Stairlift or Home Elevator for Aging Parents?

Transcript of Interview: “Stair Lift or Home Elevator for Aging Parents“

Mike Barnes: [00:00:00] I know a lot of us with aging parents tend to worry about our parents because of safety. Making sure they’re okay.

I know I worry about my dad all the time as he’s moving around. He’s almost 90 years old, and he’s still doing great, but I still worry about him.

Kim Barnes: Right, whether there’s stairs involved- wherever they’re living. So today we’re gonna talk to Allison Starkey, who is a physical therapist and CEO of Gateway of Charlotte.

And Allison, as we get started, let’s talk a little bit about with our aging parents from a physical therapist perspective, how do we know when stairs are getting unsafe? Because I think that’s often our very biggest worry when our parents especially are trying to stay at home.

Alison Starkey PT: hi guys, and thanks for having me. It’s a pleasure to be here. this is a subject that comes up with all of our clients, without fail, that the stairs are so difficult either getting in and out of the house, but more importantly up to that other level where the bedroom and the bathroom are located.

Everybody wants to stay in their own bed. Maybe [00:01:00] there isn’t an option for a downstairs bathroom or a downstairs bedroom, and how do we solve that?

Kim Barnes: How do we, know it’s not safe? What are some

signs that we should be looking for?

Alison Starkey PT: if someone’s really not able to step up using a handrail safely or they need a lot of assistance, I would say that’s not a safe situation. more than, more, than most, I would say that the patients themselves, your older folks, are gonna say, “I just, I don’t wanna do the stairs.” They’ll tell you first if they feel unsafe on there.

there are a subset of, clients that are like, “I’m fine. I can do it. I don’t need help,” and you’ll see that actually that’s not the case, and, it’s very easy for older folks to fall backwards, which can result in, sometimes fatal injuries. it’s, If you imagine yourself falling backwards on the stairs, it’s, it’s really dangerous

Mike Barnes: I think one of the worst things that we can do, and I think we’re all guilty of this, is putting it off too long. We’ll [00:02:00] say, “Ooh, I don’t know. If Dad’s having some trouble on the stairs, maybe after the first of the year we’ll look at that. Maybe next summer we’ll try and figure that out.” When should we really look at that, and when should we fix things to try and make them as safe as possible?

Alison Starkey PT: again, that’s another great question. so I think when it comes to safety, we need to talk about fall risk. So if you have a parent that’s had a fall, they will poo-poo it and say, “Oh, I tripped going into the post office,” or, “I caught my slippers on that rug, and I, if I don’t wear those slippers, I’m fine,” and they’ll beat it to the side as not important.

But if somebody, has had a fall, they really should be evaluated by a physical therapist to see what their risk is and what recommendations we might have. so that’s always a good time to do it. if they need a device such as a cane or a walker or, we have concerns about them going up and down stairs, it’s really helpful to have that PT evaluate them and see where they are and make recommendations

Kim Barnes: And then [00:03:00] w- how do you have those conversations with your parent? Because stairs are one of the most dangerous parts of our house, aren’t they? as far as, you see statistics and things like that. How do you get them to sort of take action and say, a- and how do you decide which might be the best option for them?

Alison Starkey PT: So I, I think that’s really tricky, and, if you approach a parent and say, “I think you should do this,” generally that’s not gonna be met very well. your parents know everything. They, don’t need to be told how to live their lives or what’s good and what’s bad. And so often bringing in a professional can really help you with that.

in addition, I often, tell families to say something along the lines of, I’m really worried about you falling down the stairs,” and bring it back onto yourself as a concern. and play the card that when they’re not safe, that makes you [00:04:00] worried, and you don’t know how you’re gonna be able to take time off to take care of them, and that this is something that keeps me up at night.

So make it, about your distress, and they’re likely to be a little bit more receptive.

Mike Barnes: We’ve seen about stair lifts for a long time, but it’s amazing what home elevators can do now. Because y- you think about a huge elevator that’s gonna cost millions of dollars. It’s not like that, though

Alison Starkey PT: No, elevators have come a very long way. The technology is just phenomenal, and, there are devices now called shaftless elevators that basically, the elevator goes, down from your ceiling, and then when it’s up on the, next level, there’s a essentially a trap door that closes, and then all the space underneath that area is completely clear.

So a lot of people say, I don’t have room for an elevator. that’s really not an option for me.” but actually these are, it’s wonderful technology. it’s one of those things you can put an [00:05:00] elevator pretty much anywhere these days, whereas before that was not the case. And I think from a cost point of view, when you look at the difference between rental in an assisted living or independent living and staying at home with an elevator for that u- upper floor access, it’s very comparable and, I think a lot of people will consider it

Kim Barnes: How do you decide if do we start with a stair lift and then we graduate to an elevator? Do we start with an elevator first? How do you make those decisions?

Alison Starkey PT: again, another good question. I think that, really it’s dependent on the situation, which is why it’s so helpful having a physical therapist or an occupational therapist chat with you about it. Generally, going up to the second level is something that you can do on a stairlift, but it has its limitations.

So the therapist will help you work through your medical history and see what components of your medical history may deem the necessity to have an elevator later [00:06:00] on. if you are considering doing a stair lift and then if I need it, I’ll do an elevator, I would absolutely encourage you to look at an elevator first and avoid the expense of a stair lift.

the advantages over a stair lift are quite significant. If you’re not able to stand up and pivot and you’re in a wheelchair most of the day, an elevator’s definitely the way to go. If you, have a parent with some cognitive issues and they’re not able to follow the instructions, we don’t want anyone getting stuck halfway up the stairs and then getting stranded.

the, the decision for me when I’m advising, clients is how much do you wanna stay home? And if you’re really committed to stay at home, do you wanna be able to go to your bedroom and bathroom upstairs, or is that something we can move downstairs to avoid the stairs altogether? If they’re really committed to staying in that bedroom, then an elevator is a great option[00:07:00]

Mike Barnes: When you talk about the decision-making, I know a lot of it depends on relationships and personalities, but I think for a lot of us, I know me and my dad for one thing, is that if I tell my dad, “Dad, you need an elevator,” he’s gonna say, “Okay. I don’t know, son. yeah, maybe I’ll get to that eventually.”

But I think if someone like you, a physical therapist, occupational therapist tells him, “No, John, you need an elevator,” he’ll believe it more. is that usually the case in what you’ve seen

Alison Starkey PT: Absolutely. Absolutely.

I think that, that transition in relationship from, child with your parent to then parenting your parents is a term that we use a lot. That’s a very difficult transition for many parents. they feel like they’re being managed by their children, not in their best interest, and then there’s all of that lifetime of tricky relationships, all intertwined together that, just makes it uncomfortable for everybody.

And I think it’s very helpful to have an [00:08:00] expert come into the house and also talk your parents through, what’s the process, how much is it gonna cost. one of the highlights that I often use is that did you know that an elevator will actually increase the value of your home? people, older folks who are moving to the new homes now are looking for elevators, and rightly so, and so it’ll actually increase your home value, whereas a stairlift, actually decreases your home value.

It leaves … Especially if you have wooden stairs, can leave, damage from the bolts that are installed. And, and I think it, if you’re touring a house with a stairlift, it labels the house a little bit, whereas an elevator is really fit for all. You can put your laundry in there, and you can have your grandkids practice going up and down.

It has, it’s a lot more utilitarian, and, great for anyone that’s, interested, really [00:09:00] committed to staying at home

Kim Barnes: and how do you make those decisions as far as when you’re talking to a client and giving them their options as far as, okay, you either need to put in some sort of a device, a stair lift or an elevator to be able to safely stay at home, or maybe living in a s- in a community. How do you make those decisions?

Does it come down to do you have people to care for You those kinds of things too, in addition to just do I wanna get up to the second floor?

Alison Starkey PT: Well, that’s a, another great question. It, is complex. It’s really, a combination of several things. Your medical history and what your trajectory is gonna be like over the next 10 years. h- do you have something like Parkinson’s disease or MS that we know is gonna progressively get worse?

do you have a supportive family that can support you with your decision? is your house well-maintained and you don’t have to worry about maintaining your house? Or are [00:10:00] you somebody that would really like to stay home, but you have no one to help you, no family to do the things that you need done, and maybe you’re at risk of loneliness in your old age?

And we know that then making that jump over a facility-based care model is really beneficial because, you’re gonna have people interacting with you every day. You don’t have to worry about getting to the bank or going to the grocery store or driving, that everything’s done for you. And I also think that if you, really are in a situation where you’d benefit from going to a facility, going earlier than you think you need is always a better thing.

when you go earlier, you have the opportunity to, build relationships with other residents, with the staff, and those are the people that are gonna look in on you when you’re not feeling so great, and so I think that’s really helpful.

Mike Barnes: And I guess it’s also a factor if you know that in the near future you’re gonna have to use a walker or maybe even a wheelchair[00:11:00]

Alison Starkey PT: Yeah, for sure. we all hope that using a device such as a cane, a walker, or wheelchair is temporary, but the physical therapist will be able to give you a good idea, especially if they’ve been working with you a month or so, where we think you’re gonna end up. Are we gonna be able to get you better enough to be able to not use a walker or a cane, or is this something that we think you’re gonna need to use that walker probably for the rest of your life?

And those are tough conversations, but I think they’re really important to help you plan ahead

Kim Barnes: Well, and I think that, you mentioned it a little bit earlier, but also when you think about an elevator being able to help in some ways in everyday tasks, whether it’s taking the laundry or if you have groceries, depending on where your kitchen is or, where that level of your house is, being able to also look at it from the utilitarian, perspective as well as, of course, obviously the safety as well

Alison Starkey PT: Yeah, and I think, all of those things are really important. And, [00:12:00] I think also the thing with an elevator that is that if you are in a wheelchair, you can still use the elevator. They come in a variety of sizes, and wheelchairs come in a huge variety of sizes. And again, that’s something that you can talk to your therapist about, like what kind of dimensions would I need?

What kind of chair would we have to accommodate? And we can propose what the worst-case scenario is so that if you think you might be in a wheelchair for the rest of your life, that we’re gonna make sure that what we’re getting a- actually is fit for purpose and big enough for you to use

Kim Barnes: And I guess the, the thing about also realizing or thinking about the fact that having a device that can get you to the other floors just allows you to access all of your house rather than being potentially sort of stuck on the first floor

Alison Starkey PT: Yeah, and I think that’s very important from a safety point of view. in the unfortunate event of an emergency in the house, whether there’s a gas leak or a [00:13:00] fire, God forbid, it is really important that you be able to exit the house safely. So if you’re upstairs and you’re having trouble getting down the stairs, we need to come up with a solution that is, that could get you out efficiently and quickly

Mike Barnes: And I guess the last thing has to do with the, teamwork type of strategy. Is it okay for, us if, Kim and I to talk to you to- about my dad and without Dad around and say, “Do you think he should get an elevator? Do you think we need to move into independent living? Do we think this?” So that way we’re on the same page, and then we bring Dad into the picture.

Is that okay to do something like that?

Alison Starkey PT: Yeah, I think, you can do that depending on the situation. most people will have a physical therapist, coming to the home from an agency. And you can certainly request to have a quiet word with the PT or the OT and say, “I’m thinking this, what are you thinking?” And have a discussion out of the, out of the, the parents’ ability to hear you just from a [00:14:00] privacy point of view.

Or, “Can I walk you to your car?” is always a good one.

Kim Barnes: okay. Yeah, that’s

Alison Starkey PT: and ask those questions, in a confidential way. and then, you can team up with your physical therapist or occupational therapist and say, “How do you feel about proposing this to Dad as an option? ‘Cause this is something that we think he’d really benefit from, but we want it to come from you.”

And, that’s perfectly acceptable, for you to approach a physical or occupational therapist to have that discussion. We’re always glad to help out. We know how it is. we know parents can be tough.

Kim Barnes: Yeah, a- and so from your perspective as a physical therapist, obviously your concern is their safety just like the families, and I think these are, the stair lift and especially the elevator idea is something that can make you f- that you really stand behind as a way if, again, as you mentioned, they’re really committed to wanting to stay at home, what are the ways that we can do that safely?

Alison Starkey PT: Yeah, [00:15:00] absolutely. it is all about safety and, someone can be very committed to staying home but not be in a safe environment, and that’s a huge concern for us as therapists because, w- we don’t wanna leave anybody in a situation where they have the opportunity to really hurt themselves.

in my experience, most people are like, “I never wanna go to a nursing home,” or they’re like, “I can’t wait to move out of this house.” And it’s, the minority, interestingly, that are in the middle, and sometimes need a middle push either way. I think also that many families are not aware of all these new elevators and what they look like.

and there are plenty of videos online if you search for them to orient you to what is available, and then you can make an informed decision. But it’s … The, the technology is just fantastic. every time I see them in action, I’m like, gosh, it’s amazing that thing works the way it does.

it’s really amazing. And they look nice and, and again, if you have [00:16:00] someone who is just committed to staying home and just loves that intangible, cost of leaving their own bed or their own bedroom where they’ve been for a very long time and they find that comforting, then, we can make it happen, and that’s

The nice thing is that we have choices these days, and we can really help people be safe.

Kim Barnes: And while that’s an investment, it might s- in the long run might be less expensive than moving to a community. But do you also have people who once they hear, “Oh, you’re gonna need, to do these updates to your home,” they think, “Oh, okay. then maybe I’ll go ahead and move.” So I guess it helps f- like- Helps make the decision

Alison Starkey PT: Yeah. it, yes, that does happen. I think though that, a lot of families are unaware of the expense of a facility, and they’re surprised that Medicare doesn’t pay for it, and they’re surprised, at how much these places cost. And so although the number for an elevator can be quite big and it scares a lot of people, you have to compare it to the cost of a facility, and it’s a one-time charge as opposed to a monthly [00:17:00] charge.

So if you have someone that’s gonna live three, four, five years, that’s a lot of money. And, whereas an elevator, in the house is a one-time charge and can really open up the ability to stay home safely

Mike Barnes: Yeah. So many great suggestions and ideas. Alison Starkey, thank you so much

Alison Starkey PT: Thank you for having me. It was a pleasure. You guys have a great evening

Mike Barnes: Thank you. I, think what we’re learning, and we always talk about this, is teamwork.

talking to a physical therapist, occupational therapist- and finding out what they think, because they’re looking at your parent and knowing what they need. We also know what they need because of their personality, and doing what’s safe.

Kim Barnes: But they can come with that objective-

Mike Barnes: Yes …

Kim Barnes: perspective that our parents may not see that, may not think that we have.

Mike Barnes: Exactly. Easier said than done sometimes. Hey, if there’s any other topic you’d like us to discuss, please let us know. Parenting aging parents.

*This transcript is auto-generated. Please excuse any typos or mistakes.