by Barbara Ballinger
Despite the allure of senior communities that offer a surfeit of amenities, such as pools, gyms, coffee bars, and cooking classes, most older adults—76 percent of Americans age 50 and older—want to remain in a home throughout their golden years, according to an AARP survey.
Often, when older adults do move, it’s for reasons other than the desire to live in a 55-plus community, such as high real estate taxes, ongoing maintenance tasks and costs, the absence of an accessible first-floor bedroom and bathroom, or a neighborhood that makes them too dependent on cars to get around.
Helping clients who want to purchase or update a home where they can age in place is a growing niche in real estate and ancillary industries. Agents and brokers who are Senior Real Estate Specialists (SRES) or Certified Aging-in-Place Specialists (CAPS) can help this cohort find homes or stay put and modify their homes to address physical or cognitive impairments.
Architects, designers, and health care advisers schooled in accessible design are also offering services to this segment of homeowners. Even insurance companies have stepped up to the challenge. Chubb North America offers a personal risk service, in which an agent goes into a home and recommends resources that a homeowner can tap into to stay safe. And Aetna Medicare offers a “Resources for Living” program to help members and caregivers access and supplement benefits through such services as meal deliveries or transportation to appointments.
Although most homeowners accept help when a crisis occurs, such as a fall or stroke, most experts say anyone 55 years and older should plan their future living situation long before they have difficulty climbing stairs or stepping into a bathtub. It often doesn’t require an expensive remodel, addition, or redesign that makes a house look institutional. A new category of home auditors can help clients analyze which changes to make. Daniel Edwards, owner of the Handyman Connection in Hanover, Mass., is developing a program to train people to conduct an aging-in-place analysis by providing a checklist of options.
There are now “living laboratory” homes that allow people to see possibilities first-hand. Rosemarie Rossetti’s Universal Design Living Laboratory in Columbus, Ohio, opened seven years ago to showcase what she needed to live independently after a bicycle accident that left her paralyzed. Also in Columbus, Lisa Cini, founder of Mosaic Design Studio, is transforming a home that will open later this year to demonstrate accessible features to the public.
Four strategies offer the greatest promise and least cost for most aging-in-place homeowners and knowing these will help agents and brokers be the advisers their clients need.
Better Living Design in Asheville, N.C., and architect Jeffrey DeMure, author of Livable Design, recommend four steps to improve existing homes: putting essential spaces on a main level, including a first-floor bedroom; creating a zero-step entry; ensuring good interior air circulation; and improving kitchens and bathrooms.
When steps lead up to the front door, getting into and around a home can be a logistical nightmare for someone who’s wheelchair bound. Another challenge is interior hallways and doorways that are too narrow for wheelchair users or someone with a walker to pass through. Often these situations occur when an apartment building, condo building, or house was constructed before the Americans with Disabilities Act law was passed in 1990. That legislation dictates measurements for public buildings, such as requiring door openings to be at least 32 inches wide. While private homes don’t have to meet the same criteria, more builders and architects are following the same guidelines so their designs work for everyone. It’s known as universal design.
When it comes to circumventing stairs, a basic aluminum ramp runs $3,000 to $6,000, while a nicer wood design could be double the price, says Edwards. An elevator would be more costly—from $15,000 up—and many homes don’t have the space to accommodate it, says architect Josh Zinder, of Joshua Zinder Architecture + Design in Princeton, N.J.
Zinder transformed his father’s home after he had a stroke and worked on architect Michael Graves’ home after he became paralyzed from a spinal infection. He says rooms can also be switched around to avoid taking down walls or putting on additions. Zinder made a living room into a bedroom because it was more accessible to a bathroom, and then made the original bedroom into a den.
Because falls can be devastating for elderly homeowners, Daejin Kim, an aging-in-place expert and assistant professor of interior design at Iowa State University, suggests horizontal rather than vertical storage so homeowners don’t have to use stepstools. Falls can also be avoided by removing area rugs, clutter, and electrical cords that stretch across a room. Switching out carpeting for hardwood, linoleum, or vinyl flooring is also an option, says Rossetti.
As eyesight worsens, painting rooms lighter colors can help, says Jennifer Naughton, executive vice present and risk consulting officer at Chubb. Even lowering one countertop can improve the daily living of a homeowner who’s in a wheelchair, says Dak Kopec, an associate professor of healthcare interior design at the University of Nevada, Las Vegas.
Kopec teaches students to design spaces that cater to an aging population. He also recommends modifying outdoor space, if possible, since quality time outside can help increase serotonin and lessen anxiety and depression.
Besides making architectural and design changes, there are new products that can make almost every facet of life easier for older homeowners. A stair or chair lift provides a relatively easy, affordable way to get to a second or third floor in a multilevel home or apartment. Most run under $2,000. And although remodeling a bathroom can become expensive—$33,374 for a mid-range universal design space, according to the 2019 Cost vs. Value Report—switching out a tub that’s difficult to climb into for a curbless shower with a bench is affordable and helps “avoid an accident waiting to happen,” says Kopec.
A heat lamp in a bathroom helps older adults cope with the common problem of feeling cold. “It’s an easy retrofit to remove a fan and rewire for the lamp,” says Edwards. He also likes to add touchless faucets that make turning water on and off easier for arthritic hands and fingers and replace doorknobs with easier-to-turn lever handles. Grab bars look less institutional when selected in a nylon coating or sharp black, red, or yellow color, says Zinder. While they’re becoming common in bathrooms, Kim also suggests them for kitchens and hallways for safe walks to a bathroom.
Rossetti says good lighting is also important for performing tasks around the house and making nighttime bathroom visits safer. Many lights now come on automatically at dusk, so no programming is required. Because bending and reaching deep into a cabinet can become harder, items like ShelfGenie’s custom pull-out shelves retrofit base cabinets without a major remodel, says ShelfGenie CEO Andy Pittman.
Now is a good time to be an aging adult. “They are the first [generation] to have readily accessible tools that enable them to make smart decisions,” says Cini, a senior living designer and author of The Future is Here: Senior Living Re-Imagined (2016, iUniverse) and BOOM: The Baby Boomers Guide to Leveraging Technology (2018, self-published). The latest technology, such as robots (examples include Roomba, robotic lawnmowers, and robotic security systems) and smart-home devices that are connected through a central hub, can help alleviate the challenges of aging, she says. The first step to make everything work is to have the highest-speed internet.
When her soon-to-be-finished Henry C. Werner House opens in Columbus, homeowners will be able to tour and even stay overnight to test out her recommended designs and products. Examples include a robot that can prepare a gourmet meal, bathrooms with the latest heated wash-and-dry bidet toilet seats that can decrease infections and increase comfort, smart flooring, and furniture for aging in place. She hopes to duplicate the house in other markets.
But fewer modifications may be needed in the future because schools like the University of Nevada and Boston Architectural College now teach students how to incorporate aging-in-place features when a home is designed and built.
Bringing in Help
When health worsens—whether physical or mental—and it becomes harder for a homeowner to perform activities of daily living, a helping hand may be essential to stay in a home. The good news is that there are many more resources available today for finding the right help on a part- or full-time basis when family members aren’t available or need backup. Many can be found through local nonprofit organizations, universities, or a person’s insurance company.
Peter Ross, CEO and co-founder of Senior Helpers based in Towson, Md., started his firm in 2002 to provide personalized in-home care based on his own experience caring for his mother. “Too many take bathing, toileting, grooming, and being ambulatory for granted,” he says. “Our goal is to keep people out of the hospital and emergency room, but the challenge is finding the right caregivers to help.” Though the need is outpacing demand with the number of caregivers growing at a 14% annual rate, while the need is growing by 64% per year. His firm, which has offices in 43 states, starts by doing a home safety inspection, then finds the right caregiver for the homeowner’s needs.
Laura N. Gitlin provides another type of resource through her Communities Aging in Place, Advancing Better Living for Elders program in Philadelphia. Her coordinated multidisciplinary teams help seniors manage low-cost house repairs and provide occupational therapy and nursing care. For now, it’s offered only in the Philadelphia area, but other cities may have comparable programs. Gitlin’s co-authored book, Tips for Aging at Home: Doing What Matters (Camino Books Inc., 2019), suggests smart-home technologies that monitor and help homeowners remain safe and healthy, such as toilets with built-in alerts to monitor blood glucose and protein levels.
And several insurance companies are taking advantage of Papa Inc., a digital health company based in Miami that provides college-age “grandkids on demand” who have been vetted to assist older adults with transportation, house chores, technology lessons, meal services, and other needs. The program is also designed to counter the problem of loneliness, particularly among aging adults. Aetna Medicare’s partnership with Papa Inc. rolled out Oct. 1. “The goal is to help those who are frail and struggling to make their homes accessible,” says Dr. Robert Mirsky, Aetna’s chief medical officer. Humana Inc. has also partnered with Papa to provide help for qualifying members of its Medicare Advantage plans.
Prioritize Your Tech Shopping List
A huge number of aging-in-place tools are available for homeowners. Senior specialist Lisa Cini cites these seven categories as a good place to begin:
Lighting. The Battery-Powered Motion-Sensing LED Stick-Anywhere Nightlight can be used in stairways, bathrooms, closets, kitchens, and hallways.
Clocks. The Dementia Day Cycle Clock displays the day of the week and whether it’s morning, afternoon, evening, or night to help with memory issues.
Pill dispenser. The Med-Q Automatic Pill Dispenser flashes the corresponding day’s slot with a bright red light and sounds an alarm that increases in volume until the individual takes the pills at the scheduled time.
Radio. The One Button Dementia Radio allows a person to turn the radio on and off without confusing buttons and dials.
Wanderer alert. With certain types of dementia, a homeowner may wander from a room or even out the front door. The Wander Alarm Security Alert chimes or vibrates to let a caregiver know that a door or window has been opened.
Fire prevention. The iGuardStove and FireAvert are automatic stove shut-off devices to prevent a flame or pan from being left unattended and starting a fire.
Easy-to-care-for pets. Pets provide unconditional love but require care, and many aging homeowners don’t have the ability to feed, walk, groom, and cater to them. Joy for All companion pets are animatronic animals that respond to hugging, petting, and motion, and even purr to provide companionship.
Robotic technology. In Ireland, the robot Mylo helps to alleviate stress and worry for those who live alone. It can sense a fall or cardiac event, check heart rates, initiate an emergency response, and speak slower for those who have a hard time hearing or comprehending. It is now being tested in the U.S.