Recently, I’ve been thinking more deeply about some of the design barriers that exist between my house and me, after attending one of The Center for Health Design’s webinars, “Beyond Aging in Place: Opportunities and Innovative Solutions through Universal Design,” presented by Jane Rohde, principal and founder, JSA Associates (Catonsville, Md.), and Jordana Maisel, director of outreach and policy studies at the Center for Inclusive Design and Environmental Access at the University at Buffalo and co-director of the Rehabilitation Engineering Research Center on Universal Design in the Built Environment (Buffalo, N.Y.).

My house was built in 1930, so there are a few features that work for me only because I’m fully mobile. When I wake up in the morning, I head to my bathroom to get ready for the day. At 5 feet 10 inches, I must bend way down to reach the tiny sink, I step over a high bath to get into the shower, and I travel down a long, winding staircase to get to the kitchen.

The design of my home will become an issue if I choose to age in place, as many in this country are choosing. But by using universal design principals, I could better prepare my home to adapt to my changing needs and mobility limits as I age, such as a sink that flexes to different heights or installing a barrier-free shower.

This same thinking on flexibility and serving the needs of people of all ages and abilities needs to be applied to healthcare environments to better serve patients. During the webinar, Maisel discussed how universal design should improve human performance, health and wellness, and social participation through the following eight goals:

Human performance:

  1. Body fit: Does the design accommodate a wide range of body sizes and abilities?
  2. Comfort: Does the design keep demands on body function and perception within desirable limits?
  3. Awareness: Does the design ensure that critical information for use of the space is easily perceived?
  4. Understanding: Are methods of operation and use intuitive, clear, and unambiguous?

Health and wellness:

  1. Wellness: Does the design actively seek the state of being in good health as a goal?

Social participation:

  1. Social integration: Does the design treat all groups of people with dignity and respect?
  2. Personalization: Does the design provide opportunities for choice and expression of individual preferences?
  3. Cultural appropriateness: Does the design respect and reinforce cultural values and the social environmental context?

The healthcare community is beginning to address these goals in new build and renovation projects. Many emergency departments (ED) throughout the country are developing spaces that are specifically designed for an older population by including features such as handrails, shock-absorbent flooring, and low beds.

Handrails, for example, support a patient’s movement throughout the space with less risk of falls (which support the human performance’s body fit goal by recognizing the differing physical abilities of an older individual), while also promoting health and wellness as well as social participation by providing patients with the ability to move around independently if they choose.

Designers should ask themselves if their proposed designs meet these goals for human performance, health and wellness, and social participation. If not, what universal design feature can they add to ensure a space can work for people of all ages? After all, we’re all aging all the time, so our spaces should reflect that, not pretend that we’ll be young forever.

Carolyn Glaser, MA, EDAC, is vice president for strategy and operations at The Center for Health Design. She can be reached at