If you want to stay in your home as you age, take a look around and think about whether your home is a suitable place for you to spend your 70s, 80s, and 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 often made very difficult by a widespread lack of age-friendly home modifications. As researchers for MetLife's Mature Market Institute have noted, most homes use "Peter Pan" housing designs, because they appear to be built for people who will never grow old.
The basics promoting aging in place are well-known. 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 we will be able to find it. The rising numbers of seniors means there will be more demand for available institutional care slots. Meanwhile, the number of caregivers may actually decline as smaller numbers of younger workers confront rising demand for senior care.
The message is clear: Staying home and receiving care in your home will increasingly 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 often not the case today.
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MetLife says sustained improvements in three areas are needed to help people achieve rewarding aging-in-place experiences.
1. 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.
Progress on developing age-friendly communities has been slow, but there was a promising developing this week. The Pfizer Foundation and Grantmakers in Aging announced formation of a national effort: "Community AGEnda: Improving America for All Ages." It will provide $550,000 to Grantmakers in Aging plus five grants of $150,000 each to boost age-friendly community development efforts in Atlanta, Kansas City, Miami-Dade County, Phoenix, and Indiana (programs in Bloomington, Huntington, and Indianapolis).
2. The home must become a technologically enabled hub for individuals. Communications advances are moving increasingly sophisticated healthcare and monitoring services into the home. Successful age-friendly homes should include remote sensing and communications tools, interactive testing and medical diagnostic devices, and online access to community support and social activities.
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3. Age-friendly housing needs to employ 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.
MetLife spells out three sets of priorities for home modifications. The first priority, which it says should entail modest costs, is to prevent falls. Six specific changes are "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; [and] soft path lighting for nighttime mobility."
The second priority is to make a home more accessible and easier to navigate. Costs here can be more extensive, ranging from a few thousand dollars to 10 times that amount. 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.
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Lastly, there are 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. 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 master bedroom unit is a sensible contingency for extended-care needs.
Although expenses may appear steep, consider the alternative of spending upwards of $5,000 or more a month for a unit in a full-service retirement or assisted living community. Even including all costs of at-home care and continued residency, your payback period might not be very long. And if the work helps avoid an at-home injury with hospitalization expenses, the savings might be even greater.