ADAPT- The Approach to Accessible and Affordable Housing Solutions for People with Disability and Aging in Place

Abstract

Studies conducted by US federal and state government agencies, NGOs, and advocates for independent living attest to the need for accessible housing for people with significant disabilities and for those aging in place. According to AARP, by 2030 more than 20% of the population of the United States will be age 65 or older and 87% of adults age 65+ want to stay in their current home and community as they age. Unfortunately, staying in home to many people with mobility or physical impairment presents both logistical and financial challenges. In 2017, Auburn University’s College of Architecture, Design and Construction (CADC) proposed to collaborate with HUD in the development of housing solutions for people with disabilities and those seeking to age in place and was granted a 3-year project from the federal government. This paper will illustrate the team’s approach to comprehensive housing solutions that are both accessible and affordable for people with disability and aging in place.

1 Introduction

Studies conducted by US federal and state government agencies, NGOs, and advocates for independent living attest to the need for accessible housing for people with significant disabilities and for those aging in place. In the United States, escalating health care costs are exacerbated by dramatic increase in the number of people with disability and chronic illness in the over-65 population [1].

The Medicare Current Beneficiary Study (2015) indicates that 74% of Medicare beneficiaries reported living with two or more chronic conditions including heart disease, hypertension, diabetes, arthritis, osteoporosis, pulmonary disease, stroke, Alzheimer’s, Parkinson’s and cancers [2]. The cost of institutional care for our aging population is escalating beyond our collective capability to pay. Nationally, the annual private pay costs for nursing home services average 241% of an older person’s annual income [3]. This population is projected to soar to 73 million by 2030, an increase of 33 million in just two decades with nearly 70% needing some form of long-term care. Cost of care plus increasing demand is leading to a health care and insurance crisis. Prolonging our ability to live independently with home-based care is the optimal solution and what people want.

According to AARP (2014), by 2030 more than 20% of the population of the United States will be age 65 or older and 87% of adults age 65+ want to stay in their current home and community as they age. Among people age 50 to 64, 71% of people want to age in place [4]. Unfortunately, staying in home presents both logistical and financial challenges to many people in current and future society.

Federal guidelines define housing as “affordable” if total costs, including rent, utilities, insurance and taxes, don’t exceed 30% of a renter’s or owner’s household incomes. According to Harvard’s Joint Center for Hosing Studies (2014), a third of adults aged 50 and over in the US are still paying approximately 50% of their income for housing that may or may not meet their needs [5]. To remain at home, affordable options that accommodate the challenges of aging and disability must be made available and be exposed to people in need.

In 2017, Auburn University’s College of Architecture, Design and Construction (CADC) proposed to collaborate with HUD (Department of Housing & Urban Development) in the development of housing solutions for people with disabilities and those seeking to age in place and was granted a 3-year project from the federal government. This paper will illustrate the team’s approach to comprehensive housing solutions that are both accessible and affordable for people with disability and aging in place.

2 The Team

The CADC at Auburn University houses three schools with professors from Architecture, Industrial Design, and Building Science. In addition to the internal collaboration, the CADC partners with Auburn’s Center for Disability Research and Policy Studies to offer an interdisciplinary team of architects, designers, construction professionals, smart home technologists, people with disabilities, and disability research and policy specialists. Auburn also has secured participation agreements for Advisory Council members from Habitat for Humanity, AARP, Volunteers of America, Alabama Institute of Deaf and Blind, Alabama Home Builders Association, and individuals with disabilities who have been actively engaged in policy issues, advocacy, and home adaptation.

The team contains the essential elements in it unified structure to provide a highly experienced and qualified cross-disciplinary team capable of addressing all kinds of challenges mentioned above.

3 The Goal and Final Deliverables

The overarching goal is to enhance the capacity for independent living among people with disabilities and those seeking to age in place through new and existing home design solutions.

To achieve this goal, we need to generate design guidelines and recommendations that do not just meet individual needs but also are easily accessible and understandable. Therefore, the final deliverables for this project will include (1) design guidelines and recommendations for accessible and affordable housing that later can be delivered to the individuals in need, (2) A mobile application (app) that allows users to find and share recommendations and tips needed for creating an accessible and affordable living environment.

4 The Approach

A systematic approach is required for the team to extract, analyze, learn, create, and synthesize to ensure the feasibility of our design solutions. The entire project is divided into 4 major phases in which each has a specific goal and can be related to others in a seamless way. These 4 phases are (1) Research, (2) Concept Ideation, (3) Solution Testing, and (4) Application (Fig. 1).

Fig. 1.

The 4 phases of ADAPT project

The team identified a group of experts and practitioners to provide guidance to the project, and advisory panel. The team would convene the advisory panel a given number of times throughout the duration of the project to share research findings to date, identify challenges and best practices, and provide guidance to the next phase of project development. From the meeting with the experts, the team was able to finalize the Final Management and work plan (FMWP) and begin project activity.

4.1 Phase One_ Research

In the research phase, the team was divided into 5 working groups each with a specific task:

• 1. The New Housing Design Working Group researched on best practices, challenges and recommendations.

• 2. The Redesign of Existing Home Working Group researched on best practices, challenges and recommendations.

• 3. The Focus Group Working Group identified potential participants and conduced a Focus Group session to collect information on specific needs of those with mobility issues and those with significant visual impairments.

• 4. Policy Analysis Working Group researched on best practices, challenges and recommendations.

• 5. Implementation Strategies Working Group researched on best practices, challenges and recommendations

Working groups convened multiple times to complete their recommendations for presentation to the full group at the second Advisory Panel meeting.

Focus Group Working Group conducted a survey at the Focus Group session by utilizing a checklist. This checklist detailed some of the requirements found in the ADA Standards for Accessible Design (Standards). The ADA Accessibility Guidelines (ADAAG), when adopted by DOJ, became the Standards. However, individual homes are not required to be accessible, therefore this checklist was used for the Focus Group participants to identify accessibility problems and solutions in their existing homes.

This checklist was structured based on the four priorities recommended for planning readily achievable barrier removal projects:

• Priority 1: Accessible approach and entrance.

• Priority 2: Access to main living spaces: kitchen, bedroom, living room.

• Priority 3: Access to bathroom.

• Priority 4: Any other measures necessary.

The key findings from Focus Group session were summarized and categorized into 7 major groups of recommendations including: Clearance, Reach, Strength, Posture, Lighting, Climate Control, and Safety. The demand for applying Universal Design principles in all design solutions were also emphasized in the research findings. The 7 key principles of Universal Design philosophy are explained below [6, 7]:

• 1. Equability of design suggests that the item is useful and marketable to people with diverse abilities. Provisions for privacy, security, and safety should be equally available to all users.

• 2. Flexibility of design assumes that the design accommodates a wide range of individual preferences and abilities.

• 3. Designs are Simple and Intuitive if procedures to use the item are easy to understand, regardless of the user’s experience, knowledge, language skills, or current concentration level.

• 4. Perceptibility requires that the design communicates necessary information effectively to the user, regardless of ambient conditions or the user’s sensory abilities. This is accomplished through the implementation of multiple modes (pictorial, verbal, tactile) for presentation of essential information.

• 5. Tolerance for error means that the design minimizes hazards and the adverse consequences of accidental or unintended actions.

• 6. Designs that require Low Physical Effort can be used efficiently and comfortably with minimal fatigue.

• 7. Proportionality assumes that appropriate size and space is provided for approach, reach, manipulation, and use regardless of user’s body size, posture, or mobility.

These 7 key principles of Universal Design philosophy should be applied to the designs of both housing solutions and mobile application.

All working groups reported their findings from research to the full team and the advisory panel. The feedback and comments from the meeting were used to development an implement plan to guide what will refine the parameters of the design activity.

4.2 Phase Two_ Concept Ideation

In the design phase, the New Housing Design Working Group and the Redesign of Existing Home Working Group created high quality, technically appropriate illustrations and drawings to illustrate the critical design and planning issues relevant to new and existing construction. All preliminary designs were documented in orthographic drawings, renderings, diagrams and cost analysis. Two examples of preliminary housing design are shown in Figs. 2 and 3.

Fig. 2.

Accessible layout for a 736 SQ small cottage

Fig. 3.

Accessible layout for kitchen renovation

The app design considerations and general outline on app content were also generated in this phase and presented in a flowchart as shown in Fig. 4.

Fig. 4.

The flowchart of the preliminary app concept (was first called my OASIS and changed to ADAPT later)

All design drawings, the app flowchart, cost assessments for each design and policy recommendations and strategies were presented to the full team and the advisory panel. The feedback and comments from the meeting were used to develop and implement plan to guide what will refine the parameters of the testing activity.

4.3 Phase Three_ User Testing

Feedback from the advisory panel was used to select and refine the designs to be prototyped and tested. Once defined, the designs were converted to testable formats to include immersion technology and constructed prototypes. Users to participate in the testing process were identified and scheduled for testing sessions. Note that all photographs taken during the testing process can’t be disclosed due to HIPPA’s privacy policy.

In this phase, designs were tested by users in two different formats: immersion technology (3D projection and virtual reality) and walkthroughs of constructed room prototypes. As tests were conducted, comprehensive notes (based on audio recording) documented participants’ feedback. The notes functioned as guides for the team to refine and finalize designs that later became the outlines and recommendations for the mobile application and other dissemination materials.

4.4 Phase Four_ Application

After presenting all final designs to the Advisor Panel and HUD, the team collected feedback for any final alterations in design prior to final documentation.

All project documents including designs for both new home construction and existing home renovation, cost analyses, policy recommendations and strategies for implementation were collected and reviewed prior to the development of mobile application.

In this phase, the app outline was refined and simplified based on the 7 key principles of Universal Design philosophy. The 7 major groups of recommendations (Clearance, Reach, Strength, Posture, Lighting, Climate Control, and Safety) are now converted into 3 essential categories: Mobility, Visibility, Safety. Tips including Financial Aid, State/Federal Programs, Building Professional, Assistive Products, Videos, and New Technology are provided as part of recommendations. All recommendations will be customized based on the information provided in the House Profile function where resident profile and house location are stored. The refined app structure is presented in a flowchart as shown in Fig. 5.

Fig. 5.

The refined flowchart of ADAPT mobile application

To ensure that ADAPT app is easy to understand and intuitive to use, all design recommendations are presented in illustrations with great color/value contrast, scalability and color-coding that can be associated with a specific category of recommendations (Figs. 6 and 7).

Fig. 6.

Mobility recommendations for a laundry room designed for residents in wheelchair

Fig. 7.

Visibility recommendations for a bathroom designed for aged residents

The initial GUI concept features function icons comprising both symbol and text and utilizes grid system to ensure all graphic elements are easy to see and absorb. ALL functions on the homepage are hidden but can be easily accessed through the swiping gesture (to the right). A few examples of the ADAPT pages are presented in Fig. 8.

Fig. 8.

Examples of ADAPT’s page designs

5 The Expected Outcome

Although ADAPT app is still a work in progress and needs to be tested, the team hopes that this app is able to offer a One-Stop-Shop for accessible and affordable housing solutions. Users can utilize ADAPT to find and share tips and recommendations needed for creating an accessible and affordable living environment. What’s even better is that people with disabilities or those seeking to age in place in the US can better utilize the resources provided by the government for making their house more affordable, accessible, and enjoyable.