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My 95-year-old mother-in-law lives in a daylight basement in our home. I would like someone to tell us if this is still a safe enough situation for her, or if we need a single story home, and/or if she should be living *with* us rather than in her own space. I think we could arrange for the person doing this evaluation to have access to notes from the geriatrics consultant in addition to interviewing my MIL and those of us who live in the home.

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Frayde, thanks for the update. Your mother sounds like quite a woman - climbing the stairs 3 - 5 times a day!

One suggestion on that: get a carpenter (not a handyman) to reinforce the stair railings by anchoring them to each and every stud. That will provide more support if she begins to fall and needs to grab onto the railings.

A skilled carpenter can create a type of hinge that goes over the railing and is screwed into the studs, or something similar.
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Thanks, everybody, for your input. To put the "daylight basement" issue to rest... My MIL has floor to ceiling windows the lengths of two walls and an outside door to a wrap-around patio designed so that she can sit in the shade or the sun depending on the weather. My husband put the patio in, but the living space was designed by the architect who designed the house when it was being built. It was designed as an apartment.

She has early dementia, but this mostly means now that she simply forgets things, like appointments and whether or not we've taken care of something that needed doing. I am concerned about whether or not she is taking her medications correctly, but she won't use a pill box and won't let me help her. She is also not on anything critical, mostly supplements, so this is not the issue it could be (they've recently taken her off antihypertensives).

She is a woman of routine, almost of an obsessive nature, so I completely trust her to turn off the oven, lock the door, feed the cat, etc. She eats breakfast and lunch on her own, but eats dinner with us 5 nights out of 7. She likes to make her own dinner sometimes because she says "it gives me something to do in the afternoon."

My biggest concern is the stairs. She won't use the phone to call me and ask/tell me something (so she wouldn't use an intercom). She insists on climbing the stairs. So she does, usually 3-5 times a day. Yes, it's good exercise. And perhaps she's going to fall down and break her hip... or worse. *This* is what I'd like an outside person to assess. I don't think she'll go for a chair-lift on the stairs either...

I appreciate the ideas for OT and PT. I'll look into that first thing Monday! Thanks again everyone!!!!
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Use your common sense, do you really want an agency telling you what to do. If you disagree with their evaluation, you are screwed.
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An additional thought...the fire department may also have some suggestions to offer.
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I do know from DIY and home improvement forums that criteria for living space for basements does vary by jurisdiction, so the local building inspection department is the source for advising if the basement can be considered living space and meets their standards.

Beyond that, there's the issue of whether it's suitable for someone of 95 years of age. Ingress, egress and certainly accessibility issues would be considered.

An OT'ist and/or PT'ist can perform this evaluation. Perhaps you could speak with your MIL's PCP, orthopaedist, or internist to get a script for this kind of evaluation. I've never heard of it being done that way, i.e., as a specific evaluation, but the therapist(s) would need some type of script to be reimbursed by Medicare, unless you want to pay them directly.

If your MIL has mobility issues, perhaps home PT could be ordered, and the eval could be a part of the eval. When my father returned from rehab after his first hip fracture, both the PT and OT reps came to the house first for evaluation before he was released.

Personally, I would think that additional measures should be included, such as an intercom, possibly something like a nanny-cam... i.e., ways she can communicate with your family immediately if she needs help. Still, unless she's in really good physical condition and has good mobility for her age, I'd be concerned about her being alone in a basement.

I'd also beef up the external security for the walk-out areas, and ensure that if she needs to leave in an emergency she can do so. A concern I would have is in the event of a fire, can she get far enough away from the building? It may be that special ramps would need to be built.
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I found this definition: "A daylight basement is normally found in a house that has been built on a slope. It will have a doorway to outside and the other part is considered to be underground." In Minnesota we call this a "Walkout basement." It is very definitely perfectly legal to use these levels as "living space." That is what they are intended for! Even in a basement without an outside door, bedrooms are legal if they have egress windows -- whose measurements are sufficient for a fire fighter fully equipped to easily enter. We added an egress window when we moved in here, not for a bedroom but for a party area. We didn't want the stairway to be the only easy way out. Our neighbors put in an egress window so their teenager could move downstairs.

Pam, I don't know how it is in "most other states," but in Minnesota a daylight basement is perfectly acceptable as living space. My mother lived in my sister's lower level for 15 months. There were sliding doors down there that were accessible to a wheelchair. It was a split entry so to go out the front door Mom had to climb up 7 steps. The physical therapist worked with her specifically on that skill.

The local building inspector could certainly answer any questions about the legality of the situation, but I read the question as being more about the safety of having MIL in more-or-less independent housing, instead of integrated in with the family.
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North Carolina building codes and most other states, have limitations on use of basements to occasional use, such as family rooms or laundry rooms, and prohibit basements as a "living space". Small children and any persons with limited mobility must be housed on a floor with adequate egress, meaning doors or escape windows that meet code. So your question is best answered by your local building inspector.
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An occupational therapist and also a physical therapist evaluated our space for potential safety hazards and ways to reduce risks. That was very helpful.

But I sense this is not what you mean. You know the situation better than anyone and are probably in the best position to make judgments. But if you want a more experienced set of eyes and ears to give opinions, call your region's agency on aging and see what services might be available for this purpose.

Can MIL climb the stairs OK? Does she have some way to summon you if she needs help? Is she at risk for wandering? What are your major concerns about the arrangement?
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