Creating a Functional Environment for Older People Who Have Vision Problems

Prepared by the American Foundation for the Blind

The Importance of Carefully Crafting Spaces

The use of lighting and color contrast, and the reduction of glare are important factors to be aware of in creating the best environment for older people in general. They are crucial for older people who have trouble seeing, either because of an eye condition or because of normal age-related changes in the eyes. It is important to take these factors into consideration when designing environments for all older people, particularly in senior centers, retirement communities, assisted living environments, and nursing homes.

Considerations in Assessing the Environment

The following suggestions can be used to make an initial assessment including the primary environmental elements needed for older people who are blind or low vision to be able to function independently in any environment. A vision rehabilitation professional can assist in assessing the environment and making recommendations to enhance safe, independent functioning and active participation for older people who are experiencing vision problems.

Lighting

In recreation and reading areas, provide floor lamps and table lamps including task lighting.
Advise people with vision problems that light should always be aimed at the work they are doing, not at the eyes.
Replace burned-out lightbulbs regularly.
Place mirrors so that lighting doesn’t reflect off them and create glare.
For window coverings, use adjustable blinds, sheer curtains, or draperies, because they allow for the adjustment of natural light and prevent glare.
Keep a few chairs near windows for reading or doing handcrafts in natural light. Ensure those windows have adjustable window coverings to control glare as mentioned above.

Furniture

Arrange furniture in small groupings so that people can converse easily. Do not move furniture from place to place without informing people who are blind or low vision. Do not place furniture in pathways.
Make sure there is adequate lighting near furniture such as task lighting for reading.
When purchasing new furniture, select upholstery with texture when possible. Texture provides tactile clues for identification.
Use contrast on the furniture such as a light beige pillow on a darker colored sofa to aid in locating the sofa.
Use brightly colored accessories, such as vases and lamps, to make furniture easier to locate.
Avoid upholstery and floor coverings with patterns. Stripes and checks can create confusion. Make sure the floor coverings and upholstery are done in contrasting colors to add in navigation.

Pro Tip

Ensure TVs are situated at a 90-degree angle from windows, where residents can see it away from glare. Mount or elevate the TV at an appropriate height and place it at a comfortable distance in front of furniture so that it is at a low-strain, eye-level position for those viewing it. Tilt horizontal blinds up, away from the screen and residents viewing it.

Elimination of Hazards

Replace worn carpeting and floor coverings.
Tape down or remove area rugs.
Remove electrical cords from pathways, or tape down for safety.
Do not wax floors; use nonskid, nonglare products to clean and polish floors.
Keep desk chairs and table chairs pushed in.
Move large pieces of furniture out of the main traffic areas.

Use of Color Contrast

Place light objects against a dark background—a dark table near a white wall, for example, or a black switch plate on a white wall.
Install doorknobs that contrast in color with doors for easy location.
Paint the woodwork of the door frame a contrasting color to make the door easier to locate.
Mark the edges of all steps and ramps to prevent falls or use tape of a highly contrasting color.

Hallways and Stairways

Make sure that lighting is uniform throughout hallways.
Locate drinking fountains and fire extinguishers along only one wall throughout hallways to allow individuals who are blind or low vision to trail the other wall without encountering obstacles.
Install grab bars as needed. Grab bars can come in colors or can be wrapped in contrasting tape.
Light stairwells clearly.
Make certain that stairway railings extend beyond the top and bottom steps and paint them a contrasting color to the wall
Mark landings in a highly contrasting color.
Ensure that windows at the end of halls do not produce glare, or have blinds or shades to manage the glare.

Signs

Place all signs at eye level, with large lettering according to specifications outlined in the Americans with Disabilities Act (ADA).
Provide braille signage according to ADA specifications.
Mark emergency exits clearly.
When making signs by hand, use a heavy black felt-tip pen on a white, off-white, or light-yellow nonglossy background.

These basic environmental design and safety tips can go a long way toward making your facility a comfortable and accessible environment for older persons who are having vision problems as well as for everyone else who uses the facility and services.

Environmental Checklist for Safety and Accessibility

It is critical to make the rooms or apartments of older residents with vision problems, as well as the public areas of the facility, safe and accessible. Lighting, color contrast, appropriate signage, and reduction of glare are important factors to consider.

You can use the following checklist to assess the environment of your facility for safety and accessibility. It is best to conduct this review of your facility with a pen in hand. It would be a good idea for at least one staff person to tour the facility wearing a variety of vision simulators before completing the checklist. The problems that glare can cause in seeing objects may not be as easy to spot without the simulators.

The Entrance

Are the curb and outside steps marked with a contrasting color?
Are glass doors marked to make them more visible?
If there is a revolving door, are there conventional doors on either side?
Does the wheelchair ramp have a nonslip surface and is the end of painted in a contrasting color?

Mailbox Area

Does the area have good lighting?
Are the names and numbers easy to read?
Are the boxes that belong to residents who have vision problems identified with a bright dot or a label?

Hallways

Is lighting uniform throughout? Is there glare in any area such as at the end of the hall where there may be a window?
Do doors contrast in color with walls; do the baseboards contrast in color with walls?
Are drinking fountains and fire extinguishers located along one wall only and recessed?
Is equipment lying around in the halls?
Are ramps identifiable by a tactile change in surface and with contrasting color?
Are emergency exits clearly marked?
Are floors waxed with a nonglare, nonslippery wax?
Are signs at eye level? Is there adequate lighting to read them? Is the print large enough to be read by people with low vision? Are room numbers brailled?

Stairways and Elevators

Are stairways clearly lit?
Are landings marked in a contrasting color?
Are the Up and Down light indicators of elevators easy to see?
Can floor buttons in elevators be identified by both sight and touch, including braille?
Are floors also identified by an audible signal or are the floors announced?

Recreation Rooms, Dining Rooms, and Other Common Rooms

Are there multiple sources of light throughout the room?
Is there natural light?
Do furniture, carpeting, and walls contrast with each other? Has textured carpeting been used that makes walking difficult?
Is there furniture in high-traffic areas?
Are dining room chairs pushed in under the tables?
Do windows have adjustable drapes, shades, or blinds to eliminate or reduce glare?
Are floors waxed with nonslippery, nonglare wax?

Common Bathrooms

Are the signs identifying the men’s room and the women’s room large enough to read and easy to feel? Are they at eye level? Is there braille on the signs?
Do fixtures contrast in color with walls and floors?
Are there grab bars along the wall, on the bathtub, and in the shower?
Are the cold and hot-water faucets clearly marked?
Are rugs and bath mats nonskid?
Has glare been reduced to a minimum? For example an all-white bathroom with white walls, floors, fixtures can result in glare and difficulty navigating. Adding contrasting color can help with this.
Are there things that can be done to increase contrast?

The Resident’s Living Quarters

When reviewing a resident’s living quarters, be sure to complete this checklist together with the resident to make sure that any changes meet the approval and vision requirements of the resident.

Is there adequate lighting for the resident to read, write, and carry out other tasks in the kitchen, bathroom, and bedroom such as task lighting for reading?
Is glare a problem? What about from mirrors? Windows? Flooring?
Are rugs and bath mats nonskid?
Is the threshold flush with the floor?
Has color contrast been used effectively with walls, woodwork, floor coverings, and cabinet surfaces in the kitchen and bathroom?
Is the TV located in a place where the resident can see it away from glare? Close enough to see? With appropriate lighting?
Is there furniture in the middle of the living room floor or bedroom floor? Is there a clear path to follow to access the bathroom and other parts of the living space?
If there is a kitchen, are appliances such as microwaves marked with tactile markings? If there is a small refrigerator, is it off the floor and easy to access?
If there is a call button, is it easy to locate? Think about contrast, placement, etc.

"We, blind and seeing - we are parts of a great whole, and we depend one upon another.”

- Helen Keller

Review Test

Evaluating the resident’s environment for glare, lighting, and color contrast is key to helping the older resident function more independently.
The best place for a resident with low vision to sit in the dining room is at a table that faces the sun.
Dark towels and a dark bath mat provide the most contrast against white walls and the flooring of a bathroom.
Tactile markings on microwaves are helpful to residents to use the controls effectively.
Reading is easier with an overhead lamp rather than a task lamp.

Key: 1. True, 2. False, 3. True, 4. True, 5. False