Home Modifications for the Elderly
Home modifications can help seniors age in place.
Modifying homes to make them safer and more accessible allows many elderly people to stay in their homes during their later years. This is good news, since the majority of older Americans prefer this stay-at-home home option (often called "aging in place") to other situations like assisted living. According to the nonprofit Rebuilding Together, 80% of those aged 50 and older own their own homes, and 92% of them want to age in place. For many seniors, living in their home is not only important to their emotional well-being, it's often more cost-effective than other housing options.
This article discusses how to go about the home modification process from figuring out what modifications are needed to finding funds to pay for the renovations.
The Benefits of Home Modifications
A home modification adapts a living space so that occupants can live safely, perform tasks better, and live independently, despite their physical limitations. A home modification can be as simple as adding a grab bar in the bathroom or can involve extensive structural changes like replacing a stairway with a wheelchair ramp.
Older people are often in particular need of home modifications. The majority of seniors live in homes that were built long before architects and builders thought about designing spaces that are accessible and livable for everyone. Stairs and narrow doorways might have worked when a homeowner was 30 but, at age 80, those things can pose a hazard. Problematic house design can force many elder homeowners to leave their homes due to the danger of falling in the shower or bathtub, difficulty preparing meals when cabinets are out of reach, or inability to take the stairs to get to a bedroom on the second floor.
When planned and carried out properly, home modifications can meet the particular needs of an older occupant so that they can continue to perform the tasks necessary to caring for themselves and safely navigating their home.
Figuring Out What Home Modifications You Need
Assessing the home to determine what modifications are necessary is the first step in the home modification process. The senior or their relatives or friends can go through the home, room by room, looking for areas of improvement. You can download one of the many good home assessment checklists from the Internet to aid in this process. And sometimes it's worthwhile to turn to specialists for ideas and help in planning for home modifications.
Room By Room Assessment
Go through each room with an eye towards the following:
Safety. Does anything pose a safety hazard in the room? Can the senior move around the room and perform tasks safely?
Accessibility. Is everything accessible to the senior? Can they reach things and work switches, doors, cabinets, and plugs? Can they perform necessary or desired tasks in this room?
Adaptability. Are there things in the room that could be adapted so they are easier for the senior to reach or use or so that the senior can get around more easily and safely?
Here's an example of things to look for in a kitchen:
- Are cabinets easy to open?
- Are dishes easily reached?
- Can the senior sit while preparing meals?
- Are counter tops at a comfortable level?
- Are stove controls easy to see and easy to manipulate?
- Are there kitchen rugs or mats that pose a slipping hazard?
- Can the senior reach and easily turn on the faucet?
- Is the water temperature low enough so that it doesn't scald?
- Is there enough light?
Online Checklists
Several organizations publish comprehensive lists of questions to ask and things to look for when assessing a home for possible modifications. For example, Rebuilding Together publishes an online Home Safety Checklist at www.rebuildingtogether.org (click "Resources," "Home Modifications," and then look for the checklist.) The American Association of Retired People (www.aarp.org) and the Fall Prevention Center of Excellence (www.homemods.org) also have online checklists.
Getting Help From a Specialist
If you're considering a home modification, sometimes it makes sense to get assessment and planning help from a specialist.
Occupational therapists. Many occupational therapists work with the elderly. They are good resources for evaluating seniors' homes for hazards and for identifying ways to make the home more user-friendly. If the senior has a particular physical limitation such as failing eyesight or cerebral palsy consider contacting an occupational therapist that specializes in that particular condition.
Certified aging-in-place specialists (CAPS). The certified aging-in-place program was developed by the National Association of Home Builders along with the AARP. Certified aging-in-place specialists (CAPS) have been trained to anticipate and meet the needs of seniors. They learn strategies and techniques for identifying barriers in a home, planning, and sometimes performing home modifications so seniors can live in their homes longer as they age. You can find CAPS in your area by visiting the AARP's website at www.aarp.org (click "Family," then "Housing & Mobility," and look for the CAPS Locator in the Resource section.)
Many home modifications are inexpensive. Examples of typically low-cost modifications include replacing cabinet knobs with pull bars, installing grab bars in the bathroom, adding night-lights, increasing bulb wattage, and getting rubber grips for faucets. And some changes are free such as removing throw rugs that pose a slipping hazard and regulating water temperature to avoid scalding. But other modifications can be pricey, such as installing a wheelchair ramp or lowering kitchen counters.
Here are some ways to cover the costs of home modifications:
Sliding scale and reduced fee services. Some contractors will do home modifications for the elderly for a reduced fee or on a sliding scale, depending on the senior's income.
Loans. Sometimes seniors can obtain a second mortgage or use a home equity line of credit to pay for repairs and modifications.
Funds from Title III and Title V of the Older Americans Act. These funds are distributed to local area agencies on aging (AAA). To find your local AAA, visit the Eldercare Locator at www.eldercare.gov.
Rebuilding Together. This national nonprofit can provide some seniors with assistance in home modifications. Visit their website at www.rebuildingtogether.org to learn more.
Medicare and Medicaid funds. If ordered by a doctor, some types of home modifications might be covered by Medicare or Medicaid such as hospital beds, walkers, and raised toilet seats. To learn more about these health care programs, see Nolo's Health Care: Medicare & Long Term Care section.
Community development block grants. These funds are available through cities or towns, and usually go towards housing rehabilitation in specific neighborhoods.
Hiring a Home Improvement Contractor
Some larger modifications will require the homeowner or relatives to hire a contractor. It's important to use caution when hiring a contractor. Unfortunately, some shady home improvement contractors prey upon the elderly charging excessive fees, doing shoddy work, or getting paid and then failing to do any work at all.
To protect against scams or to make sure the work is done correctly and on time take these steps:
Investigate Before You Hire a Contractor
The best way to avoid problems is to be choosy when hiring a contractor. Get recommendations from trusted family and friends. A good reputation is often the best indicator of an honest, competent contractor. Make sure the contractor is licensed for the particular work you want done and that they are insured. Also check with the local Better Business Bureau, local consumer protection agencies, and your state's contractors licensing board to see if any complaints have been filed against the contractor.
Get More Than One Bid
Meet with several contractors. Ask them specifically how they will carry out your home modification plan, what materials they will use, and how much they will charge. Get all specifics in writing. Keep in mind that the lowest bid is not always the best deal if the contractor plans to use cheap materials or cut corners.
Sign a Contract
Once you choose a contractor for a home modification, sign a written contract that specifies the work to be done, materials to be used, time frame for the project, and the cost. The contract should also lay out the payment schedule.
Tie Payments to Completion of the Work
Payment for the home modification job should be tied to completion of the work. Often, the homeowner makes a small down payment to start (so the contractor can buy materials). The remaining payment should be structured either as one final payment upon completion of the project or, if the project is large, partial payments as various stages of the work are completed. The details should be included in the contract.
To learn about others ways to help older relatives remain in their homes safely including information about in-home support services and how to protect seniors from fraud get Long-Term Care: How to Plan & Pay For It, by Joseph L. Matthews (Nolo).