Recently, during a visit to her doctor's office in Sequim, Wash., Sue Christensen fell to her knees in the bathroom when her legs suddenly gave out.
The 74-year-old was in an accessible stall with her walker, an older model that doesn't have brakes. On her left side was a grab bar; there was nothing to hold onto on the right.
Christensen tried to pull herself up but couldn't. With difficulty, she rearranged her clothing and, inching forward on her knees, exited the stall. There, she tried calling the front desk on her cellphone but was placed on hold by the automated phone system.
Altogether, Christensen, who has a herniated disk in her back, was on the floor for almost half an hour before a nurse and her husband, who'd been parking the car, lifted her to her feet.
"I just wish there had been a button that I could have pushed indicating that someone in the restroom needs assistance," she said.
For older adults, especially those who are frail, who have impaired cognition, or who have trouble seeing, hearing and moving around, health care facilities can be difficult to navigate and, occasionally, perilous.
Grab bars may not be placed where they're needed. Doors may be too heavy to open easily. Chairs in waiting rooms may lack arms that someone can use to help them stand up.
Toilets may be too low to rise from easily. Examination tables may be too high to get onto. Lettering on signs may be too small to read. And there may not be a place to sit down while walking down a hallway if a break is needed.
"Most hospitals and clinics have been designed for 40- or 50-year-olds, not 70- or 80-year-olds," said Dr. Lee Ann Lindquist, chief of geriatrics at Northwestern University's Feinberg School of Medicine in Chicago. "Additional thought has to be given to seniors who have functional disabilities."
What changes could be made to better accommodate older adults' needs? I asked geriatric specialists and seniors to identify practical issues that should be addressed. Here are a number of suggestions that came up repeatedly.