Adapt your home to promote aging in place.

As we experience illness and as we grow older, our physical abilities often change. We may find that it's more difficult to get up from the toilet; we may rely on a walker or a wheelchair. However, the homes in which most of us live right now are designed for young folks in the best of health. Since illness is a possibility for all of us (and aging is a certainty), some modern homebuilders are designing homes to meet the needs of people with a wide range of physical abilities. Whenever we buy a home or remodel our current home, it makes sense to think about possible future needs and incorporate them into our current plans.

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It's easy to find general "accessible housing" guidelines on the Internet. Use discretion when applying those guidelines to a specific situation. For example, the Americans with Disabilities Act (ADA) sets standards for grab bars and wheelchair-turning space in public bathrooms, but those standards are not necessarily ideal for your own private bathroom.

Gregory A. Miedema, the president of Dakota Builders in Tucson, Arizona, is a certified "aging-in-place specialist" (CAPS). He talks with hundreds of people a year about their building plans, describing himself as "a remodeling contractor who is incorporating the aging-in-place philosophy into everything we do." Each project requires specialized consideration, he says. "When you're remodeling a residence, remember that not every disability or ability is the same. When I walk into a home for a consultation, I ask, what's comfortable for you? When installing a grab bar, you want it to be right at your side, just where you would normally put your hand."

B. Duerstock, PhD, who uses an electric wheelchair, decided to build his own accessible home and posted an extremely valuable description of the process on the Internet. "Finding a house that is handicapped-accessible or that could be easily modified is a crapshoot," he writes, explaining his own decision to build. "Finding the right house to be adapted can be as rare as finding one that is already accessible." Discussing ADA specifications, he notes, "... One must determine whether each requirement is helpful to you. For instance, I sit higher in a electric wheelchair than manual wheelchair users, so my table height clearances are higher."

If You're Buying a House

When you're looking at houses, ask yourself, "Suppose someone in our family broke a leg and was on crutches for two months ... how would this house meet our needs?" The most important feature to consider is whether the house is one-story or multi-storied? If multi-storied, does it include an elevator? Could someone live on the ground floor, if necessary? If there are steps leading up to the front door, is there room to build a ramp? Modern houses often have open floor plans, which may be easily adapted to meet specialized needs. Look for wide doorways and hallways. A large bathroom with a walk-in shower is a plus.

Remodeling

If you're remodeling your house or building an addition to your current home, incorporate features into your current plans to make the home more accessible in future years, without affecting livability or costs. For example, consider extra blocking in bathroom walls (to support future grab bars), lower electrical switches, and higher electrical outlets.

The National Association of Home Builders surveyed remodelers in July 2007, asking about remodeling projects they'd done in the past year that had been designed to help people grow old comfortably in their own homes. Top priorities included grab bars, higher toilets, curbless showers, and wider doorways. (See Figure 1.) In fact, Miedema and his wife just remodeled their own house. They made all the hallways 42 to 48 inches wide. Most of their doorways are 36 inches wide, with two 32-inch pocket doors in the master bedroom. (A 32-inch pocket door has the same effective width as a 36-inch wide standard door.) "You need a bigger door if you're using a wheelchair or a walker," Miedema says. "Picture yourself using a walker. Your elbows flare out, and it's just like carrying a laundry basket."

Their master bath has a "comfort height commode." That's a toilet seat designed to be a bit higher than the standard toilet. They have curbless showers with built-in corner benches, and both have adjustable shower heads that can detach from the wall on a metal hose. "These are changes I suggest to all my clients," Miedema says. "Sometimes they say, 'you know, I don't really need to sit down in the shower.' But that's because they all live in the same place, at the mouth of a big river in Egypt called denial. We break the ice; we raise the suggestion."

Adapting a Home at Any Time

There are some features that are so easy to install, they make sense at any time. At the top of the list: grab bars in the bathroom. They'd come in handy for all of us, at every age or state of health. Bathroom falls are a substantial cause of in-home accidents. If you can find the studs in your house, grab bars are easy to install, Miedema says. "When the studs are 24 inches on center, install a 24-inch grab bar. If they are 16 inches on center, get a 36-inch grab bar, put it at an angle, and you have a 32-inch spacing. Also, install a vertical grab bar on a single stud."

An adjustable showerhead sounds like a great idea for everyone, too. Installing a curbless shower would be a substantial remodeling project, but just changing the fixtures sounds doable for everyone who owns their own home. (And if you are renting, bring up the subject with your landlord, since these modern fixtures improve the value of the home.)

Miedema notes that improved lighting is another feature that's easy to add without extensive remodeling. "Good lighting is something we often overlook when we discuss about accessibility. Sometimes the problem isn't getting around; it's being able to see clearly where you're going. Add some task lighting or a bit more direct lighting. Consider a dimmer switch so you can brighten the light or turn it off when you need to. Just be sure to plan for sufficient lighting when you walk through the hallway at night."

Elaine Zablocki is the former editor of CHRF News Files.

Resources

The National Association of Home Builders has developed a certification program for "CAPS" specialists trained in "aging in place" remodeling. For a list of local CAPS specialists, please visit http://www.nahb.org/aginginplace.

"Building an Accessible Home," by B. Duerstock, PhD, is a detailed article about choices involved in building an accessible home from scratch. This page includes links to additional "accessible housing" websites. Highly recommended. Available at: http://www.vet.purdue.edu/cpr/bsd/building.html.

Easter Seals and CENTURY 21 have developed a series of tips on how to identify an adaptable home and how to make a home accessible. Great checklists! Available at: http://www.easterseals.com/site/PageServer?pagename=ntlc_easyaccesshousing_tips.

The Home Safety Council has valuable pointers on fall prevention and other home-safety issues. Available at: http://www.homesafetycouncil.org/resource_center/resourcecenter.aspx.

Figure 1: Type of Aging-in-Place Remodeling Projects Done in Past 12
Months

Percent of Respondents)

Grab bars                            90%
Installing higher toilets            75%
Curbless shower                      63%
Widen dooways                        56%
Ramps or lower thresholds            50%
Added lighting/task lighting         47%
Added bedroom on entry level         39%
Installing non-slip floors           30%
Installing easy-to-read thermostats  11%
Other                                 9%

Source: RMI Special Analysis, NAHB

Note: Table made from bar graph.