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What if they have dementia or a stroke? How to adapt homes for couples so they can age in place



a kitchen with a sink and a mirror: In this Hong Kong flat redesigned by Longevity Design House for its ageing occupants, simple modifications have been made, such as more accessible storage and a timber handrail on the wall that doubles as a physiotherapy bar.


In this Hong Kong flat redesigned by Longevity Design House for its ageing occupants, simple modifications have been made, such as more accessible storage and a timber handrail on the wall that doubles as a physiotherapy bar.

Having lived in their three-bedroom, two-bathroom flat for more than two decades, a retired Hong Kong couple in their seventies never wanted to leave. But they realised the design of their home in Quarry Bay had to change to reflect their twilight years.

What might have been practical when they were in their fifties was now potentially perilous, and they wanted a better use of space.

“They’re both fit and healthy now, but they’re looking ahead to at least the next 10 years,” says designer Patrick Lam Kwai-pui, founder of Sim-Plex Design Studio in Sheung Wan, whose modifications should enable the couple to remain in their forever home. With people living longer than ever, this couple’s desire to live well and independently is indicative of an “active ageing” trend.

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“If you have a reasonably comfortable home, adequate support and a fulfilling social life, that is the optimal environment,” says Vivien Mak, lead architect on the publication Elderly-Friendly Design Guidelines, commissioned by the Hong Kong government’s Architectural Services Department in 2019 and publicly available on its website.



a person standing in a room: The interior of a flat redesigned by Patrick Lam, founder of Sim-Plex Design Studio, incorporates rounded corners on furniture, and a shoe cabinet in the entrance area that provides a sturdy seat with storage underneath.


© Provided by South China Morning Post
The interior of a flat redesigned by Patrick Lam, founder of Sim-Plex Design Studio, incorporates rounded corners on furniture, and a shoe cabinet in the entrance area that provides a sturdy seat with storage underneath.

The first issue Lam tackled for his clients was the bathroom, widely regarded as the most dangerous place in the home, especially for those aged over 65.

The bathtub in the en suite was replaced by a shower with grab rails on a tempered glass screen. The toilet was repositioned to allow more space around it, and the flooring replaced with anti-slip tiles.

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In the master bedroom, the double bed was moved away from the wall and replaced with a lower, custom-built full walk-around. At 500mm, including the mattress, the bed is the same height as a chair – recommended as optimal. Two-way light switches by the bed ensure the couple don’t fumble their way to the bathroom in the dark.

Doorways were widened to 900mm (from the standard 700mm) to allow for wheelchair or walking-frame access, should the need arise.

Recognising that eyesight tends to fail with age, Lam installed spotlights recessed into the cabinetry to complement the ambient light troughs on the ceiling, and for maximum illumination in the kitchen, bulbs that give off a bright, white light. The hob and sink were positioned by a large window to bathe the work areas in optimal light.



a room with a sink and a window: Longevity Design House redesigned the bathroom in this Tsing Yi flat to make it safer for the elderly owners to use.


© Provided by South China Morning Post
Longevity Design House redesigned the bathroom in this Tsing Yi flat to make it safer for the elderly owners to use.

In the living room, Lam specified rounded edges on furniture – a safety feature recommended to guard against injury from falls – and beside the shoe cabinet in the entry, he provided a sturdy seat with storage underneath.

Of course, some older folks’ needs are more complex, as Lawrence Lui Wai-ching discovered when caring for his father, who had late-stage lung cancer. The experience inspired Lui to co-found Longevity Design House (LDH), specialising in home renovations and maintenance for the elderly, in 2015.

The studio’s 100-plus projects to date span the gamut from 360 sq ft (33 sq metres) flats in a public housing estate to upmarket private residences larger than 2,500 sq ft. Everyone wants to live safely and with dignity in their home environment, regardless of their economic circumstance, he says.

Very simple gestures like providing handrails, replacing doorknobs with handles and light switches with bigger ones that are easier to operate, are empowering for the elderly

Vivien Mak, group director of P+T Group

At the start of every LDH project, an occupational therapist assesses the client’s situation, and takes into account their likely future needs. A recent stroke survivor might expect their mobility to improve as time goes on, although someone with a degenerative disorder, such as Parkinson’s disease, might expect the opposite.

LDH then prepares a design proposal based around four principles – safety, accessibility, flexibility and independence.

However, the LDH team is mindful not to make the home look like a hospital or elderly-care facility. For instance, residents with mobility issues might need handrails along walls to keep them safe, but a sturdy grip hold can be disguised as part of timber cabinetry or in decorative wainscoting.



a room filled with furniture and a large window: The interior of a Tsing Yi flat redesigned for the elderly by Longevity Design House.


© Provided by South China Morning Post
The interior of a Tsing Yi flat redesigned for the elderly by Longevity Design House.

One of LDH’s projects involved the redesign of a 1,100 sq ft flat in Sha Tin occupied by a retired professor and his family. The professor was already in a wheelchair, but was otherwise in good physical condition, and he wanted to continue living as a contributing member of the household.

LDH’s solution involved demolishing a wall to provide a wider entrance, and rearranging the indoor spatial alignment to allow for a wheelchair turning circle 1,500mm (59 inches) in diameter.

“The owner wanted to be able to make his own coffee, so we provided a lower-height bench in the kitchen to set up the coffee machine,” Lui says. “As he liked gardening, we modified the balcony access so that the adjoining floor heights are even, enabling him to tend the pot plants outside without assistance.”

A detachable extension was made for the family’s antique timber dining table so they could come together for meals – something Lui and his team always try to accommodate.

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In another four-person household, the elderly mother had recently suffered a stroke, and a lot of medical equipment was crammed in to the 400 sq ft Tsing Yi flat that had been their family home for 30 years. LDH’s modifications were simple, but effective: a sliding door replaced the toilet hinge door, and the mother’s bedroom was reconfigured to provide a more user-friendly bed and storage. A timber handrail on the wall, used for balance, doubles as a physiotherapy bar.

In the case of another family, who had bought their flat in a Sha Tin public housing estate, the father had a form of dementia that would progressively worsen and also impede his physical capability.

The man’s bedroom, next to the flat entrance, posed a risk because he could easily walk out of the flat by mistake, especially at night, so he was moved to a bedroom farther away. His bed was also too high, and the living room sofa too soft, both of which add to the risk of a frail person falling.

“Apart from a wet floor, the second largest cause of falls at home is inappropriate furniture,” Lui says.



a person standing on a sidewalk: Smart-home functionality will be integral in ageing-in-place developments, including even personal robot companions such as Temi, which can follow a person and call for help in the event of a fall.


© Provided by South China Morning Post
Smart-home functionality will be integral in ageing-in-place developments, including even personal robot companions such as Temi, which can follow a person and call for help in the event of a fall.

A movement sensor, time-controlled via an app that can be installed on a carer or family member’s mobile phone, sends alerts if the father is wandering in the night.

Lui expects such smart-home functionality will be integral as ageing-in-place developments evolve – to the point of using personal robot companions such as the Temi, which can follow a person, perform tasks and call for help in the event of a fall, and provide audiovisual communication to help alleviate loneliness.

“So even if I’m in another county, I could still ‘be’ there with my dad, watching television together,” Lui says.

While the design guidelines commissioned by the Architectural Services Department were intended mainly as a reference for public buildings, indoor and outdoor social spaces and care homes, Vivien Mak, group director of P+T Group, says they apply equally to the private home setting.

“Very simple gestures like providing handrails, replacing doorknobs with handles and light switches with bigger ones that are easier to operate, are empowering for the elderly,” she says.

“You don’t want to hear that they feel useless. Accessibility in the household environment is important in that sense.”

In developing the guidelines, Mak’s team conducted extensive research, including workshopping with the elderly themselves and following their daily living habits, as well as studying overseas best practices.

According to Hong Kong government projections, the number of people aged 65 and over will increase from 16.6 per cent of the population (1.16 million) in 2016 to 36.6 per cent (2.59 million) in 2066.

Mak challenges young designers to “think ahead 30 years” and walk a mile in the shoes of the elderly. “You can still design in ways that are subtle and stylish, but also long-lasting, so as to be workable for the elderly,” she says.

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This article originally appeared on the South China Morning Post (www.scmp.com), the leading news media reporting on China and Asia.

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