If you want to stay in your home as you age, take a look around and do some hard thinking about whether your home is a suitable place for you to spend your 70s and 80s (perhaps beyond). If you were in a wheelchair, could you navigate your home without help? Could you cook meals? If you had trouble walking or getting out of bed, how hard would it be for someone to help you? Are there grab bars in the bathrooms? Easily accessible wall switches?
Surveys show that overwhelmingly, people want to grow old in their own homes. But such aging in place, as many experts call it, is made very difficult by a widespread lack of age-friendly home modifications. As a recent report from MetLife notes, most homes use "Peter Pan housing" designs, because they appear to be built for people who will never grow old.
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The report, "Aging in Place 2.0," repeats many things we already know. More of us are getting older and living longer lives. The odds are good that we will need some period of extended care during our later years. Such care is very expensive, and that's assuming you will be able to find it. That rising number of seniors will intensify demand for available institutional care slots. Meanwhile, the number of caregivers may actually decline as part of the same age wave producing more and more older people.
The message is clear: Staying home and receiving care in your home is increasingly going to be the default choice for retirement living. It is cheaper than institutionalized care. And it can also be a more satisfying place to age. However, that's seldom the case today.
The MetLife report says sustained improvements in three areas are needed to help people achieve rewarding aging-in-place experiences. First, the current array of medical, social service, and community support services should be unified in a coordinated network that can provide the right mix of services tailored to an individual's changing needs as they age. This will not only improve the quality of services but, if done properly, reduce costs.
Second, the home must become a technologically enabled hub for individuals. The successful aging-in-place home will feature remote sensing and communications tools, interactive testing and medical diagnostic devices, and online access to community support and social activities.
Lastly, there's the aforementioned need for age-friendly housing that employs what are called "universal design principles". Without the right physical environment, all of the coordinated services and interactive technology in the world won't produce a good result. Fortunately, making your home ready for your "future self" is something you can begin doing now. It needn't be done in hugely expensive chunks, either.
The report sets out three priorities for home modifications. The first priority, which it says should cost $1,000 or less to achieve, is to prevent falls. It sets forth six specific changes: "removing throw rugs especially in the bathroom; installing grab bars and grips in the bathroom; assuring sturdy handrails on both sides at steps; good lighting and switching especially at stairs, halls, and entries; securing or removing carpets at stairs; soft path lighting for nighttime mobility."
The second priority is to make a home more accessible and easier to navigate, and can cost between $4,500 to $30,000, MetLife says. Here, a common objective is to remove raised entrances between rooms and to the house itself. This is not only needed for wheelchair access but for ease of use by older occupants who risk falls by tripping over raised thresholds. The cheapest changes involve common-sense relocation of furniture so people can have unencumbered pathways through their home. Such easy access to bedrooms and bathrooms is particularly important.
Lastly, the report notes, are the more expensive changes that include bathroom and kitchen makeovers. These modifications include a no-step shower or even a lift to help people get into the bathtub. Other bathroom changes include a sitting space under the bathroom sink and extra space around the toilets so a caregiver can provide assistance if needed.
In the kitchen, a big focus of universal design changes is to lower work and storage areas so that wheelchair users and older occupants can prepare meals and have easier access to food, dishes, and cooking tools. If you like to spend time outdoors, consider providing coverings to protect you from the sun and rain. The report also says you might want to consider a back-up power generator. Doing all of this work could cost up to $75,000. For owners of multi-floor homes, the bill could be even higher, especially if you think a first-floor bedroom unit is a sensible contingency for extended-care needs.
Starting with a more modest set of objectives, however, the report says they make financial sense. "Using $10,000 as a sample cost for basic structural modifications compared to assisted living costs at $3,000-plus a month," the report says, "avoiding those costs for a little more than three months will pay for home modifications." Even including all costs of at-home care and continued residency, it adds, the payback period is not very long. "But if one hospitalization or one serious fall with medical and healthcare consequences is avoided, the savings appear much earlier."