Smart Guide to Aging in Place

PLANNING HOME IMPROVEMENTS

6. When to hire a general contractor

Many professionals can help you make aging-in-place home improvements. It all depends on the scope of work you need, according to Kopec, who says a handyperson can do small jobs and cosmetic improvements such as replacing a toilet or installing grab bars. “If you’re going to be doing things like widening doorways or installing ramps for mobility devices, then you’re going to need to hire a general contractor,” he says. “A contractor needs to be involved with anything structural.”

7. When to hire an interior designer

If you’ll be doing major projects — a kitchen or bathroom remodel, for example — you might need to engage an interior designer. They can create home modifications that look natural instead of institutional. “If you go into a house and see grab bars in the bathroom, you know immediately that the person who lives there has stability issues,” Kopec says. “Most people don’t want that. An interior designer can help you make modifications in ways that don’t stand out.” Lilly agrees, adding that grab bars don’t have to look like they belong in a bus station. “There are a million choices,” she says. “We can install grab bars that are incorporated into towel bars or toilet paper holders that are matte black and beautiful and discreet.”

8. Where to find aging-in-place specialists

Look for contractors and designers specifically trained in aging-in-place modifications. The National Association of Home Builders (NAHB) offers a Certified Aging-in-Place Specialist (CAPS) program that teaches the technical and customer service skills that remodeling and design professionals need for aging-in-place projects. If you are a member, you can view the more than 3,000 CAPS professionals in NAHB’s online directory. Another program is the Executive Certificate in Home Modification (ECHM) Program, offered by the Fall Prevention Center of Excellence at the University of Southern California Leonard Davis School of Gerontology. (A directory of alumni is available at Homemods.org.) The Living in Place Institute offers Certified Living in Place Professionals certification.

9. How to budget wisely

Remodeling costs can vary widely, depending on the modifications you need. According to the home-improvement website Fixr, expect to spend $90 to $300 for something simple such as installing grab bars in a bathroom — or $50,000 or even more for a new kitchen layout. Fortunately, you don’t have to do everything all at once. “Creating a budget involves assessing the necessary changes and prioritizing them based on immediate needs,” Lilly says. Kopec agrees. “You’re not going to do the whole shebang at once,” he says. “You’re going to take incremental steps based on what you think you’re going to need in the near future.”

10. See whether you qualify for financing

As it is for any other renovation or remodel, financing is available for aging-in-place improvements in the form of home-improvement loans, home equity loans and home equity lines of credit (HELOCs). Lilly says some contractors offer financing directly to customers or through banking partners.

11. Look into government funds and grants

Medicaid programs in most states pay for certain home modifications for people with disabilities. However, the qualification requirements can be strict, and the waiting lists can be long. 

The U.S. Department of Housing and Urban Development’s Older Adult Home Modification Program offers grants to nonprofit organizations, state and local governments, and public housing authorities to fund home repairs and renovations for low-income older adults; your state or local housing authority can help locate those funds. 

If you’re a veteran with a service-connected disability, the U.S. Department of Veterans Affairs offers grants for home modification. Additionally, some states provide tax credits for aging-in-place investments.

GETTING TO WORK

12. Embrace universal design

The principles of universal design are about creating spaces that are functional for everyone, regardless of age or ability. NAHB provides examples of features commonly incorporated into aging-in-place remodels: no-step entries that don’t require stairs; one-story living that locates kitchens, bedrooms and bathrooms on a single level; wide doorways and hallways that accommodate large people and objects, including wheelchairs; and open floor plans with ample space to maneuver between furniture and around corners.

13. Start outside

For many older adults, walking from the driveway to the front door can be treacherous, so it’s important to consider the exterior when you’re evaluating the long-term safety of your home. Lilly says a major priority outside is level surfaces, and she stresses the importance of repairing sidewalk cracks, a major tripping hazard. It’s crucial to eliminate curbs and irregular surfaces — think stone paths and brick walkways — for the same reason. Good visibility also is critical, so bright landscape lighting is essential for sidewalks, pathways and porches. Be mindful of needs specific to your region, Kopec says. In the Midwest and Northeast, slippery surfaces are a seasonal concern, especially in winter. Improvements such as heated driveways or hand railings along sidewalks can help.

14. Make entries easier

If the path to your front door is steep or has lots of stairs, a ramp might be a good idea, Lilly says, especially if you have or anticipate having mobility issues. If a ramp isn’t feasible, make stairs safer by installing secure handrails on both sides of stairways for support. Widening doorways can make a big difference for those with mobility aids, she adds. Aim to have at least one entrance that is “zero-step.” “It’s a gait issue,” explains Lilly, who says a zero-step entry with a flat threshold reduces trip-and-fall hazards. “As we get older, we tend to drag our feet a little bit more. We shuffle,” she says. “So a flat surface is safer.” A bench is a nice finishing touch, Lilly notes. “A bench … beside the front door is a very common way that we can make it easier to put purses and groceries down while we open a door,” she says.

15. Get a grip

For a simple and low-cost aging-in-place improvement, replace doorknobs with lever-style handles, Black says. “People who have arthritis of the hands really aren’t able to grip doorknobs anymore, but they can do levers,” she notes. “A lever is a great example of universal design because it works for people of all ages and abilities.”

16. Secure area rugs

Because rugs are dangerous tripping hazards, Lilly recommends removing all of them from a home to create stable, even surfaces. “Area rugs are the No. 1 risk in a home,” she says. “Area rugs should either be donated or thrown in the trash.” If you can’t bear to part with your rugs, make sure they’re low pile — high-pile rugs are bigger tripping dangers — and secured to the floor with a nonslip mat or anti-slip rug tape, Kopec says. Avoid curling edges and corners that are easy to stumble over.

17. Combat clutter

Clutter can be just as dangerous as rugs, according to Lilly. She recommends removing excess furniture and belongings — especially those that block your home’s major arteries. “Decluttering can significantly enhance safety by reducing tripping hazards and making the home easier to navigate” and essential items easier to find when you need them, Lilly says.

18. Bolster your bathrooms

Bathrooms are wet and slippery, making them hazardous places for older adults prone to falls and fall-related injuries. That’s why Kopec says bathrooms should get a big slice of a homeowner’s aging-in-place budget. To keep bathrooms safe, he recommends doorless roll-in showers, which can accommodate walkers and wheelchairs, with flat, no-step thresholds that reduce tripping risks; bidet systems to simplify toilet hygiene; hand showers or shower wands to make it easier to wash hard-to-reach body parts; and built-in shower benches, which give people with chronic obstructive pulmonary disease (COPD), emphysema and other health conditions a safe place to sit when they feel short of breath. In addition to grab bars next to toilets and on shower walls, Lilly suggests comfort-height toilets, which are easier for older adults to sit down on and stand up from. Other smart ideas include slip-resistant strips on shower floors and either lever-style or touchless bathroom faucets for people with arthritis. 

19. Create a more comfortable kitchen

The kitchen is the heart of many homes, so it’s a natural spot for strategic improvements. Black says two of the most functional are swapping out drawer and cabinet handles — D-shaped ones are easier to grasp than knobs — and lowering counters to seat height. The latter makes it easier to reach objects on countertops, keeps appliances accessible for wheelchair users and allows you to sit during strenuous tasks such as chopping and mixing. Kopec suggests a cooktop with a separate oven, built in at a higher level: “That way, when you’re taking something out of the oven, you just take one step and place it on the counter, without twisting or bending over.” If a range is your only option, consider one with a double oven, and try to use the top one more than the bottom one. Kopec also suggests a sink with a sprayer that’s long enough to reach the top of the stove. That lets you fill pots with water and avoid the strain of carrying them. Finally, replace lower cabinets with ergonomic pullout shelves, Lilly suggests. They’re easier to access.

20. Make your living room more livable

One of the most important considerations in living rooms is lighting, according to Kopec. He says the ambient light from lamps might not be bright enough — and the cords can create tripping hazards. Instead, he recommends overhead lighting operated by a remote control — a ceiling fan with an attached light fixture, for example. Hardwired fixtures such as wall sconces can provide bright, cord-free illumination. In living rooms that get a lot of sun, the problem might be too much light, Kopec notes. If glare makes it hard to see where you’re stepping, sheer curtains can help, he says. Finally, consider updating your living room furniture. Get rid of pieces with sharp corners that can cause injuries and bring in sofas and chairs with armrests. These provide support when you’re sitting down or standing up. While you’re at it, avoid seating that’s too low or too deep; chairs and couches should be tall and shallow enough that they’re easy to stand up from.

21. Batten down your bedroom

Your bed should also be at the right height for ease of access, Kopec says. “You want to make sure that your bed is not too high or too low,” he says. “When you’re sitting on the edge, the back of your knee should be on the edge of the mattress and your foot should be flat on the floor. That’s the ideal height for a bed.” An adjustable bed can give you an extra boost when you’re getting up in the morning. Likewise, a handrail next to the bed provides extra support when you’re standing up. So does furniture such as nightstands or bookshelves, but make sure they’re secured to the wall so they don’t tip over, Kopec adds. Also, you need a clear and well-lit path from the bed to the bathroom, Lilly points out. That might require repositioning your bed, installing handrails you can grab as you traverse the room or purchasing motion-activated night-lights to guide you in the dark.

22. Make stairs and hallways safer

The safest stairs are no stairs at all, according to Lilly — she recommends single-level living if possible. If it’s not possible, consider installing a stair lift. If a lift isn’t feasible, make movement safer by installing handrails on both sides of the stairs. Put adhesive nonslip treads or a low-pile carpet runner on the steps, and add motion-activated night-lights so you can see where you’re stepping. (Handrails and night-lights are also a good idea in long hallways.) Though stairs can be serious fall hazards for older adults, they can also provide beneficial exercise, according to Kopec. “Not all people have knee problems or balance issues,” he says. “There are some people who are older who will go up and down the stairs two or three times in a row as part of their daily exercise regime. That’s contributing to their muscle strength within their legs, as well as the growth of their stabilizer muscles, which are the smaller muscles that cause us to go backward and forward. Doing that type of exercise, if you can, is really important to your overall health and well-being.”

23. Mind your pets

For older adults, pets can provide exercise, support and companionship. Unfortunately, they can also be dangerous tripping hazards. “You have no idea how many people I know who have ended up in the emergency room because they tripped over their animal,” Black says. It’s important to weigh the benefits of pet ownership with the risks. And if you do opt for a pet, make appropriate accommodations, Kopec says. Cat owners, for example, might raise their kitty’s litter box to avoid squatting or bending over to clean it.

GET HIGH-TECH HELP

24. Get smart about smart homes

Homes full of internet-connected objects — from appliances, thermostats and doorbells to TVs, lights and window treatments — aren’t just smarter.

They might also be safer, says Abbie Richie, tech guru at the Smarter Service, which provides technological concierge services to older adults, senior living communities and active adult communities. “I don’t think we could talk about aging in place without talking about tech,” Richie says, citing voice-activated digital assistants such as Google Home and Amazon Echo, best known for the voice of “Alexa.” Once you learn have the proper setup, you can program smart assistants to do compatible everyday tasks, including opening blinds, turning on lights and locking doors, with just the sound of your voice. That’s a major asset for people with disabilities or other mobility challenges. Most smart assistants come with safety features such as home monitoring and emergency assistance. The former allows caregivers and loved ones to check in on you remotely; the latter lets you call for help in case of a fall or other emergency.

25. Explore assistive devices

With most smart home devices, comfort and convenience are front and center. With assistive devices, safety is the main attraction. A common example is a medical alert system, such as Life Alert, Medical Guardian or One Call Alert. A medical alert system is typically considered when an individual requires a dedicated emergency response service with a wearable pendant or bracelet, Sokolsky says, adding that these systems are best for individuals who have mobility issues, are at risk for falls or have a history of medical emergencies. This option is suitable for older adults who may not have the ability or desire to interact with technology extensively, she says. Richie says other examples include electronic medication reminders and dispensers, and fall-detection systems that use radar-based in-home sensors to track your vital signs and monitor for accidents.

26. Get a dose of telehealth

Since the COVID-19 pandemic, most older adults have probably had at least one virtual telehealth appointment with a medical provider. “Telehealth is here to stay,” Richie says. “It provides so many conveniences for an older adult with limited mobility, and also anyone with limited immunity who just doesn’t want to risk going out for a routine checkup.” Although most people access telehealth through their computer or smartphone, Richie says it will become increasingly common to have virtual health appointments through your television via remote caregiving platforms such as JubileeTV, Uniper and Independa Health Hub. 

27. Keep an eye on ‘AgeTech’

AARP’s AgeTech Collaborative — an ecosystem of investors and start-ups — defines AgeTech as “a growing category of technology solutions designed to meet the needs of the world’s aging population” and “make the process of aging easier.” Examples include smart home features, assistive devices and telehealth applications. If you’re interested in how emerging technologies such as artificial intelligence, robotics, wearables and the metaverse might help you age in place, you might want to pay attention to AgeTech.

WHERE TO FIND RESOURCES

28. Take advantage of in-home services

Many in-home services — including medical care, help with personal hygiene, meal preparation and more — are available to help you continue living in your home, even when everyday tasks get more difficult. “Some people can manage everything, but maybe they need somebody to deliver groceries to their home or somebody to come in and do the housekeeping,” Black says. “It’s OK to need a little bit of help.” AARP has a comprehensive collection of resources for in-home caregiving.

29. Get CAPABLE

CAPABLE (which stands for Community Aging in Place — Advancing Better Living for Elders) is an evidence-based, client-driven fall-prevention program that was created in 2009 by the Johns Hopkins School of Nursing. It takes a holistic approach to aging in place. Offered free to qualifying older adults, the four- to five-month in-home program marries assistance from three different but complementary professional helpers: an occupational therapist who helps people find better ways of doing everyday tasks, a registered nurse who consults on health matters, and a handyperson who makes needed home modifications. Instead of coming into a home, diagnosing aging-in-place obstacles and fixing them, CAPABLE practitioners ask clients to identify their challenges. Then they work together to analyze why the clients are experiencing those challenges and what modifications — not only to their home but also to their behavior — might help. “Together, we’re problem solving and brainstorming,” says occupational therapist Amanda Goodenow, strategic partnership specialist for the CAPABLE National Center. “The overarching goal of the CAPABLE program is to teach the client how to use that methodology — problem-solving and brainstorming, breaking down the issue, then coming up with a solution — so that when future challenges come up, they don’t feel stuck.” The CAPABLE program is available only in select states where specific entities have obtained funding to offer it. Eventually, the program may be available nationwide and fully covered through Medicare and Medicaid.

30. Leverage government resources

Local, state and federal agencies can connect you with valuable information and vital services. At the federal level, the U.S. Department of Health and Human Services’ Administration for Community Living offers the Eldercare Locator, a nationwide service that connects older Americans and their caregivers with trusted local support resources. Affiliated with the Eldercare Locator are more than 600 Area Agencies on Aging (AAA); in communities across the country, they coordinate and offer services that help older adults remain in their homes.

31. See what’s available in your community

Be sure to check with your city or county government to see what they’re doing to help older adults age in place. One program is the “villages” movement, which began in Boston in 2002 and has spread to more than 250 communities across the U.S. The city of Fairfax, in Virginia, provides a typical example of the concept in action. Officials describe Fairfax Village in the City as “a city-supported, volunteer-driven program developed to support … residents aged 55 and older … who wish to stay independent while remaining in their homes.” As part of the program, the Village recruits vetted city-based volunteers who provide personal services including check-in calls and visits, help with yard work, technology assistance and transportation to appointments. As explained on the city’s website, “The goal … is to support healthy aging by sharing useful information, strengthening personal connections between neighbors and providing opportunities for social interaction.”