With loved ones living longer and needing more care, many families struggle with the best way to help an aging relative.
More than three-quarters of U.S. adults age 50 and older want to stay in their current homes for as long as possible, according to AARP’s 2021 “Home and Community Preferences Survey.” But a May 2020 study by the U.S. Census Bureau found that less than 10 percent of U.S. homes are "aging-ready," meaning they have a step-free entryway, a first-floor bathroom and bedroom, and at least one bathroom accessibility feature, such as a grab bar or shower seat.
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 USAging, a national association of local Area Agencies on Aging.
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.”
Simple steps to prevent falls
Falls are a major health hazard for older Americans, causing millions of injuries and 32,000 deaths a year, according to the U.S. Centers for Disease Control and Prevention. Some simple, inexpensive adjustments can go a long way toward reducing risk, says Bryan Oden, a longtime physical therapist and the cofounder of BubbleCare, a Texas-based company that helps families find caregiver assistance.
For example, Oden says that when he would do home safety evaluations for his company, about half the homes he visited had a pet. To prevent tripping, he recommends having a secure area for the pet as the older resident 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, he recommends plug-in sensor lights. With age come increased chances of cataracts and increased problems seeing well under low light levels.
Keep in mind that what might look to you like minor steps to age-proof a home may strike your parents "as something bigger, like losing independence," Oden says. "It could be very upsetting and a major obstacle for change. Have empathy, understanding and compassion."
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 seek out a contractor designated by the National Association of Home Builders as a certified aging-in-place specialist (CAPS).
High demand for home modifications
A third of U.S. adults polled by AARP in June and July 2021 expect that they will have to modify their current residence so that they or a loved one can age in place. The most acute needs include:
- Bathroom safety features, such as grab bars or no-step showers: 79 percent
- Accessibility features, such as a ramp, chairlift or wider doorway: 71 percent
- Emergency response system: 61 percent
- Smart-home devices, such as a doorbell camera or voice-activated assistant: 48 percent
- Improved exterior lighting: 38 percent
- Improved interior lighting: 29 percent
Source: AARP, “Home and Community Preferences 2021”
The industry group created the CAPS program to give homeowners some assurance that they are hiring a builder with knowledge about the challenges older clients can face. The aim is to reduce the risk that someone inexperienced with the needs of an older adult could create a harmful situation — grab bars improperly installed, for example.
More than 9,000 people have been certified as CAPS, and training is offered at 30 to 40 locations each year around the country and in Canada. But Dan Bawden, who helped found the program and trains peers for the certification, says that number 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, the owner and president of Legal Eagle Contractors, a custom building and remodeling firm based in Bellaire, Texas. “In really older houses, doors are almost always too skinny.”
Modification costs range from basics, such as $500 for adding grab bars, to $2,800 to widen a doorway. To truly modify a 2,000-square-foot house not built for accessibility can be a $100,000 to $150,000 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, Bawden says.
Some financial assistance available
Local or state programs can provide financial assistance for retrofits such as grab bars, Bawden says. In some cases, funds may be available for a change a doctor prescribes as medically necessary.
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 allows these plans to pay for shower grips and other safety devices designed to prevent falls and for accessibility 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.
Editor's note: This article, originally published Nov. 28, 2019, has been updated with more recent information on the 65-plus population, fall risks, the CAPS program and home-modification costs.