How Accessibility, Isolation, and Continuity of Care are Affecting Your Community

August 5, 2021 by Damian Sempio, OT - Occupational Therapist · Co-Founder, Thrive for Life LLC

Damian is a licensed occupational therapist and co-founder of Thrive for Life LLC, Hawai'i's OT-led home accessibility company. With 40+ years of combined clinical experience on his team, he has completed 500+ home assessments across O'ahu and the Hawaiian Islands, specializing in aging-in-place design, equipment specification, and accessible home modification project management.

Approximately one in four Americans aged 65 and older are socially isolated (NAP). This isolation presents significant health risks, including premature mortality, poor mental health, high blood pressure, and obesity. Social isolation is linked with a 50% increase in dementia, higher risks of stroke, and, in some cases, even suicide (CDC). We have the unique opportunity to help identify, limit, and alleviate the adverse effects of social isolation on the aging population. But how?

Accessibility

So what is accessibility? Merriam-Webster defines accessibility as capable of being reached, capable of being understood, or accessed by differently-abled individuals. As OTs and accessibility specialists, we can use our skills to increase the quality of life for the communities we serve.

Importance of continuity of care

Complications in care surrounding the COVID-19 pandemic highlighted a reality many of us were already aware of, continuity of care is vital to our communities’ health and well-being. With hospital beds full and the healthcare industry stretched to its maximum capacity, it was our elderly community that paid the price. Many individuals who needed care no longer felt safe leaving their homes for treatment. Those who did leave their homes were hurried through the system to create more space for more critical COVID patients. The cumulative effect of a lack of medical accessibility and receptivity is critical in its own right. With an increase in ageism, inability to receive preventative care, and the onset of a more sedentary lifestyle, our older population was left feeling isolated and abandoned by the health community on which they depend.

Value of accessible home modifications

For some individuals, leaving their home is not only about if but how. Physical limitations on mobility isolate our elderly communities, even if they are highly motivated to get out and experience the world. Often what we think creates mobility opportunities still leaves accessibility gaps. It’s great that your town has a curbside shuttle service for those in need. How will those individuals get to their curb or into the office once they arrive at their destination without extra support? Those three steps between your garage and living room can feel like a mountain for someone experiencing limited mobility and isolation. Creating home modifications and physical mobility solutions keeps the elderly and people with mobility issues safe in their own homes while also creating a bridge between their isolation and the outside world. Poor mental health brought on by isolation compromises the body’s ability to fight off illness and disease. Neglecting mental health can create new ailments while compounding preexisting conditions (Blue Cross Blue Shield). By increasing accessibility through home modifications, we allow individuals with limited mobility the freedom to connect with the outside world or even parts of their home which were previously inaccessible. Physical and emotional accessibility is not a luxury. It’s a vital component to a healthy mind, strong body, and happy life. Reach out to learn more about creating an accessible environment for yourself or your clients. CONTACT US TODAY

Have questions about accessibility modifications for your Hawai'i home?

We offer free home consultations across O’ahu and the Hawaiian Islands. Call, text, or email — we’ll point you in the right direction.

How Medicare Can Save Millions by Investing in Home Modifications

August 5, 2021 by Damian Sempio, OT - Occupational Therapist · Co-Founder, Thrive for Life LLC

Accessible home modifications are an overlooked but extremely cost-effective way for Medicare to save millions of dollars on healthcare for America’s senior citizens. Bureaucratic red tape and political healthcare arguments in general have kept us from moving forward. However, the benefits in both reduced healthcare costs and increased quality of life for our elderly mean that Medicare should begin investing in these critical healthcare solutions. Where do we want to put our healthcare dollars?

Why Home Modifications?

Home modifications are just what they sound like—changes to a home to accommodate the needs of the person living in it. As we age, we may need accommodations that specifically address limited mobility, arthritis, sight or hearing loss, and other issues. These can be as simple as installing lever-style door handles, grab bars, better lighting, or ramps—or as extensive as smart technology, stairlifts, walk-in tubs, widening doors and hallways, or eliminating thresholds. Occupational therapists can determine what modifications are needed and make targeted recommendations.

Cost Benefits of Home Modifications

The #1 cause of senior citizen medical expenses is accidents in the home. They fall, sustain a traumatic injury, and it’s a downward spiral from there. Once you’re injured, you’re more likely to have another fall within the first year. A second fall means that at the very least, you may need a walking device. Worse, you may very well become dependent on a caregiver, need to move to a care home, or even die. Accessible home modifications can prevent these accidents. And they can do it at a fraction of the cost of medical care. For example, widening a doorway to accommodate walkers or wheelchairs can cost less than $100 in materials. A step-free entrance can range from $1000 to $4000. Non-slip flooring can cost as little as $3 per square foot. (AARP) Remodeling a bathroom is one of the most effective projects for preventing falls, and can cost anywhere from $2000 to $20,000. But compare those costs to the costs of moving into a care home, or needing more intensive care after an accident. Long-term care is expensive. Assisted living facilities can cost $4000 per month, and residential care homes can cost up to $10,000 per month. Nursing homes can easily cost $7000 per month. These outcomes could be delayed or avoided with the proper prevention. Even with a clear understanding of both the potential for improved quality of life and the enormous cost savings of accessible home modifications, one of the biggest roadblocks is how to pay for it.

Medicaid Is Already Doing It—Why Not Medicare?

Medicaid already pays for home modifications through waiver programs. Each state provides a way to waive the traditional guidelines of Medicaid so that whatever modifications are needed can be completed. These are not always ADA compliant—they are specific solutions for individuals. The truth is that Medicare could replicate what Medicaid is doing. Original Medicare doesn’t pay for home modifications. However, we’ve started to see some movement with Medicare Advantage plans that allow states to customize their plans in order to cover accessible home modification. In some cases, Medicare Advantage plans will pay for an occupational therapy evaluation or a very few rare modifications. One of our goals locally is to work with our Medicare Advantage plans to try and have home modifications be a benefit for everyone in our area. However, these changes are only partial, patchwork fixes that do not adequately address the need. What’s more, by failing to provide adequate means to age in place, they end up spending more money on more expensive care.

Medicare Could Save Millions by Investing in Home Modifications, Too

Medicare already provides healthcare benefits for US citizens over the age of 65. These are the very people who often need home modifications to avoid more expensive medical care. In addition, Medicare provides healthcare benefits for those under 65 but who have certain disabilities. This is another group that would also be helped with home modifications to avoid accidents and extended or expanded home care. The data shows that healthcare dollars can be saved by implementing programs that invest in home modification. In 2015, the total medical costs for falls totaled more than $50 billion, with 75% of that cost paid by Medicare and Medicaid. And studies have shown that installing home modifications directly results in a reduction in the need for care in the home by up to 46%. For questions and assistance with your home modification needs, contact Thrive for Life. CONTACT US TODAY

Have questions about accessibility modifications for your Hawai'i home?

We offer free home consultations across O’ahu and the Hawaiian Islands. Call, text, or email — we’ll point you in the right direction.

Tips For Choosing The Right Wheelchair For Your Needs

December 21, 2020 by Damian Sempio, OT - Occupational Therapist · Co-Founder, Thrive for Life LLC

Wheelchairs can be liberating or they can be aggravating. For people who are in need of a mechanism for movement, wheelchairs offer a range of mobility options that can have people on the go again. The various styles and designs in which wheelchairs are made can make choosing the correct device for your needs overwhelming. Finding the right wheelchair for your needs will enable you to lessen the hassle and achieve maximum function. As wheelchairs are designed for various types of activities and uses, their sizes, weights, styles, and capabilities all have effects on the user’s experience. Ultimately, when selecting the right wheelchair, especially for a first time user, working with an occupational therapist is recommended. However, there are a few tips that can help you cut down through the decision making the process of selecting the right wheelchair for your needs. Manual Wheelchairs Manual wheelchairs are typically intended for people who have use of their upper body strength, needed for short periods of time, or infrequent use. These types of wheelchairs are maneuvered by the user propelling the chair forward or backward by physically pushing the wheels. The modern models of manual wheelchairs are considerably less in weight than those of a few decades ago, making them easier to fold and load into vehicles as well as to maneuver around in general. While these styles of wheelchairs have made strides in their design options such as added suspension systems that smooth the ride, they primarily are standard utility chairs that are lacking in extra frills. Power Wheelchairs If a person is unable to push themselves with their upper body use or strength, then the better option is a power wheelchair. These designs are powered by electric motors and batteries and controlled by using a joystick for direction. The traditional style resembles a motorized standard-issue wheelchair, where other styles such as the platform model power chair are more advanced. The list of equipment options on power wheelchairs are varied and can range from lighter weight easy to transport to off-road ruggedness. Depending on your level of needs, the power chairs can offer extensive capabilities that allow you to have more independence as well as mobility. However, the bulkier the wheelchair is, the more in-depth your transportation plans will need to become. Points To Keep In Mind Once you have a clear idea of your needs, it is best to test a few wheelchair models if possible before you purchase or rent one. Your weight, height, and physical needs all come into play when choosing the most comfortable fit for you. You will also want to keep in mind the level of use in which you will be required of the wheelchair, if you only need it for trips that require a lot of walking or if you need it to complete daily tasks. All of these considerations will help you determine what wheelchair best suits your needs. Contact Thrive For Life today for all of your wheelchair needs.

Have questions about accessibility modifications for your Hawai'i home?

We offer free home consultations across O’ahu and the Hawaiian Islands. Call, text, or email — we’ll point you in the right direction.

How To Make Your Pool More Accessible

December 21, 2020 by Damian Sempio, OT - Occupational Therapist · Co-Founder, Thrive for Life LLC

At Thrive for Life, we’re all about helping customers to age in place, as they experience what it’s like to live at home in their later years. Many people really desire to stay on their property rather than moving to a retirement community, and we help to make that happen. If a senior happens to have a pool on the premises, there’s no reason they can’t outfit this amenity for enhanced access so that they can continue to use it. Today we’ll talk about some aspects of making pools accessible for those with mobility restrictions and other kinds of limitations. Here are some key ways to add ADA access for a pool. Pool Stairs and Ramps One way to help with this kind of access is to re-engineer the entrances to a pool in the form of pool stairs and ramps. Some out-of-the-box pool stairs are very narrow, and not very easy to navigate for anyone. They’re halfway dangerous! When it comes to convenient and safe access for the mobility impaired, a ramp is the gold standard. A ramp with a rail provides that level of safety that you need to enjoy your pool confidently as you age. It’s also more convenient for most pool-goers. Lifts Pool lifts can be another way to get ADA accessibility for a pool. The key here is to make sure they have the right safety features and lock-up designs to prevent accidents related to unauthorized use. Aquatic wheelchairs Doctors and physical therapists know that pools are a great way to work the body and maintain muscle tone for seniors. The key here, though, is that if someone has particular limitations like lack of lower body strength, they may not be able to do the cardio and training exercises in the pool safely. An aquatic wheelchair can fix this problem. Ask us for more detail about how to use one of these tools to work out safely in a pool. Slip Safety With any of these solutions, it’s also very important to monitor areas around the pool for slip safety. Additional railings and textured non-skid surfaces may be necessary. Having the right eye for safety is critical in designing these systems to really protect seniors who may be more vulnerable to injury from a fall scenario. Ask us about how to customize an outdoor or indoor pool for use by at-home seniors. We excel at helping to offer aging family members more independence and a better quality of life at home!

Have questions about accessibility modifications for your Hawai'i home?

We offer free home consultations across O’ahu and the Hawaiian Islands. Call, text, or email — we’ll point you in the right direction.

Essential Ways To Make Your Home Wheelchair Accessible

December 21, 2020 by Damian Sempio, OT - Occupational Therapist · Co-Founder, Thrive for Life LLC

Making your home accessible means it will be possible for anyone to come into your home and visit. There are many ways that you can make accommodations for those who are in a wheelchair or have limited mobility. Although it will cost time and money to make the proper modifications, the benefits can be so rewarding. Here are some of the ways you will want to modify your home to become wheelchair accessible.

Modifying Your Entry Way

At least one entryway in your home needs to be wheelchair accessible. Installing a wheelchair ramp will allow easy access for anyone who wants to enter your home who has a disability. There are a variety of styles and shapes you can choose from your entry ramp, such as concrete, wooden, or aluminum ramps. Aluminum ramps are easier on your budget and durable as well. To accommodate a wheelchair, every doorframe of your home, including the main entryway, should be at least 32 inches wide so a wheelchair can come through. Be sure you want to widen the main entryway as well as any interior doors. When installing doors, such as bathroom doors, make sure the door swings outwards, so it’s easier for someone in a wheelchair to enter a bathroom and close the door.

Modifying the Bathroom

Setting up the bathroom is one of the most important ways to make your home wheelchair accessible. First, make sure there is one full bathroom on the main floor of your home. You will also want to be sure the bathroom is slip-proof. So, remove any rugs to prevent possible accidents. Next, your bathroom should have a bathtub or shower designed for someone with limited mobility. You will want to include things such as a transfer seat, grab bars, handrails, a bath bench, and a roll-in shower. For your toilet seat, add a raised seat to your existing low-level toilet seat. Also, install grab bars around the toilet, which are 33 to 36 inches high, and a grab bar right next to the toilet around 42 inches in length.

Modifying the Bedroom

For your bedroom, you will want to make sure there is enough space for someone with a wheelchair or walker throughout the room. First, you’ll want the bed size to be comfortable enough to sleep in, with enough space for someone to move around the bed in a wheelchair or walker. Also, be sure that the dresser is within reach of the bed, making it easier for someone with a disability to get dressed without getting up. Getting your home ready for someone with a disability can be an expensive investment, but the freedom it allows makes it more than worth it. For questions and assistance with your home transformation, contact Thrive for Life for your next project.

Have questions about accessibility modifications for your Hawai'i home?

We offer free home consultations across O’ahu and the Hawaiian Islands. Call, text, or email — we’ll point you in the right direction.

Top home modifications To Prevent Falls

December 19, 2020 by Damian Sempio, OT - Occupational Therapist · Co-Founder, Thrive for Life LLC

At Thrive for Life, we understand the importance of fall prevention for seniors who wish to age comfortably in their homes. Falls are a serious concern, with 3 million falls reported annually by the CDC. Of these, 300,000 cases result in hip fractures—a major cause of long-term disability. Our mission is to provide families with the tools, resources, and personalized care needed to ensure their loved ones remain safe. Each individual has their own unique needs, and we work hard to develop customized solutions for fall prevention.

Personalized Fall Prevention: One Size Doesn’t Fit All

Understanding Individual Needs When it comes to fall prevention, there’s no one-size-fits-all solution. Some seniors may require comprehensive support with lifts and handrails, while others may prefer minimal assistance that allows them to remain more independent and mobile. Take Jim, a World War II veteran with a heart of gold. After evaluating his condition, we learned that Jim had excellent upper-body strength and was transitioning to a new prosthetic leg for improved mobility. Although we initially suggested a full setup of support, including a stairlift and an ADA-compliant bathroom, Jim had other ideas.

“I don’t need all that stuff,”Jim said. “Just give me support bars and a ramp out front to get in and out.”

His straightforward approach taught us that each person’s preferences and health conditions are different. After analyzing his property, we made a plan that included sturdy handrails and a ramp for accessibility.

Tailored Solutions That Work

For seniors like Jim, sometimes all that’s needed are minimal modifications. Jim’s request for built-in resistance bands on his back patio showed us how committed he was to maintaining his upper-body strength and mobility. By adding resistance bands, Jim could stay active without the need for more intensive modifications. At Thrive for Life, we emphasize understanding the individual while still planning for long-term safety. We ensure that seniors are safe while allowing them to maintain independence and quality of life.

Customized Fall Prevention Strategies

Home Evaluations: Each senior has different mobility levels and needs. A proper home evaluation ensures that necessary changes are made based on these factors.
Support Bars and Ramps: For those like Jim, sturdy handrails and easy-access ramps provide security without over-complicating daily routines.
Minimalist Safety Options: By offering built-in resistance bands or lightweight supports, we help keep seniors mobile and active while maintaining safety.
Comprehensive ADA Solutions: For seniors requiring more assistance, we also offer stairlifts, ADA-compliant bathrooms, and other mobility aids.

The Value of Qualified Consulting

We believe seniors deserve to enjoy their golden years with peace of mind. At Thrive for Life, we specialize in providing tailored solutions to meet the specific needs of every individual. Whether it’s installing support bars or designing a fully ADA-compliant home, our goal is to help seniors remain safe and independent in their homes. Contact us today to learn more about our fall prevention services and how we can assist in creating the perfect plan for your family’s unique needs.

Concerned about fall risk at home?

A home fall risk assessment goes room by room and identifies hazards most families don’t see until after an incident. Schedule yours — it’s free, it’s thorough, and it gives you a clear action plan.

Top 3 reasons why you shouldn’t make your remodeled bathroom ADA compliant

December 18, 2020 by Damian Sempio, OT - Occupational Therapist · Co-Founder, Thrive for Life LLC

1. ADA guidelines do not apply to the home setting.

The United States Access Board states, “These enforceable standards apply to places of public accommodation, commercial facilities, and state and local government facilities” (https://www.access-board.gov/guidelines-and-standards/buildings-and-sites/about-the-ada-standards). The next time you have a contractor work on your home for either you or a family member with a disability and the contractor starts to use the term “ADA”, ask them what their experience is working on ADA jobs in non-residential and residential arenas just to see if your situation would benefit from ADA guidelines.

2. ADA design and specs is a cookie cutter approach.

Often, people with high medical needs such as those who have had a stroke, spinal cord injury (SCI), brain injury, or ALS require custom home modifications. Why would a person who has a high-level SCI and no functional use of upper and lower extremities, require grab bars at ADA specifications installed in their bathroom that they cannot physically use? They don’t, there isn’t a need to install them – though it is always a good idea to install blocking for future grab bar use if you are going to be building new walls anyways. Don’t get me wrong ADA is better than nothing and it is a good foundation to start from, though its a guideline and will not suit everyone’s needs. Example: We had a client with a spinal cord injury that was 6 feet tall. Her routine was to use the toilet, then shower immediately after. She did this for hygiene and routine reasons because it just made sense to bath after using the toilet. She also did this because it provided an opportunity for her to be reclined in her chair afterwards as some people who have had a SCI have a difficult time regulating their blood pressure, especially after a bowel movement, which is known as a vasovagal episode. Compound this with medications and a full stomach after breakfast equals the possibility of passing out. Our client had general contractors come in and redesign the bathroom to ADA specs which included a 60″x30″ minimum roll in shower. This might have sufficed for other people, though in her situation she was 5’6″ long when reclined in her shower commode wheelchair after using the toilet in order to increase her blood pressure and prevent dizziness and fainting. Add on a couple more inches for the wheelchair leg rests and handles in the back and her total length was coming out to almost 6 feet. Ultimately she had to bath perpendicular to the shower with her feet and half of her body protruding out into the bathroom as the ADA designed bathroom that her contractor made, did not address her specific medical needs. She contacted us at Thrive for Life LLC and we created a design that provided more comfort and accessibility, while at the same time addressed her medical needs and her caregivers’ needs.

3. ADA design can end up costing more.

When remodeling for accessibility, it is critical to employ a designer who is experienced, educated and knowledgeable in creating modifications for residents with disabilities. Those of us who have this expertise can create a customized space without the cost of unnecessary modifications or even worst, having to redo the bathroom all together. Two areas where money is unnecessarily spent in a remodel include: 1. Installing items that are not needed like grab bars for someone who cannot complete transfers. 2. Installing 36″ doors. This is a common misconception that all doors need to be 36″ wide, when, in reality, it’s the door width opening that matters. If a resident has a 32″ door and we can install swing-away hinges and achieve 32″ of space, then the doorway is ADA compliant. We work with contractors all the time that say, “So you’re gonna need 36″ doors everywhere, correct?” This depends. If a caregiver uses a 16″ wide transport chair to push a resident around the house, and we don’t have any 90-degree left or right turns in order to access the bathroom or rest of the home, then no we will not need any 36″ doors that yield “at least” a 32″ door width opening. This is because a 16″ transport chair with small wheels in the front and back, will be at most 20″ wide, putting money back in your pocket instead of widening doors that you do not need. ***HACK TIP*** If you have a walker and you cannot get through some doorways in your house and all you need is a couple of inches, try this. Switch the 2 front wheels, so put the right wheel on the left leg and the left wheel on the right leg and you will instantly have a walker that is 2″-4″ narrower.

Planning a bathroom remodel for accessibility?

Before your contractor writes a spec, talk to an occupational therapist. We’ll tell you exactly what your family member needs — and just as importantly, what they don’t. It’s a free conversation that could save you thousands.