With loved ones living longer and needing more care, many families struggle with the best way to help an aging relative.
Adapting your home to accommodate another’s needs is a step some are hesitant to make. But if you’re contemplating this move, consider advice from the experts who say the trend is likely to continue as the nation’s population ages.
“We’re hearing more from the caregivers that are modifying their home so their older relative can move in with them,” says Sandy Markwood, chief executive of the Washington, D.C.-based nonprofit National Association of Area Agencies on Aging, also known as n4a.
Local agencies can provide in-home safety assessments, Markwood says. But she acknowledges the accommodations are often not easy.
Step 1: Low-cost safety tips
Many people find that they can make these changes themselves.
• Add textured, no-slip strips in the bathtub and shower.
• Apply nonslip wax on floors.
• Place a waterproof seat or chair in the shower.
• Put nonskid treads on steps.
• Remove throw rugs.
• Remove wheels on chairs.
• Replace standard doorknobs with lever handles.
• Replace toilet with a raised or high-profile toilet.
• Use rubber-backed bathmats.
Step 2: Expensive changes
These modifications often require professional help to make a home more accessible for a wheelchair.
• Alter the shower for walk-in rather than step-over entry.
• Create zero-threshold entryways.
• Move light switches for easy reach from a wheelchair or bed.
• Widen doorways and hallways.
“The first thing people think of is, This is going to look like a hospital, and I don’t want my house to look bad,” she says. “There are things you can do that blend in with that decor and make house a home.”
Don’t let Fido and his toys trip up Mom
A physical therapist for more than 20 years, Bryan Oden is cofounder of a Texas-based company that helps families find caregiver assistance. Its services include a home safety evaluation.
Simple adjustments don’t require a lot of money but can make a big difference, Oden says. About half of the homes he visits have a pet, and to prevent tripping he recommends having a secure area for the pet as the elder moves around.
“It’s a huge fall risk,” he says. “At no point in time have I ever said, ‘You need to get rid of your animal.’ But at the same time you need to keep them away.”
Another area of concern is a change in floor surfaces from tile to wood or carpet, which creates potential dangers at doorways.
“A great recommendation is putting orange tape to help alert you,” Oden says.
Additionally, throw rugs are a hazard, especially for people on walkers, as equipment can clear the front but get caught up in the back. Electrical cords are another danger, he says.
For additional lighting, Oden recommends plug-in sensor lights. With age come increased chances of cataracts and increased problems seeing well under low light levels.
Older houses present challenges
For an online glimpse at assorted modifications, visit The Lifetime Home, an interactive resource created by the Fall Prevention Center of Excellence at the University of Southern California Leonard Davis School of Gerontology. It provides a room-by-room set of potential hazards as well as fixes.
Those who aim for more extensive and expensive remodeling can locate a certified aging-in-place specialist (CAPS), a designation from the National Association of Home Builders to give homeowners some assurance that those hired have knowledge about the challenges older clients can face. The aim is to reduce the risk that someone inexperienced with the needs of an elder could create a harmful situation — grab bars improperly installed, for example.
More than 8,000 people have been certified as CAPS, and training is offered at 60 to 70 locations each year around the country and in Canada. But Dan Bawden, who helped found the program and trains peers for the certification, says the number certified represents a tiny fraction of the country’s contractors and remodelers.
“Having homes that are unfriendly to seniors as they get older is nothing new,” says Bawden, a custom builder and remodeler based in Bellaire, Texas. “In really older houses, doors are almost always too skinny.”
Modification costs range from basics, such as $400 for adding grab bars, to $2,000 to widen a doorway. To truly modify a 2,000-square-foot house not built for accessibility can be an $80,000 to $100,000 project if it includes installing additional lighting, building ramps to get inside from outdoors, widening doorways, remodeling floors without bumps and threshold changes, and redoing at least one bathroom and the kitchen, he says.
Some financial assistance available
Local or state programs can provide financial assistance for retrofits such as grab bars, Bawden says. In some cases, a doctor’s prescription for a change deemed medically necessary is another option to consider.
As a general rule, traditional Medicare doesn’t cover most retrofits.
But your loved ones may fare better financially if they’re enrolled in some types of Medicare Advantage plans. Medicare now allows these plans to pay for shower grips and other safety devices designed to prevent falls. And beginning in 2020, the plans may pay for improvements to a member’s home, such as permanent ramps or wider hallways and doors to accommodate wheelchairs.
Low-interest loans for home improvements are options. If your family’s income is low, you live in a rural area and the home being modified belongs to someone age 62 or older, the renovations may qualify for the federal Rural Housing Repair Loans and Grants program from the U.S. Department of Agriculture.
Your state or local government also might have a loan or grant program to help seniors stay in their homes. Habitat for Humanity offers a Home Preservation program for low-income families. The national program targets exterior repairs, but some affiliates also will help with accessibility.
Also check with social service agencies that lend equipment such as wheelchairs or ramps.
Sharon Jayson is a journalist in Austin, Texas. A native Texan, she spent 10 years as a USA Today staff reporter in McLean, Virginia, and later in Austin.