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Aging in Place for Homeowners

If you’re lucky enough to be an able-bodied person, you’ve probably never walked around your home and considered what you would have to change if you or a loved one were not so fortunate. Unfortunately, both accidents and aging can render a person unable to get around without a wheelchair or cane, and things like stairs and narrow hallways suddenly become a huge problem. Adapting a home for the elderly or disabled can be a complicated and expensive process, and homeowners who find themselves needing to do it are often at a loss for where to start.

Why We’re Asking:

With the baby boomer generation starting to approach retirement, adapting homes for the elderly and disabled is becoming more and more common. But the task can be quite daunting. Our experts have a lot of experience with what challenges remodeling homeowners face, and they know what the most important changes are–and what things tend to get over-looked. Hopefully, their advice can help homeowners in this situation know where to focus their energies, and how to ensure that they get the most for their money.

So tell us, experts:

How do you prepare a home for the disabled or elderly?

What changes should be made first?
What problems might homeowners forget to consider?
How can people building homes from scratch plan for the possibility of adapting their home later?
Are there any changes that aren’t worth the cost?

Many homeowners don’t even consider the challenges faced by the elderly or disabled, but they should. Tell us your stories about adapting homes in the comments below!

Experts, post your answers in the comment field below!



  • Kahshanna Evans 08/05/13

    Before arriving on the shores of PR I studied wellness and communication for a decade. When dealing with loved ones on the topic of health and happiness instincts are quite relevant to consider. Preparing a home for the elderly depends on any special needs being addressed and making the living space accommodating. Light, circulation and fresh air should be factored in as well as climate concerns. After recently having my workspace renovated I am aware of the importance of changing the dynamic of a living space to nurture creativity, energy and overall wellbeing, the relevance doesn’t change just because we grow more experienced (and hopefully wiser) over time. Changes that should be identified relate to safety and health but also to having an inspired space people feel good in no matter what age they are. My grandmother and her husband live in Chicago and it’s becoming a royal pain to shovel snow on the front cement steps which are quite steep. The humble house isn’t set up for fancy lifts so they are extra careful and ensure railings are safe. For those without the budget to make expensive changes in suburban areas, I suggest changing too much independence thinking and create healthier habits–no need to do too much without help. Local organizations or outstanding students looking for a weekend job may be able to help with odd laborious jobs it’s simply time to retire from. When at all possible living closer to the ground in skyscrapers enables food and water supplies to reach the elderly and handicap during unforeseen emergencies such as extreme weather.

    People fortunate enough to build scratch homes can incorporate healthy living, wide doors, bathrooms that allow easy entry to showers which handicap people can utilize. Many new green homes are designed around nature to literally allow courtyards within the home to surround trees to be the center of the home. Designing nature into our lifestyle only supports inspiration during our final years. Optimal storage should also make it less likely to trip or bump obstructive objects.

  • Mark Puglisi 08/05/13

    As a baby boomer myself I can see the needs for changes in the home as I grow older and less “flexible”(yeah, lets call it that). Certainly any remodeling that you plan, you would want to consider these special needs when your dealing with any contractor. Some of the things you may want to look into would be sink height, space under cabinets for those that require a wheel chair, showers, tubs, assistance rails, ramps, etc.

    My specific area of expertise isn’t really dealing with these things, other than there can be preparation work that the homeowner would need to do, but may not be able to physically handle.

    Home shows for special needs can have lots of ideas and products that are available and incorporated into any plan. Do your homework first, make a list of the things you may need. It’s a lot more cost effective to make the changes and additions the first time.

  • Tanya Stock 08/05/13

    The NAHB has a Certified Aging in Place program that offers Contractors and other trade professionals a training and in turn certification program that enables them to be “experts” on the needs of home adaptation for the elderly or well frankly anyone in need of accommodation regardless of age.

    I am an advocate of what I call the New Family Home, the idea of multi generations learning to live together. We are seeing many more of those type of homes being built and remodeled to accommodate anyone from Seniors to their Grandchildren moving in together in “perfect Harmony.” Think Full House, Hot in Cleveland or even the Real World for ideas on how to have many generations under one roof.

    This does include the idea of a “Mother in Law” or “Granny Flat” that allows independence within reach. Community courtyards, simple access and needs where there can be multiple family members living in a residential “community” of their own.

    Co-housing is the new housing of the future.

  • DeAnna Radaj 08/05/13

    I’ve worked on many projects for those w/mental & physical disabilities, as well as helping clients incorporate aging-in-place principles into their remodeling plans if they plan on staying in that home. Lighting, changing out cabinet/drawer hardware (to levers for those w/arthritis and/or other hand issues) as well as faucets & shower/tub fixturing are at the forefront. In answer to your questions:

    What changes should be made first? Lighting…as you age, the lens of your eye yellows & you “see” differently. Brighter, natural spectrum lighting is key. Also, adding accent lighting to help “guide” those who are sight-impaired will also help them with life quality & independence. Changing out the hardware & bath/faucet fixtues is next. Then look at the flooring (low pile carpet if you must have carpet, or changing out to hard flooring so a walker, cane or wheelchair can be more easily managed throughout the space). Next would be painting, as with lighting, to help highlight areas of the home (sinks, tub, hallways…) for those w/sight issues. Adding grab rails (which have become quite fashion forward as of late as seen at KBIS) in the bathroom & making sure their are handrails in the hallways & at all stairs (interior & exterior) to help move about the home. If a full bath remodel is called for, incorporating seats in the shower & showers w/no curb/transition showers.

    What problems might homeowners forget to consider? Lighting to take into account how your sight changes as you age, flooring transitions & changing out any/all handles to open/close or turn on/off. Most people know about increasing door width if small door thresholds or narrow hallways, as well as installing ramps to get in/out of the home but not taking into account the seemingly “little” activities that we do numerous times a day that require dexterity.

    How can people building homes from scratch plan for the possibility of adapting their home later? Hire a designer who is certified in Universal Design &/or Aging-In-Place so these design elements are incorporated from the start to save on remodeling costs at a future date.

    Are there any changes that aren’t worth the cost? No, as it depends on what the disability is. You can’t put a price on your independence & increased life quality. If someone is still in good health & looking to the future, incorporating universal design principles will not only help you age in place, but it will also increase the value of your home as it increases the buyer pool for your home.

  • Greg Chick 08/06/13

    Well, yea I get it but as a person that is blind in one eye and deaf in one ear, and 57 yrs. old and with RA, I suggest we make sure we build these homes to look young!. Denial is a popular thing and as a curve ball I am going to suggest form issues too! Form issues suggest current style and not looking like a rest home. Integrate the ADA into design having form and the most overlooked issue is acoustics. Echo comes from surfaces and hearing issues are understanding what one hears, not the sound being loud enough. Carpet is good but actually an acoustic engineer is even better. Room intercoms work when just yelling from one room to another wont work. Another issue is low angle sunlight in winter has been popular for solar gain, but glare is bad in many rooms so white tile floors can be blinding… Issues are not just “ADA” rules being followed, but experience applied. Talk to residential care nurses for input, they deal with this for a living. A roll in shower is needed, but so is a deep tub with a door, and a floor drain in bathroom. Motion sensor lights and motion sensor circulation pumps on the hot water that work w/o timer because the occupancy schedule might be all day not just early am and night. Plumbing the hot water circ loop at 48″ above floor instead of in attic or floor is a way of making the supply to the fixture from the loop only a 1/4 cup of water or one second! The distance is the issue, not if you have a pump or not. Each fixture can have its own temp limit if a mixing valve is used at the fixture, look at ASSE 1016 approved listed fixtures. Tall grandiose ceilings are not the best functionally speaking. Greywater and or rainwater use will be very well accepted so design in theses options. If code issues seem laking look to the IAPMO Green Plumbing Mechanical Code Supplement that has all you need in it to for clearing up some grey areas… pun intended, in waste water code issues. Rain water is fantastic on plants and hobby gardening is growing… pun again. Relax and let it rain. Life is a system not an isolated compliance with the lowest bidder or shopping consumer.
    Greg Chick, LEED GA, ARSCA AP, Green Code Expert.

  • Patsy Parr @ Fix It NOW! (VIA LinkedIn) 08/07/13

    My company has been providing mostly ramps and roll-in showers for folks with physical handicaps for nearly 30yrs. Usually this work is done well after the home was built, and the alterations are very costly at this point. Entrances and hallways need to be widened, bathrooms enlarged to accommodate a wheelchair, etc. When I sit back and think about it, it makes me wonder why houses were built without regard to the fact that we all age, and will eventually have difficulty moving around in our homes. When I broke my ankle several years ago, it opened my eyes to just how difficult even one step can make it to enter a building for instance!

    If I was building a house today, or if I was in the market for a house, there are several specific things that I would strongly consider:

    Access to the house and grounds: Are the sidewalks wide enough to accommodate a wheelchair? Are there any steps at all required to get into the home? Is the door wide enough, and is the threshold flat enough to get over? Even if a wheelchair is not required at this time, you never know if or when you or one of your family may need one.

    Once inside the house I would make sure that the “flow” of the house is roomy enough to accommodate a chair and/or crutches. Passage ways from one room to another should be at least 36″, and furniture placement should not restrict this “flow”. If there is a deck, the doorway should be flat and wide enough to easily roll outside. Can a full life be lead on one level of the home, if it ever becomes necessary?

    The bathroom should have at least a 36″ wide doorway, and enough room once inside to close the door and make a transfer to the toilet. The sink should have enough room under it, and be low enough so that a person seated in a chair can easily roll up with his/her legs underneath and be able to wash his face. A “barrier free” shower with grab bars and a seat are a necessity. A single lever faucet and hand-held shower head should be included. If a bath tub is desired, that could be arranged as well.

    The kitchen, again, should have wide enough passages to easily accommodate a chair. There should be sufficient lower cabinets to hold necessities, and leave the uppers for seldom used items. A lower sink can be installed so that the person in the wheelchair can roll close enough so that his/her legs fit underneath, but I would save this only for those who will actually need it.

    To me, these things should be standard. They’re not so out of the ordinary that they should be considered anything but smart. The specialty items, like the special bath tub, lower sinks, and grab bars can be added as needed, but the space to get around in a chair, the lack of any steps at all on the first floor, and a full bathroom on the first floor are basic. You never know when or if you will need these features.

  • Steve Robinson 08/07/13

    First, you will find each user and situation is fairly custom re: needs. Find out what those needs are (or may become depending on the disability) and make sure you meet those needs. You will find in most homes, especially renovations, the need to be a bit flexible on what needs are met and how they are met. It is a process of prioritization meeting reality.
    Second, most homeowners are not aware there is an incredibly helpful design document available from the Department of Justice (responsible for enforcement of the ADA). These standards dimensionally define an amazing array of disability solutions. These standards have been developed to meet the broadest spectrum of disability needs (say shower size or door clearance), so meeting the standards will likely meet the need of the homeowner unless there is a very specific condition. The ADA standards can be downloaded for free from http://www.ada.gov/2010ADAstandards_index.htm. Yes, the 2010 standards are current. It is thick and daunting, but is extremely helpful.

  • Deborah L. Cannon 08/08/13

    All of these are great suggestions. One suggestion I don’t remember seeing – lower light switches and raise receptacles. They should be within reach for those in a chair or with limited reach ability.

  • Grand View Builders 08/08/13

    When an elderly parent moves in with his/her family, it can be a huge adjustment for all parties involved, including the house itself. The best way to approach this situation is to plan ahead of time to the best of ones ability. Planning ahead can help anticipate challenges that an elderly or handicapped loved one may face when trying to navigate his/her new home.

    At Grand View Builders, our goal is to help every homeowner build their dream home. Below are some solutions we suggest to many of these clients looking to provide comfort for elderly family members, without sacrificing aesthetics or re-sale value of the home.

    We always recommend hardwood or laminate tile floors if a homeowner has a parent or loved one in a wheelchair who may move-in. Carpet can make it difficult to move around independently in a wheelchair because it takes more energy to do so. Hardwood and laminate floors not only make the home easier to navigate; they are also very popular and can increase the re-sale value of a home.

    Installing handrails in the shower and other locations around the house, such as near sinks or shelves, will provide support and also allow for independence. There are handrails sold with suction cups attached, which makes installation quick and hassle free. Suction cups are a great alternative to permanent handrails, which is important if the loved one’s stay is temporary or the homeowner plans on moving in the future.

    For those worried about wheelchairs not fitting through standard doorframes, we recommend making the doorframes a bit wider or installing French doors throughout the home. These double doors will create wide spaces, allowing a wheelchair to pass with ease and will not compromise the aesthetics of the home.

    In order to accommodate our homeowner’s dreaming of a two-story home, we recommend including a bedroom-suite on the first floor so the family member will not have to travel upstairs. If in the future, the family decides to sell the home, having a downstairs master bedroom or guest quarters will add a unique aspect and increase the value of the home.

    While accommodating an elderly family member can be a huge adjustment, with future planning and a little creativity, homeowners will not have to sacrifice the plans for their dream home in order to care for a loved one.

  • Northeastern Exterminating 08/08/13

    No matter the age, pest control in a home is very important to help prevent the cause and spread of many types of infections and disease. But when faced with an elderly client they must be treated slightly different because of the increased chance of health risks. Infants and elderly have one thing in common and it is a weaker immune system then healthy active adults.
    When applying pesticides in the homes of elderly or in nursing homes caution must be taken. Since the elderly are higher risk clients when we treat their homes we must do so carefully. We may utilize a method called integrated pest management in these homes so help reudce the risk of re infestation. Teach the client about how keeping clean can benefit as well as sealing up any rodent entry ways.
    Lets not all forget, we will all be elderly one day so treat them as you want to be treated. We all have parents who are elderly. Whenever i am faced with an elderly client i treat them like my mom or pop. Respect for the elders go a very long way, and its not just what you do for their home its also what you do for their hearts. They have seen the world twice around so give them some respect! :)

  • Wayne Caswell, Modern Health Talk 08/08/13

    Modern Health Talk features dozens of articles on getting your home ready for the disabled or elderly. (See http://www.mhealthtalk.com/tag/getting-ready/.) Some of the best ideas are included here.

    WHAT CHANGES SHOULD BE MADE FIRST?

    Focus on Safety before convenience, Easy before difficult, Temporary before permanent, and Affordable before extravagant.

    Making homes safe and friendly for seniors can include major considerations like eliminating stairs, expanding doorways, building a first-floor bedroom/bathroom suite, and making sinks, counters and appliances wheelchair-accessible. But there are also smaller projects that can go a long way toward improving mobility and the ability to safely live independently.

    Just remember that as we get older, or suffer an injury or other disability, our sore joints, weakened muscles, and a lack of balance, dexterity and vision make simple tasks difficult, including reaching, bending, lifting, and moving about. This can contribute to accidents and affect our personal hygiene, nutrition, and well-being. So remember what Benjamin Franklin said, “An ounce of prevention is worth a pound of cure.” With planning and preparation, you can help prevent falls and injuries rather than react to them.

    FIRST, AVOID FALLS – This may be the single most important objective, because here are the statistics:
    • Each year in the United States, one of every three persons over the age of 65 will experience a fall. Half of them are repeat fallers.
    • Falls account for 87% of all fractures among people over the age of 65 and are the second leading cause of spinal cord and brain injury.
    • For people aged 65-84 years, falls are the second leading cause of injury-related death; for those aged 85 years or older, falls are the leading cause of injury-related death.
    • Half of all elderly adults (over the age of 65) hospitalized for hip fractures cannot return home or live independently after the fracture.
    (See http://www.mhealthtalk.com/2013/04/slip-proofing-your-home/)

    GET A GRIP – Replace rocking chairs and unstable furniture, because seniors may try to use them to steady themselves. (See http://www.mhealthtalk.com/2012/08/singing-in-the-shower-more-than-accessibility/)

    DE-CLUTTER & REORGANIZE – Clean house and discard everything that’s not needed, remembering to reuse (donate) and recycle where possible.

    LIGHTEN UP – Replace heavy pots, pans, vacuums, and trash cans with lightweight models.

    WHAT PROBLEMS MIGHT HOMEOWNERS FORGET TO CONSIDER?

    SEE THE LIGHT – Bright lighting is important to people with poor eyesight, so replace existing light bulbs with the new compact fluorescent or LED variety.

    STAY WARM – Seniors can get cold when not moving around, so cut the chills with attic insulation and weather stripping to eliminate drafts, and add ceiling fans for use during summer months.

    PHONE HOME – Cordless phones can be put in any room, or every room, but look for models that are easy to use. Mobile phone access away from home is a safety issue in my book, but rather than look for the simple models with big buttons for seniors, consider smartphones and the benefit of apps designed for seniors.

    FRIENDLY FURNITURE – Consider adjustable beds and chairs that recline easily, but avoid cushiony furniture that’s hard to get in and out of.

    APPLIANCES – Front-loaded appliances are easy for someone in a wheelchair to use. Top-loaded models are not. But get the extensions that raise the washer/dryer to make them easier to load.

    PERS – Personal emergency response systems ($50 install, $15-35/month monitoring) provide a wearable pushbutton for summoning help. They are often available as accessories to existing monitored home security systems.

    DOORWAYS – Remove doors that serve no useful purpose, and make doorways wider (at least 36”) so people can get around with canes, walkers or wheelchairs.

    STAIR RAMPS – Make sure all stairs and outside steps have sturdy handrails, and for wheelchair entry, replace or cover steps with ramps. They can be made permanent or temporary.

    STAIR LIFTS – If your two-story home lacks a bedroom and full bath downstairs and you can’t remodel, then consider a stair lift ($3,000-$12,000). They can be purchased or rented, and you can often find good refurbished models. They can even traverse a spiral staircase. (See http://www.mhealthtalk.com/2011/06/managing-stairs-the-stair-lift/)

    DO YOUR CHORES – In addition to any professional medical help that’s needed, consider the relatively inexpensive cost of weekly maid service, lawn care, and Meals on Wheels.

    SAVE MONEY AND THE ENVIRONMENT – Purchase wisely, buy second hand, recycle, and donate.

    OTHER OPTIONS – Add up the total costs of adding a room downstairs, remodeling a bathroom, or reconfiguring cabinets and counters to add knee space and pull-out shelves. You may find that remodeling is more expensive than moving.

    HOW CAN PEOPLE BUILDING HOMES FROM SCRATCH PLAN FOR THE POSSIBILITY OF ADAPTING THEIR HOME LATER?

    UNIVERSAL DESIGN – The concept is to design homes and products for use by anyone regardless of age or ability. Doing that broadens the market appeal and increases your home’s value. Wide doorways and zero-step entryways, for example, are just as useful for a young couple with a baby stroller as a road warrior with wheeled luggage or a disabled person with a walker or wheelchair. It’s a lot easier to make the right design decisions up front, because the cost of doing a complete kitchen or bathroom remodel, replacing a tub with a walk-in shower, for example, can be quite expensive and cost over $30,000.

    CAPS – The National Association of Home Builders has a Certified Aging-in-Place program to teach contractors about building and remodeling for aging-in-place. This training gives them an appreciation of the problems faced by the elderly and disabled, as well as the various solutions available. But be sure to check out your contractor, since some states have laws that shield builders and contractors from lawsuits and accountability.

    INDEPENDENT FOR LIFE – There are many good references for designing homes and neighborhoods, and one is this book coauthored by Henry Cisneros, the former HUD Secretary under Clinton. (See http://www.mhealthtalk.com/2012/08/make-life-long-homes-a-priority/.)

    LOW MAINTENANCE – An important part of aging in place is making caring for a home more manageable. Cut down on grass that needs mowing by making your yard more natural, with low-maintenance native plants and trees that also provide shade and can cut cooling costs. Driveways and walkways made of gravel, pavers or other permeable systems not only allow rain water to reach the ground, but they can offer seniors a safer, less-slippery walking surface if well maintained. When building from scratch or remodeling, ask your contractor to use materials that are low-maintenance and support our environment for future generations. Examples are wood species that rapidly renew such as bamboo, finishes that are low in volatile organic compounds, and recycled-content materials in carpeting, siding, concrete, decks and fences.

    BLOCKING – Even if you decide not to install grab bars, it’s a good idea to include wood blocking behind the sheetrock in showers and by toilets, similar to what builders already do for the future installation of ceiling fans.

    CHANNELING – When your lot or zoning dictates a two-story design, consider having the architect include a channel between floors that can be used initially as closet space but converted later to a shaft for a home elevator if needed. (See http://www.mhealthtalk.com/2012/07/home-elevators-a-rising-trend/.)

    ARE THERE ANY CHANGES THAT AREN’T WORTH THE COST?

    Even a $50,000 remodel for wheelchair accessibility can be financially better than the nursing home alternative, which can cost over $100,000 per year for a private room and shorten one’s lifespan. Because of the much lower cost of home healthcare, if that’s an alternative, and the fact that most remodeling projects can be entirely funded with home equity, remodeling can help save the family estate. On the other hand, you might want to question the value of permanent and expensive improvements that don’t add value to the home, especially improvements that scream, “I’m old and frail.” But if you get good advice and plan carefully, you should be able to avoid that problem.

  • Wayne Caswell, Modern Health Talk 08/08/13

    As Peter Pan said, “I won’t grow up. I don’t want to go to school. Just to learn to be a parrot, And recite a silly rule.”

    The problem is, Peter did grow up and is growing old, but he still lives in a Peter Pan home with stairs, inaccessible bathrooms, inadequate lighting, and lacking many of the safety features that would help Peter avoid falls or move about with a walker or in a wheelchair. Even today, with all we know, builders still build Peter Pan homes.

  • Jason Todd 08/09/13

    Accessibility certainly comes to mind, but there other very important things to consider in preparing homes for our elders, such as comfort and energy efficiency. The extreme heat of the summer and cold of the winter have very significant impacts on our health as we grow older.

    More efficient HVAC systems in a home can make a difference on the utility bill, but we also need to consider more efficient buildings so we don’t “efficiently” lose conditioned air to the outside!

    What better time to improve a building for comfort’s sake, but when planning a remodel. Insulation helps protect our homes and us, from temperature swings. Air sealing helps in that regard as well, it’s like wearing a wind breaker over a sweater, or keeping the lid tight on a cooler, we need both insulation and an air barrier for comfort and for efficiency.

    Un-controlled airflow in a building doesn’t do anyone any favors. Sealing up leaks between our inside space and attics, garages, crawlspaces and basements makes that inside air all that much better since our “fresh air” won’t come from unsafe areas. Fresh air is important, and while there are great air exchangers out there, a simple ventilation system like a bath fan on a timer helps bring in the right amount of fresh air for us and our buildings.

    Go figure, what is good for our homes and for us in our later years, is good for us throughout our lives!

  • Doug Murrell 08/10/13

    Most changes to an house for the elderly would be hand railings and try to keep everything on the first floor level. There are funds available usually at local county and department of aging to help with the costly repairs and a lot of times the cost might not be as bad as you mind think.Do it simple is the best way it will work for you and keep the cost down

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