Silver Spaces' Home Assessments for Aging In Place with Dr. Jill Bjerke

Jill Bjerke, the founder and CEO of Silver Spaces, discusses the Silver Spaces Senior Home Safety Assessment that she created.

The assessment is designed to help aging in place professionals and homeowners make homes safer for older adults. It allows users to pick specific rooms in the home and answer standardized questions about safety features.

The assessment can be used by professionals and laypersons alike, and it provides detailed modification suggestions based on the user's responses.

The assessment is accessible on any device and can be customized for different users. Future developments include virtual assessments and AI integration.

Takeaways

The Silver Spaces Senior Home Safety Assessment is a tool designed to help aging in place professionals and homeowners make homes safer for older adults.

The assessment allows users to pick specific rooms in the home and answer standardized questions about safety features.

It provides detailed modification suggestions based on the user's responses and can be used by professionals and laypersons alike.

Future developments of the assessment include virtual assessments and AI integration.

Chapters

00:00 Introduction and Background
03:03 Creation of Silver Spaces
04:30 Key Features of the Silver Spaces Home Assessment
07:51 User Experience and Feedback
10:57 Assessment for Professionals and Lay Persons
13:05 Designing the Assessment for Different Users
15:46 Complex Evaluations and Modifications
18:28 Considering Health History in the Assessment
20:56 Addressing Conditions that Change Over Time
24:18 Universal Design and Multi-Generational Living
25:46 Duration and Accessibility of the Assessment
27:23 Future Developments of the Silver Spaces Assessment
28:59 Cost of the Assessment
31:00 Recommendations for Healthcare Professionals
34:21 Importance of Supportive Services
37:11 Getting Started with the Silver Spaces Tool
38:19 Conclusion

Watch Podcast episode on YouTube

Transcript

Janet Engel: 0:43

Hello, everyone. And thank you for being with me today. I have Jill Berkey. She is the founder and CEO of Silver Spaces. She is also an aging in place subject matter expert, and she was very kind to come on today and talk about the home assessment that she created 10 years ago. And tell us how Aging in place. Entrepreneurs can use this assessment to help them with their businesses and help other people. Jill, thank you for being with us today.

Jill Bjerke: 1:27

Thank you, Janet. It is really great to be able to chat with you. Especially about the Silver Spaces Senior Home Safety Assessment that I created. I appreciate this opportunity. Oh

Janet Engel: 1:40

you're very welcome. And we have had several conversations over the past few months. And you really are an innovator in this area. space and you've educated me a little bit about your home assessment. But I would like to take this opportunity to personally learn more and then also be able to educate. Other aging in place professionals on tools that they have available as a certified aging in place instructor for the NAHP students often ask me after they acquire their designation is what home assessment do you use? Did you create your own? Do you use 1 that already exists? And fortunately, as a clinician, I am very familiar with. A lot of standardized assessment tools. However, one issue that I have found is that they are not tailored to exactly the work that I need to do with that specific client. And so I have found myself,

Jill Bjerke: 2:49

Really,

Janet Engel: 2:51

Using, creating my own assessment method in order to streamline it and not be in the person's house for three or four hours and assess items in the home that really isn't even what the client is interested in changing in their home. Jill, tell us about silver spaces.

Jill Bjerke: 3:14

Your comment is extraordinarily common. It's one of the reasons I think people come to me and use this assessment. To give you some background I created a company in 2005 that helped people downsize. And I had so many people say they wish they didn't have to move that I started creating a list of things that they could do to their home to stay there safely longer. And by 2009, I had 100 items on my checklist. In 2011, I got my Certified Aging in Place Specialist designation, which you teach. And then I realized this would be a great tool. So in 2015, I released Silver Spaces as an app on iTunes. And then it went onto the internet in 2020 for version 2 and version 3 was released in 2023. Okay. I have a lot of background not only in the research area, but actually one on one with seniors and what their problems were. And your comment about finding an assessment that works, this was created by a CAHPS for CAHPS to a certain degree. But most of our clients are occupational therapists. Healthcare professionals discharge planners, care coordinators, basically anyone who works with or for or cares for seniors. Okay,

Janet Engel: 4:38

Great, because most of the students that take the certified aging in place certification are in the healthcare field. And those are the ones that are particularly interested in following a standard tool to make sure that they don't miss anything. So tell me, what are the key features of your assessment? And can you describe some of the key features of the Silver Spaces Home Assessment and how they contribute to making homes safer?

Jill Bjerke: 5:11

For older adults, as a doctor, I probably came to the aging in place subject a little differently than most, which is what went into the content of the assessment. The assessment can be used by anyone anywhere on any device, so it can be used globally. And in fact, I did demonstrate it to the World Health Organization in 2016, and they were really happy that there was a product that could be used around the world to keep people in their homes. safely. And that's the key word safely. What this assessment does is it allows you to pick whatever room in the home you want. There are I think 18 different rooms that you can choose from. The questions are all standardized. All you have to do is answer yes or no or does not apply. Or in the case of say floor coverings, you have, we have a drop down menu with choices. Because not all floor coverings are appropriate for all. It allows you to move through, you can do one room, you can do an entire house, interior, exterior, whatever you want to do. There's also a section labeled community, which helps seniors understand a little bit more about their community. Where's public transportation? How far is it to the doctor's office? Sometimes they don't really have a sense. of how far some of that stuff is. And for those who are going to not be able to drive, that can be a critical question. They need to be able to get transportation if they can't drive anymore. And that's one of the questions that's asked. So you work your way through. It's every question is very targeted. So it's there for a specific reason. So for example, we want to know if you have lever faucet. Rather than the turn handles,'cause those can be difficult for wrists. We want to know if you have a problem reaching. If you have a problem reaching, then we need to recommend pull down cabinets. So everything throughout the home is designed for, anyone universal design. Basically it should be applicable to anyone regardless of age, health ability, everything. And when the assessment is finished, then you can print a report and you can put your logo on there if you're a professional and the report gives highly detailed modification suggestions so that the homeowner now has in their hand. Some idea of where the risks are, and how do we mitigate the risks?

Janet Engel: 7:47

Can this assessment also be used by a layperson?

Jill Bjerke: 7:52

Let's say the homeowner? Definitely. We have a lot of homeowners who use it themselves, but we also have a lot of adult children who use it themselves. When I first got started, I was getting calls from the East Coast who had parents in L. A. And they wanted to make sure that their, their homes were safe, so they were able to connect their parents to this assessment. So this, the parents could do the assessment and find out whether or not there were risks there. Now, this was designed specifically with keeping the idea in mind that our health, our abilities, and our lifestyles change over time. But that doesn't necessarily mean that our homes. Meet those needs anymore. So you may shuffle now or you weren't shuffling before. So a two inch pile carpet is not gonna be an appropriate choice for you. So it was really designed to try and meet the needs of whatever person work.

Janet Engel: 9:00

Right. And that's a great point that you just made. And yesterday I had a conversation with Sue Wadden and Emily Kanz. Sue Wadden is a global director of color marketing for the Sherwin Williams company. And that was one of the things that they brought up how

Jill Bjerke: 9:21

vision changes

Janet Engel: 9:22

over time and how the color of your room, let's say that you paint the kitchen a light yellow, which is a pretty common color especially for older people. And then it's pretty common to have white cabinets. If you have windows in the kitchen, hopefully you do. And you have sunlight coming into that room, especially at certain parts of the day, depending on the orientation of your house. At some point, you're going to have an issue with glare. And that is going to create a terrible combination for the aging eye. Having a light yellow having light yellow walls and having white cabinets. Because the older person really isn't going to distinguish very well. Between one surface and another. So it's very important to plan for aging in place. Even when you choose the colors that go on your walls. So that's a great point that you brought up. Now, I wanted to ask you if adult children are able to use it or let's say a homeowner that is an older person. Tell us about the user experience. What kind of feedback have you received from users and how has this feedback affected the changes that you have

Jill Bjerke: 10:44

made to your assessment? The feedback we've gotten from our users is that it's very easy to use. Okay. Because you can pick what rooms you want to do, you go through the questions easily and answer them. And then obviously the report isn't available either as a PDF or it can be printed so that PDF can be sent to their doctor, it can be sent to their occupational therapist, it can be sent anywhere. So our users like the fact that then they can go back in and edit it. If something has changed or a year later, someone has had a stroke and now they need to reevaluate that home, they can go back in. And make changes to that original assessment if they so wish. Also the other features is that we encourage our users to let us know, to criticize us, to offer opinions, suggestions, ideas. They've even shared some photos with us that we have included in the assessment. Maybe their photo or image was better than the one we had. So we really interact as much as possible with our users because this was created for them and it has to work the way they want it to. So those are a couple of the feedbacks that we've gotten. We also try and stay very much on trend with what's happening in the aging in place space so that we're very flexible. We could go in and change it at any time. It is not static and you have to download it every time you want to use it. It is very fluid and we try and stay very fluid in line with what our users need.

Janet Engel: 12:23

Okay, and I want to ask you between professional and people who use it personally. like the lay person. How is this assessment designed differently for the professional person, let's say the occupational therapist that is also CAP certified versus the homeowner?

Jill Bjerke: 12:50

This was a challenge because I either had to create two separate products which I had thought of. Or I had to be careful how this, how the questions were worded because if you get too medical and too technical, the lay person is not going to understand. If you get too generic, then the lay person isn't going to respect your product. So we had to draw a fine line between the two and try and marry them, which is what we've done. Okay. When we have a question, we purposely put underneath that question why we are asking that question. For example, we may say what is the floor covering in the bathroom? And underneath that question, it may say, floor coverings can be very slippery and cause trip or fall issues. We want to ensure that you're, you have the right floor surface. Underneath each question, now, a health professional would probably know that. A layperson may not. We've tried to cover all bases, as it were, as much as possible. Without being redundant out

Janet Engel: 13:56

when you have a complicated scenario and I'll give you an example. I had a client. It was really the client and his wife. His wife had a stroke. She was in a self propelling wheelchair, but she did have hemiparesis or weakness on one side. And I had to take all of that into account when she did her functional transfers. Now, her husband on the other hand was much more debilitated. He was not able to sit at the edge of his bed. He wasn't able to self propel wheelchair. So basically I had to plan for him to be in a power chair and to have 24 hour caregiving. services. And the main areas that we were modifying were their bedroom, their bathroom and their closets because we needed storage for all of the medical supplies that they had. We needed storage for when the AIDS came in. We needed a space for the AIDS for them to be able to get away when they were having their lunch or taking a break. So it was a very complex situation. How does

Jill Bjerke: 15:15

using your tool,

Janet Engel: 15:18

Tie into very complex evaluations like the one

Jill Bjerke: 15:25

I just described? You've hit on a topic that now has become very, I guess, on trend because as this population ages, and by 2050, almost 25 percent of the entire U. S. population will be 65 plus. So home health care agencies are now having to deal with more and more complex issues as Adults age. So you're right on target. That is an issue What we have for our clients is a very specific Questionnaire that they can use and you're familiar with the term activities of daily living and it goes through just about everything you can think of, and it allows you to collect that data for both people living in the home so that you're getting information on what the issues are for the one person, what the issues are for the other person. By the time you get to the end of that questionnaire, you know what their issues are, so you don't have to ask them or guess. You know what they can or can't do what kind of, how is their hearing? How is their eyesight? How is their balance? Can they ambulate around? Are they in a wheelchair? Are they on a walker? Do they use crutches? And do they have a disease that's going to progress like multiple sclerosis? That changes the landscape dramatically when you're going to go and do a home assessment. We encourage our users to use this questionnaire. And it's free. We will send it to people if they so wish. So then the assessor is going into that assessment with a great deal of background information. And then they know when they're asking these questions. For example, we're looking for three different sources of light. In a room, we're looking for the task light, the ambient light, which might be a wall sconce and a basic room light. We're looking for a light switch as they walk into a room. We want that room to be lit up before they walk into it. The questions then become much more relevant when you already know the background of the person you're assessing. Unfortunately All of us are guilty of not knowing our health history, and it's very difficult if you ask an adult questions about their health history, because they'll say, I don't remember, which they probably don't. Going through this questionnaire beforehand, arms you with an unbelievable amount of information that helps you answer those questions in the assessment. Yes,

Janet Engel: 18:04

or they only know part of their health history. I like to say that they're only aware of the problems that really create a problem in their life. Like for example, diabetes, neuropathy high blood pressure. But they could have, five others diagnoses in their medical history and medical report that they don't even know are there. And so that's why when I do an evaluation, I always ask. For their latest, most recent medical report, which has all of their diagnoses and the list of their medications, because that's so important knowing the medications that people take will give you some information as to the kind of conditions that they're suffering from. And if they're at risk for falls, like, number one, if someone has orthostatic hypotension. You know that they're at a high risk for falls just by getting up from a chair. If someone has neuropathy, then you know that they're at a high risk for falls. So things like that will enable you to make modifications as soon as you read this information. Now, with your assessment, you mentioned something a few minutes ago in your last answer where you said when someone has a condition that changes over time, for example, MS, Parkinson's dementia is now. The most common disability in older adults, it used to be mobility issues. Now it's dementia, which is quite scary. How does the assessment remain sensitive? To a condition that's going to change over time, especially when it's a lay person conducting the assessment, and they may not, they probably aren't aware of how this

Jill Bjerke: 20:04

condition changes over time. That's a good question. A healthcare professional will know ahead of time if a person has a progressive disease that is going to get worse and may end up in a wheelchair or a walker. So they're going to be looking for those zero thresholds. Or now they have bumpers as they call them. So if you do have a threshold, they do have a bumper. So it makes it basically a slow rise that you can go over. But specific to dementia, I've been very tried to be very sensitive with this. And we have one question that startles people because they're not expecting it. And that question is. Do you have a oh no, the term escapes me, a hot, scald protector. That's the word I'm looking for. Oh yes. You have a scald protector on your faucet. Why? If you've got a diabetic person, they may have diabetic neuropathy, which means their hands, the sensitivity is just not as good as it should be, and they can get burned very easily. Same thing as through in the bathroom or as people get older, their skin becomes thinner. Yeah. Yeah. It becomes much more frail, so those hot temperatures can be very damaging and cause burns very unintentionally, and you can tell someone to turn their water heater temperature down, but that's not solving the problem. So we do have some very targeted questions in there. And if they don't apply, and the person just checks not applicable. It's not applicable to me, but for those who do have some of those conditions. Or do have even if there's children around, grandchildren who could be burned by hot water. There are instances where that is very appropriate. So we have tried to put questions throughout it that would be able to reference people such as you described.

Janet Engel: 22:00

And I can also think of having a multi generational living arrangement, which is more common now after COVID. One in four families in the U. S. Live in a household with three or more generations. And so what you just said, if you have children which is likely that there may be children living in the home or children visiting often, and some of the recommendations that can be made are made for universal design purposes. Not because the person has a specific disability. But because having a multi level counter in the kitchen, for example, is going to create a more conducive environment for meal prep for spending time together where children can join in the activity and then the older person can also sit down and let's be real. You don't even have to be older. Just stand in your kitchen for one hour making a recipe and your legs are going to get tired. I wish I had a multi level counter. So it's something, like you said, that's useful for everyone. So I think that's just fascinating and a great development that you have included universal design questions in your assessment. That really are going to cater to everyone in the home. So does your assessment ask specifically who lives in the home and the ages of the people

Jill Bjerke: 23:36

that live there? The very first part. Okay. The assessor at the bottom, there's a space called general notes. So they can type in there anything, any information that may not have been asked. Okay. So for instance, they could say small children visit this home every Thursday. Okay. Okay. Okay. More medications were strewn all over the counter. Now, the one that you mentioned, multilevel services, that question is in there. Because I am, as you aware standing and cutting up food is difficult for some adults, some seniors. They don't want to stand there for such a long time. They'd rather sit and prepare their food. Right. We do ask, are there multilevel services? If they're not, And the assessor feels that would be a really good option for that particular family, then they can make that recommendation. And that will come out in the report and be part of one of the changes that could be made to that home to make it safer so they can live there longer. We're trying to make it go full circle here.

Janet Engel: 24:40

Okay. And I want to ask you specifically about the assessment. How long does it take? Does it depend on how many rooms you're assessing in the home?

Jill Bjerke: 24:52

Okay, so that you can go in and just do say the primary bedroom, the primary bathroom, the kitchen and living room, just those, but there are 17 areas that can be inspected, including the interior. I'm sorry, the exterior of the home stairs. garage. It just depends on how many areas that assessor wants to look at.

Janet Engel: 25:17

Okay. And the assessment, is it on a tablet? How can we access this assessment?

Jill Bjerke: 25:25

Any device? Okay. Any device? It's not on paper. Yeah, it's a little more difficult on a cell phone to be able to scroll through the questions. I think probably 98 percent of our users use tablets. Okay. Yes.'cause they're so easy to carry around and just to answer the questions. So I think almost all of our users use tablets. That's what I used when I first developed this. It was a tablet and that was the most friendly device for me. But as I mentioned, it can be used by anyone, anywhere, on any device. Okay.

Janet Engel: 26:02

Fabulous. Future developments. Are there any upcoming features that are going to be included in your silver spaces? Home assessment.

Jill Bjerke: 26:14

We continue to stay flexible so that we're constantly adapting what our users need. But we have also researched doing virtual assessments, which can be difficult because you're asking we recommend that someone else do the assessment and film it and hold the device so that the resident can actually get up and off the toilet or up and out of bed. They can't film themselves doing that. So a virtual assessment, we have a protocol for doing that. It's not my preference, excuse me, because from my point of view, I can't see their balance. I can't see if they shuffle, so there are a lot. For me, it is not my preferred way of doing it, but sometimes it's necessary. We also have been looking into converting this into an AI product, which is going to take some research. I've been working with Iowa State University in trying to get this going, but that's a long term project. So we're trying to look down the road as to what our users might want and see if we can incorporate that into the product. Okay.

Janet Engel: 27:30

What about cost? What is the cost for a user that's only going to use it one time versus a healthcare professional that will use it in their daily

Jill Bjerke: 27:44

business? There are a variety of different price points. If someone just wants to do one, it's 39. 95 for just one. Okay. Then there's a monthly subscription. For 99 95. And that's for an unlimited number of assessments during that month. And then for employers who have two or more employees, then that is scaled down so that it goes 2 to 5 and 6 to 10 and that type of thing. So we're not charging 99 for each person. We bring that down so that rate is less as the number of employees increases who use this assessment. Because of privacy, we have to make sure that each user has their own login name and their own user ID. We don't want people sharing that. We consider this health information and it shouldn't be shared. And ours is HIPAA compliant. We respect that and try and carry that through with our pricing. We also have licensing for companies who want to bring this into their already existing suite of services. Or we can do a white label and customize the entire thing for them.

Janet Engel: 29:03

And then, of course, the

Jill Bjerke: 29:04

cost would change. Yeah. It would depend on how in depth they want to make those changes.

Janet Engel: 29:14

Okay, and I have one more question. Let's say that a lay person is using this assessment, which is very affordable I would certainly would like to have that at my disposal if I were not a healthcare professional and wanting to assess my parents home. The reality is that most people that are aging, they have some type of disability. It may not be significant. But the research shows that 33 percent or more of people age 65 and older have a disability that usually is associated with age or some age related disease process. So I would dare to say that a lot of people that want to age in place have a condition that will change over time. Simply the aging process. Is going to change over time, right? Like you said, our abilities and lifestyles change over time and we want our homes to change with us. Is there a recommendation in this assessment that will communicate to the lay person that it is suggested that they bring in a healthcare professional to make a full assessment, especially if someone has. Because that is a very serious condition and has to be assessed to determine if the person can even safely live alone or what supports they need in their environment, social supports, environmental supports. Does that exist in the

Jill Bjerke: 31:08

assessment? Not at the moment, but that has to be a very carefully worded question. Okay. And it's finding a place to put it, because not everyone is going to do all areas of the home. And so putting it where people are going to see it, you can't put it in the beginning because they haven't done the assessment yet. So it's, we're trying to figure out where is the best place to put it that people are going to look. But you are correct, very much in support of services. Whether they be transportation or if the person doesn't do the their own personal hygiene very well, and they need home care to come in and do it. That type of recommendation is invaluable. It's what will keep that person healthy longer. So it's trying to find the best place to put that, so that no matter who does the assessment, they will see it. It is a very valid question and one that I have considered for quite some time. I just, and I've asked my users, if you were going to put this in the assessment, where would you put it? So you saw it. So right now we're kind of surveying each of our users to see where they would put it because they're the users. I need to know, okay, if this is the question, where would you most likely find it? So it is an extremely important question. Because supportive services are what will keep people at home. And many times they don't even know they're there. And they're a phone call away. And often times there are grants or there's maybe it can be billed through Medicare or an advantage plan. There may be sources of revenue that could help them get the things that they need. But they're just not aware of it and they're too scared to ask. So that end of the assessment is really valuable.

Janet Engel: 33:07

Yes. Yes. And I find that most of the time people don't even know what questions to ask. Now, they aren't even aware that a certain area in their home is dangerous. They may just think that I need the shower to be remodeled and I need a different toilet because I literally cannot get on and off my toilet without assistance. But they're completely ignoring the fact. that the lighting in the home is poor and is also putting them at a very high risk for falls. So just so many areas that I always say, usually we get phone calls when someone needs a ramp. Right. And by the time someone calls you because they need a ramp, they needed a renovation five years ago. It's just that now it's become critical because they can't get in and out of their home.

Jill Bjerke: 34:00

And there is a lot of denial. I had a client I was sitting on her couch with her and she was just, she had COPD. severe COPD. And she's huffing and puffing. And I said, you need one of those alarms. You need to wear that. And she said, Oh, I have one. And I said, Where is it hanging in the bathroom? Okay, let me paint this picture for you. You stand up, you fall over because you're out of breath. You can't reach that device. If it's in your bathroom, you need to be wearing that 24 seven based on what I'm seeing and how you're having so much trouble breathing. I would worry about you. Okay. Not being able to get emergency services. And that's part of the denial. I don't want to admit. It's like, seniors will say to me, Oh, grab bars. I don't want people to think I'm old. You know what? They have become beautiful. Just gorgeous. They can be part of an interior design. A lot of seniors don't know that. They're not doing the things that they need to do to keep them safe. Yes.

Janet Engel: 35:06

Great point, Jill. Thank you so much for coming on my show today. I really enjoyed talking with you and learning about your home assessment. Tell me for a professional, like an occupational therapist or physical therapist that is newly CAP certified and wants to start their own business doing home modifications and they want an assessment tool, right? Cause we all need some kind of assessment tool to guide us. Through the evaluation, how can they get started with the Silver Spaces tool?

Jill Bjerke: 35:45

It's funny you should ask that because I did a demo this morning for a person up in New York who is just starting out and found this assessment online. I do a free demo. It takes as long as the person wants it to we can do it in five minutes, we can do it in 50 minutes but that would gives them right there a chance to see it, how it's used. The questions, how they're asked, what the recommendations look like, what kind of data is gathered. So they get a really good taste of exactly what it looks like. And our homepage silverspaces. com has a little space there that they can sign up for a demo. And we'll be happy to do one for them and they'll be able to see if it fits what they want to do.

Janet Engel: 36:34

Okay. And I want to tell my listeners that Jill is also very active on LinkedIn so you can message her reach out to her. She will get back to you right away. Definitely. Thank you, Jill. This was so nice and I hope to have you again

Jill Bjerke: 36:53

in the future. Thank you, Janet. I hope you have an awesome day as well. Okay. Thank you.

Janet Engel: 36:58

You too.