• Thermostatic mixing valves
• Scalding loss of core body temperature
• Residential lifts
• Under-utilisation misunderstanding of allowable
  types
• Electrical safety in bathrooms
• Electrocution misunderstanding of wet areas and
  zones
• Home Modifications Childrens Growth
• Changing need individual measurement
• Fire Egress
• Modification of fire exits, smoke detectors and
  egress planning
• Smoke Alarms
• Selection, placement and choices regarding smoke
  detector installation for people with disabilities

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Sustainability is built on a shared inquiry

• untapped effective design resources
• significant shift in understanding
• critical mass of enabling technologies
• potential savings to tax payers
• maintained national well-being and
• improved social capital

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• www.homemods.info

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