Along the continuum of function where “prevention” of decline is the left hash mark, “potential” bookends the right. Designing spaces and programs for older adults should include consideration of all functional points along that continuum, ensuring that prevention of functional decline does not limit the potential for functional success.
For example, stairs can be a hazardous condition of a living environment. Yet functional performance of safe stair navigation is dependent on opportunities to practice. Limiting access to the stairway may be an obvious safety measure for prevention of injury in a specific environment, but it may also be limiting functional potential to perform stairs safely in other contexts.
Older adults do not typically have access to environments that are equally safe and challenging. Older adults living at home may have frequent falls due to a lack of grab bars or railings, yet have overall better strength and balance than their counterparts living in an aggregate space, where mobility is discouraged despite a better adapted environment.
The balance between prevention and potential is the point at which a person can be safely challenged in a physical space with a minimal risk of injury. Of course, this will be a moving target and a different point for each person, especially those with dementia. But denying people with dementia the opportunity to stand, even if off balance, or rummage through their closets, even if it makes a mess, is denying them the opportunity to use what functional skill they have.