How Universal Design is Helping Home Health Providers Improve Care

Home health providers small and large are more commonly thinking about home design as an important tool for keeping patients safe, comfortable and away from hospitals. To hone that design know-how, several of them—including Kendal at Home–are turning to a certification program that works with an innovative, immersive “living laboratory.”

Launched in 2015, the Louisville, Colorado-based Living in Place Institute works with the Universal Design Living Laboratory to help home health providers identify and address potential obstacles in their clients’ homes. The Universal Design Living Lab opened in 2014 and is based in Columbus, Ohio.

One of the main ways the Living in Place Institute and the living lab have been teaming up is through the institute’s Certified Living in Place Professional (CLIPP) program, a more than $1,200 educational course that melds building knowledge with medical expertise.


“CLIPP is a widely recognized credential within the [building] industry—and increasingly so in the health services community,” Erik Listou, Living in Place Institute co-founder, told Home Health Care News. “The idea is to encourage collaboration between medical professionals and design, construction professionals to brainstorm and recommend the best solutions for keeping homes safe, accessible, comfortable and beautiful as people age.”

The CLIPP program gives providers the option to sign up for either a two-day, on-site training or a six-day virtual experience, Listou said. The Universal Design Living Laboratory—a roughly 3,500-square-foot ranch-style national demonstration home and garden—serves as a host for those who select the on-site option.

“[The Universal Design Living Laboratory’s] purpose is to be a catalyst for change in the design and building industry,” Rosemarie Rossetti, who built the living lab with her husband, told HHCN. “And we also help provide new perspective on home safety and home health, showing [providers] how environment can lead to more independence for their clients.”


So far, more than 400 individuals have completed CLIPP training, according to Listou. The group includes Kendal’s staff, which went through the program last year, visiting the living lab in the process.

“[It’s] a home designed to be sustainable, so aging in place is achievable,” Kendal at Home Executive Director Lynne Giacobbe told HHCN. “They have a classroom, and we were able to go participate in a week-long training and become certified.”

Kendal at Home, currently in the midst of an expansion push, began as an initiative of Kendal at Oberlin, a CCRC near Oberlin College. Initial investment came from The Cleveland Foundation, as well as from Kendal Corp., one of the largest not-for-profit senior housing providers in the nation.

In addition to Kendal, more than a dozen home health providers also have experience with CLIPP training, either through company initiatives or independent employee efforts, according enrollment data compiled by the Living in Place Institute. They include Amedisys (Nasdaq: AMED), Encompass Health (NYSE: EHC) and Johns Hopkins Home Care Group among others.

Representatives from Brookdale Senior Living (NYSE: BKD) have also completed the training, along with officials from the U.S. Department of Veterans Affairs.

The Universal Design Living Laboratory

The Universal Design Living Laboratory is a sprawling demonstration residence designed by Patrick Manley of Manley Architecture Group. Although the house has two major green building certifications, its dedication and adherence to “universal design” is responsible for attracting home health providers and building professionals.

In general, universal design is a framework for designing products and spaces so that they can be safe and inclusive for all, regardless of physical ability or age.

“We’re talking about making sure people have the ability to function as independently as possible, as safely as possible, with features that create comfort, convenience and peace of mind,” Rosetti, who also serves as president of Rossetti Enterprises, said. “It’s important that people have a home that’s livable.”

The living lab, for example, has wider hallways and doorways to make moving around easier for people in wheelchairs. It also has full-extension drawers and shelves, a side-by-side refrigerator, an elevator to the basement, lower rocker-style light switches and large bathrooms with decorative grab bars—all to make the house “livable” to anybody who enters.

The living lab is a demonstration home and a cite for CLIPP training, but it’s also where Rossetti has lived with her husband, Mark Leder, for the past several years out of necessity.

In the summer of 1998, the couple were riding their bikes down a wooded path when a 7,000-pound tree suddenly came crashing down on Rossetti, paralyzing her instantly from her waist on down. The injury resulted in six weeks of inpatient rehabilitation and completely changed Rossetti’s life, she said.

It also triggered a newfound interest in universal design.

“Coming home from the hospital in a wheelchair that July to a home that was not accessible was a real awakening,” Rossetti, a member of the Living in Place Institute’s advisory board, said. “I realized the house we had built was not going to accommodate me long term, so I had to figure out how to either change that environment or look for something different.”

Rossetti and Leder spent the next 10 years researching, designing and building what would eventually become the Universal Design Living Laboratory. More than 200 corporate sponsors—Marvin Windows and Doors and Kohler among them—contributed to the construction.

Today, the couple opens up their home to interested groups of individuals, builders, home health providers and other companies so they can witness the benefits of universal design firsthand.

Overall, nearly 2,700 people have visited the living lab, Rossetti said. It costs $15 per person for a visit.

“[For home health providers], visiting is all about putting home care providers in the right mindset to care and inform patients,” Rossetti said. “It’s an immersive experience where you can see how even subtle design considerations can make a big difference.”

Identifying fall hazards in the home

After finishing the CLIPP program, providers are able to use, for a fee, the Living in Place Institute’s Home Accessibility and Safety Assessment Checklist, an electronic platform that helps caregivers spot more than 600 home accessibility and safety hazards.

“It’s an electronic checklist that allows professionals to very quickly, very thoroughly assess a room condition,” Listou said. “You can take photos, share information and compare information across different geographic areas.”

Many of the checklist items are to prevent fall-related injuries that frequently lead to hospital readmissions or worse, he said.

About half of all accidental deaths that occur in the home are because of falls, according to the National Floor Safety Institute. Most fall injuries in the home happen at ground level.

“A lot of the issues related to aging and health in the home really come to light when an accident occurs, typically a fall,” Listou, who has more than 50 years of experience working in the commercial and residential building industries, said. “We know that falls are costing billions of dollars every year.”

Quick fixes to prevent falls home health caregivers can make themselves or recommend to patients include removing throw rugs and ensuring there’s sufficient lighting , preferably LED lighting, throughout the home, Listou said.

Additional design-related moves to boost home safety include making sure stairs have two handrails and installing grab bars, he said.

Written by Robert Holly

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