The U.S. Centers for Disease Control and Prevention defines “Aging in Place” as the ability to live in one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level. The figures associated with the aging population are staggering and we just do not have the infrastructure to support the numbers long term (caregivers, facilities and cost). The statistics below make our path clear; everything we can do to help people from losing independence and being able to “age in place” is the right direction.
The 65+ population now comprises 13% of the total population. Life expectancy at birth was 47 in 1900. Now it is over 77. By 2020, life expectancy is projected to be almost 80 years.
Those over 85 are a rapidly growing group within the older population in the U.S., growing from 122,000 in 1900 to 4.3 million in 2000, 34 times as large as it was in 1900. By 2030, those 85+ are expected to more than double, growing to 8.7 million people. Between 2030 and 2050, it is expected to again double, reaching 19 million.
Our primary goal with Accessible Home Solutions is to have happier, more satisfied older citizens living in homes of their choice with control, dignity, and respect — essentially independence. At the same time, we want to incorporate universal design, taking into consideration the needs of multiple generations. Accessible homes that incorporate universal design can adapt to owners’ evolving requirements.
Unfortunately, the mindset of the typical 55+ homeowner is that making a home accessible will ruin its aesthetic appeal and turn it into an “institutional” environment; that just isn’t true today. Manufacturers are embracing the aging population by developing products that are not only functional for aging in place but are beautiful as well.
Preparation and planning are key. Financial planning through traditional savings, tapping the equity in your home through a reverse mortgage, or purchasing long-term care insurance are good steps to be able to pay for Aging in Place.
It is particularly important to execute home design modifications early. The process of home remodeling requires time to plan and choose, for drawings to be completed, pricing and alternatives to be considered, permitting, materials ordering, and scheduling to occur. This process is not possible in the tumult of a health crisis and uncertainty. Unfortunately, most families do not consider any Aging in Place issues or services until a health crisis forces them to do so. Discharge planning describes the scramble to get things organized almost immediately when a loved one is coming home from the hospital or rehabilitation facility. That is an poor time to make home modifications. Emotions are high whether from relief and facing an uphill climb back to health or fear and uncertainty because the current situation is as good as it will get. This is a tough time for the careful planning required of any home remodeling project.
Wider hallways, doorways and spaces in circulation areas such as the kitchen and living area. This provides the open concept which is extremely popular today and allows for use of walkers and or wheelchairs when needed in the future.
Accessible Entrance and Exits are key to homeowners being able to stay in the home. Again, we want to try and incorporate any type of ramps and or lifts into the natural surroundings so that it blends in and keeps the aesthetic appeal of the home high. The goal is to have zero thresholds.
Technology is an increasingly affordable and accessible tool for Aging in Place. Smart solutions provide security, convenience and communications to all family members. Artificial Intelligence (Alexa and Google Home) is growing in popularity and are great tools to assist with the following:
- Heating & Cooling controlled through schedules and voice commands. With time, the home learns to adjust lighting according to predicted behavior using motion sensors and repeated voice commands.
- Digital surveillance keeps the family updated on member’s whereabouts. Smart devices manage multiple entry codes so you can control entrance to the home; and receive texts when parents arrive at their designated destination.
- Smart Appliances – coffee makers, dishwashers, refrigerators, garage doors, TV’s – all can be controlled by voice – extremely helpful for caregivers that may not be close to the home.
- Medications and reminders – use these devices to remind homeowners when to take medications, appointments and other scheduled events.
- Routines can be set-up that will control a multitude of smart devices when a certain action happens. For example, a routine can be set up that when you say, “Good night Alexa”, the thermostat goes down to night setting, doors are locked, security is activated and night lighting comes on – pretty cool stuff.
Bathrooms – according to the Center of Disease Control and Prevention (9/22/16), falls are leading cause of injury and death in older adults. In 2014 alone, there were 29 million falls causing seven million injuries and an estimated $31 billion in annual Medicare costs. Implementing zero threshold access and following ADA standards will help with fall prevention. We are fans of the European bath design as it meets the accessibility requirements while providing a modern beautiful bathroom that will enhance the value of the home.
Multi-purpose grab bars are a notable example of incorporating Universal Design and accessibility. Modern styles of grab bars function as towel holders, shelving or toilet paper holders while supporting between 350 and 500 pounds. They come in the latest finishes. Looking at them you can’t tell they are grab bars.
Lighting is crucial to prevent falling – lighting hallways, entryways and steps are all good areas to start with. Pathways can be created with dimmed lights to the kitchen or bathrooms for elders who are up during the night. Lighting can be scheduled and/or controlled via apps and smart home devices. This is another example of UD that will improve the value and aesthetics of the home; today lighting is a key component of any upscale home.
Costs & Funding
Today, most home modifications will not be covered by Medicare or Medicaid, although there is a lot of activity trying to get this changed. It makes sense that insurance companies would want to be proactive in preventing falls and injuries in the home…again small investments yield large gains in healthcare spending. We assist clients and family members with researching potential funding resources.
Using $10,000 as a sample cost for basic structural modifications compared to assisted living costs at $3,000+/month, a simple equation shows that avoiding those costs for a little more than three months will pay for home modifications. If we include customary expenses for continuing bills such as utilities, taxes, maintenance, etc., of $850/month, food at $250/month, three hours of daily assistance twice weekly at $19/hour or $456/month, and three days per week in adult day services at $804/month, it will take about 14 months to break even on the modifications. By the end of 24 months there is a net savings near $10,000. But if one hospitalization or one serious fall with medical and health care consequences is avoided, the savings appear much earlier.