* Corresponding author. Tel.

: #39-081-663661; fax: #39-081-

8073030.
E-mail address: pinto@unina.it (M.R. Pinto)
Applied Ergonomics 31 (2000) 317}322
Technical note
Ergonomics, gerontechnology, and design
for the home-environment
Maria Rita Pinto*, Stefania De Medici, Clarke Van Sant, Alfredo Bianchi,
Andre Zlotnicki, Claudio Napoli
Department of Technology, LICA, &Federico II+ University of Naples, Naples, Italy
HLM Institute, Philadelphia PA, USA
Department of Pharmacology and Toxicology, School of Medicine, University of Catania, Catania, Italy
Department of Clinical and Experimental Medicine, &Federico II+ University of Naples, Naples, Italy
Received 4 August 1998; accepted 11 October 1999
Abstract
An ergonomic approach could improve the quality of life and activities in daily living. Gerontechnology reduces the e!ects of
age-related impairments with technological devices and particular design for the home-environment. Physiological decline with
increasing age renders the daily activities at home more di$cult. This paper highlights some `common sensea and speci"c design
suggestions in the entrance and kitchen, aimed to increase the self-su$ciency of elderly people. We suggest that gerontechnology may
have a particular role in the improvement of comfort and safety for aged people. 2000 Elsevier Science Ltd. All rights reserved.
Keywords: Ergonomics; Gerontechnology; Home
1. Introduction
The ergonomic approach to home design may develop
an integrated strategy aimed at the well being and satis-
faction of ageing people. In an analysis of the ageing
pro"le we may identify Basic Activities of Daily Living
(BADLs: bathing, dressing, feeding, grooming, transfer-
ring from bed to chair, and moving around inside the
house) (Cho et al., 1998; Gill et al., 1998) and Instrumen-
tal Activities of Daily Living (IADLs: using the tele-
phone, getting to places out of walking distance,
shopping for groceries, preparing meals, housework,
handyman work, laundry, taking medication and manag-
ing money) (Cho et al., 1998). Measurements of BADLs
and IADLs determine how well ageing people can per-
form in everyday activities, given their declining func-
tionality. The di$culties encountered in BADLs and
IADLs depend on a combination of increased frailty of
elderly people and environmental hazards.
An ergonomic approach (Helander, 1995; Pinto et al.,
1996) and gerontechnology (Bouma and Graafmans,
1992) would improve the relationship between the ageing
user and the environment. Hazards associated with en-
vironmental factors depend upon the ageing persons
impairments (Tinetti et al., 1988). Although several stud-
ies underline the independent role of falls and/or fall
injuries of adverse functional outcomes in older people
(Gill et al., 1995, 1996; Tinetti and Williams, 1998), these
problems are not well documented (Alessi et al., 1997).
Check lists may be used to reduce environmental haz-
ards, which are potential risk factors for injuries and falls.
In particular, it is necessary to assess gait and balance to
evaluate the environmental risks (Pinto et al., 1997a) and
to identify criteria for improving accessibility (Pinto,
1995). Moreover, accessibility may be further complic-
ated by abnormalities in visual perception which predis-
pose the elderly to falls (Pinto et al., 1997b). In this
regard, gerontechnological solutions can compensate for
the decline in visual acuity in aged people (Pinto et al.,
1997b).
2. Physiological decline in the elderly
Physiological decline with increasing age renders the
daily activities at home more di$cult. Ageing emphasises
0003-6870/00/$- see front matter 2000 Elsevier Science Ltd. All rights reserved.
PII: S 0 0 0 3 - 6 8 7 0 ( 9 9 ) 0 0 0 5 8 - 7
Fig. 1. Home risks for ageing people: (a) to shove, (b) unpleasant bend, (c) to stretch, (d) to lose balance, (e) to slip.
problems in the environment, since people have to face
the di$culties of body decadence (Aoyagi and Shephard,
1992; Gill et al., 1999). Below, we analyse current know-
ledge of age-related e!ects on the body.
2.1. Muscular Strength
Ageing leads to demineralisation of the bones, inverted
thin/fat muscle relation, with a diminution of muscular
and movement strength (Steenbekkers et al., 1998).
2.2. Posture
Sitting and standing: Posture and movement can cause
mechanical stress on the joints (Hughes et al., 1992) and
the muscles. Ageing people spend a lot of time in a seated
position. Sitting has a number of advantages compared
to standing. The body is better sustained because there
are several support surfaces including #oor, seat, back
rest, armrest, and work surface (Yokomizo, 1985). How-
ever, long term sitting is associated with neck and back
prolonged stress. The impairment can be reduced using
an adjustable chair.
In this regard, the goal of the ergonomic assessment is
that several BADLs (Gill et al., 1997, 1998; Cho et al.,
1998) can be also performed in a sitting position. Aged
persons, standing for a long period, su!er from back and
legs fatigue. The presence of handles and grab bars can
support ageing people during prolonged standing.
Supine position: A posture common to ageing persons
at rest and in bed, which can decrease muscular strength
when prolonged. To reduce bed rest it is advisable to
adopt protocols in order to control rehabilitation. When
bed rest is necessary, an adjustable bed and a high-
performance night table could be a useful support (Pinto
et al., personal communication). For example, it may
have sliding shelves and boxes to place objects (tele-
phone, bottles and glasses, etc.).
2.3. Movements
The speed of muscle contraction diminishes with increas-
ing age (Era et al., 1992); consequently, the maximal volunt-
ary strength and di$culties in the control of movements are
reduced (Aoyagi et al., 1992). Moreover, after strength exer-
cises, elderly people have a slower restoration and a greater
fatigue than young people (Laforest et al., 1990).
Lifting: Lifting is a major cause of lower back com-
plaints (NIOSH, 1981). Aged people should not lift heavy
loads. BADL organization must be taken into account to
identify the ergonomic posture under lifting stress.
Pulling and pushing: Pulling and pushing can cause
stress on the arms, shoulders and back.
Sway: Body sway is a phenomenon common to elderly
people (Wolfson et al., 1992; Baloh et al., 1994), increas-
ing the frequency of falls (Tinetti and Williams, 1997).
Ageing people frequently use walking canes.
3. Home design solutions for elderly people
Aged people spend a lot of time at home. Analysis of
the indoor environment shows the presence of various
risk-factors worsened by the psycho-physical conditions
of the elderly (Fig. 1).
Population-based studies of nondisabled community-
living ageing people indicate that worsening of orienta-
tion and short-term memory are the domains of the
Mini-Mental State Examination (MMSE) (Pinto et al.,
1996) most strongly associated with impairment of every-
day activities (Gill et al., 1997).
The home should be "tted to the physical and psycho-
logical characteristics of the elderly person (Willcocks et
al., 1982), and it should be designed to promote familiar-
ity and orientation with the environment (Caterina and
Pinto, 1994).
We report practical recommendations to avoid risks in
the entrance and kitchen due to an incorrect behaviour of
ageing users to improve the home environment (Table 1).
318 M.R. Pinto et al. / Applied Ergonomics 31 (2000) 317}322
Table 1
Practical recommendations for the home of elderly people
Rooms Recommendations for the users' behaviour Design recommendations
Entrance Do not leave small objects on the #oor (e.g. clothes, bag); Doorstep height less than 25 mm;
Do not leave the key in the lock. Non-skid #ooring with wet soles;
Supports or grab-bars near the door;
Reducing the di!erent level of illumination between
inside and outside;
Light-switches close to all the doors;
Passages free from furniture and equipment.
Kitchen To have dry hands when using electrical appliances; Furniture placed so that reaching up or bending over
are unnecessary;
To place boiling pans in adequate sites; Non-skid #ooring with wet soles;
Do not use kitchen mats. Firm table and furniture;
Furniture with rounded corners or smooth edges;
Direct light on working surfaces;
Gas and electricity systems with `failure signalsa.
Fig. 2. Solutions to reduce risks for ageing people in the entrance. On the left (A): a plan of the entrance with common habits, represented by dashed
lines; on the right (B): Three-dimensional view of the entrance with the door provided by handles and grab-bars. In the lower position, zoom of the
technical solutions represented in "gure B: (1) box to preserve the keys near the door; (2) handle to lean and for the walking-cane; (3) coat-hanger
provided with adjustable hooks.
M.R. Pinto et al. / Applied Ergonomics 31 (2000) 317}322 319
Fig. 3. Solutions to reduce risks for ageing people in the kitchen. On the left (A): a plan with the common habits, represented by dashed lines; on the
right (B): Three-dimensional view of the kitchen. In the lower position, zoom of the technical solutions represented in "gure B: (1) kitchen stove with
raised edge; (2) window panel sliding up and down for cleaning; (3) steady table.
3.1. The entrance
In the entrance, ageing people are liable to risks of falls
and impacts. Analysis of common habits (represented in
Fig. 2, Panel A, by dashed lines) is necessary for designing
the furniture which should, in addition, be placed in the
corners of the room or along the walls to avoid impacts.
We also recommend the absence of protrusions and
sharp corners, and the use of soft materials in order to
limit injuries due to impacts. The three-dimensional view
(Fig. 2, Panel B) shows some devices to reduce risks:
a seat placed near the door could guarantee a prompt
rest on return home, and the door with a grab-bar and
a handle. In Fig. 2 (lower position) we show details of
solutions dedicated to elderly people: (1) a box to pre-
serve keys near the door, since keys left in the lock, would
prevent the door from being opened from the outside
during an emergency. If removed totally, it may be pos-
sible to lose them, forgetting where they have been
placed; (2) the door may be equipped with a handle for
the walking cane; (3) a coat hanger with several adjust-
able hooks at di!erent heights, to reduce the risk of
incorrect movements or loss of balance.
3.2. The kitchen
The risks of burns and scalds add to the risks of falls
and impacts. Common habits (represented in Fig. 3,
Panel A, by dashed lines) are analysed to design the
kitchen furniture. The shelves may be reached avoiding
dangerous movements for the ageing user. The shelf
height for ageing people is 1600 mm. In furniture with
undercupboards, the highest shelf may be placed at
1400 mm, because the user is farther away from it. More-
over, the cupboard shelves should not be lower than 300
mm from the #oor (BSI, 4467/1969). The three-dimen-
sional view of the kitchen (Fig. 3, Panel B) shows that the
oven should be placed over the kitchen cupboards, to
320 M.R. Pinto et al. / Applied Ergonomics 31 (2000) 317}322
avoid back strain. In Fig. 3 (lower position) we show
details of various solutions: (1) the kitchen stove with
a raised edge made of a "re-proof material, "xed to the
range, but removable for cleaning, to prevent hot foods
and liquids from accidentally spilling; (2) the window
panel should slide up and down for cleaning, avoiding
the use of chairs or stairs; (3) the table should be "xed
"rmly to the #oor. This may also be used as a support
when the user is standing. The table-legs should not be
protruding to avoid the risk of stumbling and/or falling.
All the appliances should be easy to use involving
simple commands. The "xed appliances and control-
knobs on cookers should be clearly marked. If the appli-
ance is turned on or o!, this must be obviously indicated.
Automatic cut-outs are recommended since ageing
people may frequently forget to switch the appliance o!.
4. Conclusions
The application of ergonomics and gerontechnology
may improve assessment of safety in the elderly persons
home. Sometimes there is a con#ict between designing for
an individual and designing for a population (`inclusive
designa): a device that suits one person may be inconven-
ient to another. In this regard, gerontechnology aims to
produce and to individualise solutions for each elderly
person.
We have presented some technical suggestions in order
to improve the safety and well-being in the entrance and
kitchen. Since older people often live in the same house
for many years, we emphasize that such homes are easily
adaptable. This allows us to preserve the life style of the
aged as desired.
Acknowledgements
The authors wish to thank Dr. Bryan Dale for revising
the manuscript.
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