Aging in Place: Making Your Home Safe and Accessible

When asked, Americans prefer to age in place.

What does that mean?
It means we prefer to remain at home – living as independently as possible for as long as we can. You can increase your chances of aging in place if you plan ahead. In this article, we will discuss the basics of aging in place and how you can take early steps to remain independent for as long as you can as you age.

“There’s no place like home, there’s no place like home…” Dorothy repeats near the end of the classic movie, The Wizard of Oz. For aging Americans their sentiment is the same – the overwhelming majority would prefer to age in place. Statistics show that older adults prefer to “age in place”, a recent study showed that 89% of seniors stated that it is “very important” to age in place. The overwhelming response among seniors to surveys is that their home is preferred to any other type of living arrangement. To seniors, death is less of a fear than the loss of independence and having to move out of their home into a nursing home.
What is aging-in-place?

It means remaining in one’s home safely, independently, and comfortably. It means you can enjoy the pleasure of living in a familiar environment throughout your maturing years, and maintain the ability to enjoy the familiar daily rituals and the special events that enrich all your life. It means you have the reassurance of being able to call a house a “home” for a lifetime!

In the U.S., the number of older adults is expected to grow to over 100 million over the next 15 years. Those aged 60 and older will represent 45% of the adult population. Nearly 75% of older adults suffer from one or more chronic diseases. Faced with these health problems, Americans will prefer to receive care at home. Despite its name, a nursing “home” is never truly home. Methods of care – including technology - that can assist seniors to age in place longer than otherwise possible will extend the time seniors can remain at home. However, just as demand for care is expected to increase substantially, the supply of geriatric caregivers will shrink. Americans will be unable to stay at home if care giving is not available in some form. Filling the “caregiver” shortage will be technology.

While the supply of caregivers is a serious concern, the majority of care is not provided by professionals or in institutions. The bulk of care is provided informally – at home by family members. Over 90% of older adults live independently (over 50% of those over age 75 live independently). Evidence suggests that nearly 75% of all community dwelling older adults receive informal care from family and friends. This care is not without cost – caregivers suffer physical problems and emotional stains in their role.

It is clear that technology will be able to help seniors stay home longer and can help fill the gap between the rising need for care and the dwindling supply of caregivers. Technology will also relieve some of the stress that family caregivers experience.

As with other aspects of retirement, it is best to plan ahead if you hope to age in place. The most obvious place to begin is safety. More than one-third of adults age 65 and older fall each year in the United States; over 16,000 seniors die each year as a direct result of falls while over 430,000 seniors are hospitalized each year due to falls (see the related article on Fall Prevention). A geriatric care manager can assist you in evaluating your home and recommend changes you can make the home to reduce the chance of suffering a fall. Many of their suggestions are simple, low cost and easy to implement. You can locate a care manager in your are at www.caremanager.org.
What is a geriatric care manager (GCM)?

A GCM is usually trained in gerontology, social work, nursing or other area of health care, or counseling. A GCM conducts care planning assessment to identify potential problems and determine eligibility for certain types of governmental assistance. They can also assess the need for other services such as financial, legal or medical, crisis intervention (especially in the case of elder abuse), counseling and support. In many cases, the GCM acts as a liason between the parent and their children who live in other parts of the country.

While safety is the most important part of making it possible for you to age in place, other changes can make the house more accessible and “senior friendly”. These changes include:

   1. How items are stored. For example, in the bedroom, building a walk in closet with storage at different heights. In the kitchen, varying the height of countertops, lowering cooking surfaces and making sure storage space is within easy reach.

When making your home more accessible, be careful that changes don’t endanger grandchildren who may come for a visit. For example, making cooking surfaces lower can put small children in danger if they can easily reach a pan of boiling water. Storage areas that can be easily reached by you may also be within easy reach of a small child. When grandchildren visit, consider placing locks on lower cabinets and watch cooking surfaces carefully.

   1. A raised toilet seat and bathtub lift can make using the bathroom safer and more accessible.
   2. Widening doors to make entry and exit from a room easier.
   3. For gardeners, raising the plant beds can reduce fatigue and stress on the back.

Working with a Specialist

Recognizing that the need of housing needs of seniors requires unique training, many organizations are offering specialized designations that demonstrate aging in place knowledge. One such program - the Certified Aging-in-Place Specialist (CAPS) designation program teaches the technical, business management, and customer service skills essential to competing in the fastest growing segment of the residential remodeling industry: home modifications for the aging-in-place. The designation is granted by the National Association of Home Builders (NAHB).

The NAHB RemodelorsTM Council, in collaboration with the AARP developed this program to provide comprehensive, practical, market-specific information about working with older and maturing adults to remodel their homes for aging-in-place.

Overview of the CAPS Program
In a three-day program CAPS teaches the strategies and techniques for marketing, designing, and building barrier-free living environments. CAPS adds value to that knowledge by providing insights into how to market to and work with seniors from marketing and communication to design and build Solutions for aging and accessibility. This includes knowledge of codes and standards; common barriers and solutions; product ideas and resources.

When you are working with a remodeler or builder ask him or her about their background and whether they have any specialized training.

While many of the changes you can make to your home are low cost, some may require a significant amount of money. Some states offer property tax deferral loans – such loans allow older homeowners to defer payment of some or all of their property taxes until they sell their homes. This can provide a source of financing for needed modifications.

Other conventional home loans can also be a source of financing, but more and more seniors are taking out reverse mortgages. See the related articles on Reverse Mortgage Basics and Is a Reverse Mortgage Right for Me?

In addition to home modifications for safety and accessibility new technology is available that monitors the senior while at home (“ambient technology”) or assists the senior with everyday tasks (“assistive technology”). These developments will be the subject of a separate article.