100: UD Perspectives, Progress, and Prospective

In our 100th episode we discuss the podcast, perspectives, and progress in the world of universal design, plus stats that show there’s still more to do.

Good Fit / Poor Fit
Good Fit / Poor Fit
100: UD Perspectives, Progress, and Prospective
Loading
/

Show Notes:

Links to topics and statistics discussed in this episode.

Transcript:

Sarah: [00:00:00] You’re listening to Good Fit Poor Fit. Our podcast is part of The UD Project, a small business rooted in occupational therapy that looks at how the design of a home environment impacts how well people of different ages and abilities perform everyday activities. We chat about this unique perspective to boost your knowledge and help you consider what can be changed in communities like yours.

Learn more about our work at universaldesign.org.

Hi listeners. Welcome back to another episode of Good Fit Poor Fit. Today I have my husband Scott with us to celebrate our 100th episode. Good Fit Poor Fit continues to be an opportunity to advocate for the importance of universal design in our current housing market. Plus, continue to talk about the need for the perspective of occupational therapists as collaborative team members. We have had a lot of [00:01:00] you find out about our organization through this podcast.

Scott: Yeah, if you’ve been with us a while or you’ve recently joined us, this podcast was created by an OT student during COVID and is part of The UD Project.

Sarah and I have been doing this work since 2012. If you’ve been following this podcast, you know, we’ve done a lot of different things like consulting, design, reviews, and now education. Throughout the years, we still have the same vision to see more homes in our housing stock that are universally accessible.

We’re talking about homes that have accessibility features integrated from the start, that work well for a wide range of households regardless of someone’s age, disability, or health related need.

Sarah: And that was definitely one of the reasons why we wanted to start a podcast, to be advocates of UD in homes and educate others.

Typically, my co-host, Rebecca Langbein, and I talk about important home features, dig into housing stats, feature OT students in their [00:02:00] capstone projects, and have conversations surrounding the need for collaboration. While she is not joining us today, I do want to give her a very big shout out and thank you as she has been contributing to these conversations for most of our 100 episodes.

As an OT working in a non-traditional space, Rebecca adds a lot of wonderful insight into the conversation. So, Scott, this being a milestone 100th episode, I feel like instead of doing a snapshot of different highlights from our previous episodes, I’d like to look at the landscape of UD from our perspective, from where we’ve been and where we’re headed and what we’ve seen happening in this space over the years.

I know that as an OT, lots of other service providers like builders and designers are typically focused on the consumer and their individual needs. That’s what we need to do in working with families, but I think your insight can show us that [00:03:00] these individual experiences are also what a lot of people across the US are experiencing, which is one more reason to keep talking about the need for UD in homes.

Scott: Sure. So what we saw back in 2012 when we got started, well a big part of it was personal, and as our listeners may know, I have had a spinal cord injury since 1999 and have used a wheelchair every day since. Sarah and I have had countless experiences of not only finding suitable places for us to live, but also lots of difficulty visiting friends and family in their own homes.

Sarah, as you saw firsthand as an occupational therapist, the challenges that people experienced after a health event that required them to go through rehab and then go home. Well, many people would be discharged from a rehabilitation stay and end up going back to the same place that they lived beforehand, only to discover that their home environment really didn’t work well for their needs.

This causes all [00:04:00] sorts of problems, and I know you and many other OTs and PTs have worked to support these people by offering consulting and home modifications.

Sarah: Definitely. And as therapists in rehab centers and clinics, discharging people every day, I’m sure you all see this as well, we’re trying to figure out the best way to get people home on a limited budget and we can’t renovate the whole house, can we?

Because that’s just a lot of work. So there’s a lot of solutions out there that we’re trying to work on. We’ve also seen quite a few professional certifications gain popularity over the years. These are great in some ways because they create awareness about the need for more functional housing, but the problem is that consumers generally don’t understand them.

Although some are gaining more popularity. Examples include CAPS, through the National Association, of Home Builders which is Certified Aging in Place Specialist, ECHM, and the CLIP certification through the Living in Place Institute. There are also [00:05:00] several different organizations who have given significant attention to home accessibility.

Some of these include AARP, Concrete Change with their visibility initiative and AOTA. Though a lot of the focus is on home modifications and assistive technology, not new construction. And we’ll talk more about new construction shortly. And we’re not saying that home mods and assistive technology are bad, but there are just a lot of issues that go along with that as well.

It’s been encouraging to see OT specific groups like the Home Modification Occupational Therapy Alliance, HMOTA, working together, and then there are also different groups who meet locally to have conversations about topics like aging in place. Maybe you’re a part of one of those. I think it’s just indicative of more people starting to recognize the need and trying to figure out what to do about it.

This actually reminds me of an email I received from an architect named Taylor Davis, and she’s actually featured on our [00:06:00] podcast. One thing that she summed up, is why we feel this is important to keep talking about universal design and the need for our communities.

Here’s what she said, “I have been fascinated by the studies that show the tiny percentage of homes in this country that have basic features, really basic features that support accessibility. And with over 65s being a growing segment of our population, having housing stock that can support their choice to live in their homes as long as they can is a pressing concern. Investing in building or renovating homes that have some accessibility features, not only enables folks to make that choice as they grow older, but as you all have pointed out, increases the number of potential purchasers down the road.”

Scott: Yeah, that’s a good quote. We’ve always based our work on the concept of universal design because the same focus for access for those aging also helps parents who have kids with disabilities or people who have had [00:07:00] injuries, or people that just have surgery or break a leg and struggle with staying safe during their recovery.

One of the big challenges is that the perception about accessibility is that it’s really only applicable for a select part of the population that has obvious disabilities or functional needs. There tends to be a mindset of people thinking that it’s only useful for quote unquote “those other people.” Now, there’s a whole psychology behind this, which is interesting because generally speaking, people adapt to whatever their situation is, but there isn’t a common recognition that accessibility is useful for everybody.

I think the big reason for this is because everybody has some sort of reference point about what accessibility is. For better or for worse, the most visible things that people see are what is commonly covered by the ADA in public spaces. You know, things like parking spaces, bathrooms, and all of those separate accessible options.

People see quote unquote “standard” versus quote unquote [00:08:00] “accessible,” and don’t recognize that there are ways to design things that can work well for everybody, without needing to attach an accessible label to it. Unfortunately, when it comes to housing, there aren’t a whole lot of great examples of this, so accessibility in housing is almost always treated and viewed as a specialized thing.

I’ll discuss some statistics that showed just how big of an issue this is though. According to data from the US government. There are over 67 million adults in the USA who live with a disability, but less than 200,000 out of approximately 140 million housing units throughout the US can be considered universally accessible if you do the math, that’s less than 0.15%.

The supply of accessible homes simply doesn’t come close to meeting the need.

Sarah: Now, these statistics are really helpful because when you think about this, it doesn’t mean that [00:09:00] all of these people who live with a disability just don’t have a place to live. It means that the majority are living in homes that don’t work well for their needs.

The main thing to take away here is that lots of people are compromising on their health and wellbeing. Just because they’re making due with the options they have available to them. And we did a lot of work early on and we got a lot of quotes from people about how housing impacts their health.

And a lot of it isn’t just because they don’t have a wide doorway to enter. It’s a lot of mental health issues that arise from that as well.

Scott: Yeah, very true. So back in 2017, the Joint Center for Housing Studies at Harvard identified that only 1% of the national housing stock offers five basic universal design features.

Now, if you remember a couple moments ago we mentioned that. Less than 0.15% of homes [00:10:00] could be considered uni universally accessible, so 1% is certainly much better than that, but still it doesn’t address the widespread need. And the focus of their study was really on five basic universal design features.

What are those features you might ask? They include a no step entry, single floor living, extra wide hallways and doorways, electrical controls that are reachable from a wheelchair. And levers on faucets and doors. Now, just because a home has a handful of universal design features, it doesn’t make the entire home universally designed.

This is also one of the challenges that we’re up against because people see the universal design label and think because of marketing that the home is going to be accessible to people of quote unquote, “all ages and all abilities.” I can tell you from personal experience that even though these features are helpful, they don’t address everything that’s needed to easily manage all of the different tasks that we all do in our homes.

Even [00:11:00] basic stuff like grooming, bathing, laundry, making meals, et cetera, you get the idea. Our best guess is that the 1% statistic that they came up with comes from the prevalence of A DA units in multifamily apartment complexes. One question that we need to be asking is whether or not this is ideal for the places that people actually want to live when accessibility needs become an issue.

But moving on, the American housing survey notes that out of all the homes in America, the median year that homes were built was 1977. In other words, the average American home is nearly 50 years old. Not only does this mean that most homes are out of sync with current styles and trends, including accessibility, but many are in need of repair or will need work in the not too distant future.

So let’s couple this with a statistic from the National Association of Realtors. They found that the median duration of home ownership is 13 [00:12:00] years. So this is important to note. When considering the age of our country’s homes, a home that’s 50 years old, will, on average, have had at least three different households living in it.

So if accessibility is only seen as a specialized option for some people requiring customization to meet individual needs, but the same homes have multiple households living in them throughout the years, then why do we not prioritize access? This is supported by a finding from the Journal of the American Planning Association that indicates that there is a 60% probability that a new single family home will house at least one person with a disability during its expected lifetime.

In other words, if more than half of all homes will need to accommodate someone with an accessibility need, then why is universal accessibility not common? These data points have major implications about the homes that are being built [00:13:00] today. If we don’t start prioritizing universal accessibility in new construction, future generations are going to be having the same conversations another 50 years from now.

And unfortunately, the housing industry is much better at being reactive than proactive.

Sarah: Yeah, there are a lot of people out in our communities living in homes that aren’t as functional for their needs. We personally know a good number of them. So to recap, if the homes in our country last for decades and typically have multiple owners.

Many of whom have a disability, it makes sense to build homes that can support accessibility needs. We definitely need more than just five universal design features in a home. Unfortunately, homes that are truly universally accessible are nearly impossible to find. Modifying inaccessible homes isn’t sustainable, even though it’s going to be needed for many generations.

The reason for this [00:14:00] is that modifications are usually specific to an individual. It’s not uncommon to see individualized accessibility features removed when they’re not seen as useful. How many of you have seen this on a remodeling show on TV? This is why accessibility needs to be viewed through a universal lens.

That said a 2024 article in Home Care magazine noted that there has been more demand for aging in place in remodeling projects in the past five years. The National Association of Home Builders says that 76% of remodelers have noticed aging in place features increasing in popularity. This is due to an awareness of the benefits and some people planning ahead while others are realizing they need more usability now, maybe after a fall. The most commonly requested features include grab bars, curbless showers, and taller toilets. Certainly helpful, but I’d say those features only scratch the surface [00:15:00] for what would really help our population.

Scott: And on a positive note, things like smart home technology aren’t as foreign as they were before.

I know a lot of people have gained independence with many tasks that were once difficult, like turning on and off the lights with smart bulbs, locking or unlocking doors with remote access, and even monitoring a family member over video for safety. Also, we’re seeing more product manufacturers choosing aesthetically pleasing designs for products that would otherwise be classified as assistive technology.

These are becoming more mainstream and seen more as a convenience than only used for medical or health related purposes.

Sarah: Yeah. We recently had an OT student do an entire project on how UD products can be aesthetically pleasing. We’ll put a link in the show notes to her project for you if you haven’t seen that yet.

The popularity of ADUs or accessory dwelling units and multi-generational [00:16:00] houses are also on the rise as many middle aged families are finding themselves in the sandwich generation of caring both for parents and kids. Finances and safety also play a role in this as well. And even more exciting people are learning about universal design.

Whenever we give a presentation, I see people nodding their heads like they’ve actually heard the term before, which is positive. I even had a conversation with a neighbor across the street from me who was chatting about it even before I mentioned what I did for work. So that was pretty cool.

Scott: So the big question is, what do we do about this?

There’s a big need, and it’s certainly no easy feat to completely change the way that the housing industry functions. However, over the years and after many conversations with designers, builders, and other housing professionals, a common theme that we’ve seen is that designers and builders respond to what people want.

We would often hear builders say that if they have a customer who has specific [00:17:00] accessibility requests, of course those customers would be accommodated. Now we kind of have to take this with a grain of salt because people really only know what they know, and even if a consumer has accessibility needs, they may not even realize what’s possible.

The same goes for builders and designers, and even us. There’s increasing knowledge about universal design and home accessibility. But it goes so much deeper when you realize that there are so many different ways to perform everyday activities at home. And knowing that the environment affects those in all sorts of different ways.

Sarah: I often say that once we start talking about this stuff and once people realize, the depth of this, that they will not be able to stop looking at accessibility when they go out around town.

Scott: Yeah, it’s kind of a sickness, but such is life. So anyway, this is a big reason that we have turned our attention towards education about these topics.

Part of the challenge is helping everyday people understanding the universal approach to home [00:18:00] accessibility. If they don’t, then they won’t know what to ask for, and the housing professionals won’t know how to respond. But on the flip side, if more people start asking for universal design and they know what that actually means, then our theory and our hope is that the building industry will respond by prioritizing it.

Sarah: Yeah, that would be pretty amazing to see more houses in the housing stock with universal design features.

The idea of designing for universal accessibility can be tricky, though. Our position is that you really need people involved to understand design from the healthcare point of view, like OTs, mainly because when looking at the idea of accessibility that works for people on a population level and understanding of a broad range of different health conditions, impairments or disabilities, is just really important.

One of my previous students, Anisha Carr, did some research that was very eye-opening in showing that collaboration between people in the healthcare field, with people in the design field is definitely possible.

There’s [00:19:00] just not a great playbook for how that actually happens. We’re going to keep exploring this though because it is an important piece to the puzzle.

So while we can share education, including design standards and guidelines, the challenge really lies in implementing those well, this is something that no one has fully solved, partially because it requires several different professionals with several different backgrounds working together. And the more people you have working together, the higher the cost.

If you didn’t know, housing is really expensive for a lot of people and most folks are trying to cut costs, not increase them. But to reiterate what Scott said, it has to start with education. That’s a big part of our focus at the moment. We have five online home accessibility courses that are video-based and self-paced that we’ve had available for a couple years, but just recently opened up to anyone 100% free. Shameless plug, you can check them out at universaldesign.org/learn, [00:20:00] and if you’re an occupational therapist, you can earn some continuing education credits for them, which is amazing.

Scott: Yeah. There’s a lot more to discuss about some of the big picture issues beyond just advocating for universal design. Advocacy is important, but if we really want to see some practical changes, more people need to know about this stuff. I would encourage you to check out our free courses, which are inside of what we’re calling the quote unquote “learning community” on our website.

The courses go deep into a lot of the issues related to universal design and home accessibility, far beyond the five basic features that the folks at Harvard identified. There are actually over 150 design elements that need to be in place for a home to be considered universally accessible. The learning community also has some discussion spaces available, which you can think of as a mini social network specifically for discussion about this kind of stuff.

We welcome your conversation in there and would love to hear your thoughts, experiences, and ideas. [00:21:00] We’ll be adding more and more content over time, so please consider signing up at universaldesign.org/learn. The need for more accessibility in housing is great, and we’re optimistic that change is possible, but we’re also realistic about it taking time.

It’s important that we do something about it now. So the more that you can learn about it and then the more that you can help other people learn about it, the better.

Sarah: Definitely there’s a lot to this conversation and we are grateful that you are on this journey with us by listening to the podcast. If you have any questions, feel free to reach out and check out that learning community for more content.

Rebecca and I will be back at the microphone very soon as we have, another student that’s gonna share her experience with us, and we’ll have more great content after that. Have a good day.

Thanks for listening to Good Fit Poor Fit. If you want to learn more… first, find more episodes with transcripts and show notes at goodfitpoorfit.com. Don’t [00:22:00] forget to subscribe! Second, check out our courses at universaldesign.org.

We cover housing topics like advocacy, collaboration, home modification, universal design and task adaptations. Lastly, if you have questions or topics you’d like us to discuss, email us at [email protected]. Thanks for fitting us into your day.

Sarah Pruett
Tags: , , , , ,

Leave a Reply

Your email address will not be published. Required fields are marked *