Aging in Place Guidelines

Aging in Place: An Overview

I. Prologue

America is aging.   The birth rate in this country has declined precipitously since 1960, and, compared to 1970, today people are living about five years longer on average.  The U.S. Census Bureau forecasts that the number of folks 65 or older will total nearly 73 million by 2030, more than doubling since the year 2000, and will constitute about 20 per cent of the population by then (and a much larger percentage of the voting population.)

Not only are people living longer, but their quality of life has improved significantly as gerontological science continues to forge ahead, aided and abetted by a greater national focus on living healthier lifestyles.

In short, seniors (all of us someday, hopefully) are living longer and enjoying it more.  Within this new paradigm of aging, a high percentage of seniors strongly prefers to remain in their own homes for as long as practically possible.  The National Aging in Place Council (NAIPC) says that more than 90 percent of older adults would prefer to age in place rather than move to senior housing.

But, the sad fact is that many older Americans don’t make adequate plans to age in place.  Surveys show that they lack the knowledge to design and implement solutions to achieve that desire, or know of resources that can come to their aid.  At present, only a small number of the 78 million baby boomers entering or approaching seniorhood are preparing adequately to live in homes that will accommodate their needs in later years.

Our mission, then, must be to initiate a well-directed, sustained effort to educate our seniors, our baby boomers and ourselves as potential self-caretakers, about how to actualize aging in place.  If we have elderly parents, relatives or friends, or if we plan on being elderly ourselves at some point, now is a propitious time to begin educating ourselves and our elderly cohort.

Accordingly, this blog will focus attention on the rudiments of AIP facility modifications and downsizing.  Discourses on senior healthcare, financial, legal and social issues are beyond the scope of this blog.

II. Aging in Place Design Principles

Short of downsizing, there are many options to choose from when considering what physical modifications can be made to senior apartments in support of aging in place.  A flexible approach may be taken whereby modifications may be installed over a period of time as needs indicate, easing budgetary pressures and minimizing disruptions.

The more common design principles for aging in place modifications are summarized below:

General Considerations:

• Single floor living
• Hallways are a minimum of 36 inches wide
• Interior doors and passageways accessing a major room are at least 32 inches wide or made that way by installing swing-clear hinges to make use of the entire doorway opening
• Interior doors have easier-to-use levered handles
• Traditional toggle switches are replaced with easier-to-use rocker panel switches including lights that automatically illuminate in the dark
• Smoke and carbon monoxide detectors are installed as required by law
• Flashlights are kept in all rooms in case of power failure
• Automatic light-sensitive night lights are installed in all rooms and hallways
• Phones are installed in multiple rooms to enable calls for help
• Scatter rugs and small area rugs are eliminated
• Larger rugs are to secured to floors with double-sided tape

Bathrooms:

• One lavatory sink countertop is lowered and open underneath to accommodate wheelchairs
• Exposed hot water pipes under the sink are insulated to prevent burns and bruises
• Shower has a curb-free entry
• Sliding glass shower enclosures are removed and replaced with a curtain for easier access
• Comfort height toilet seats are 17 to 19 inches high vs. the standard 15 inch size
• Bathtub and shower floors have non-skid surfaces
• Showers feature a hand-held, adjustable shower head at a convenient height
• Showers contain permanent or removable seating in order to bathe while seated
• Structural backing is installed at future grab bar locations
• 50-inch diameter turnaround spaces are provided for ease of wheelchair use
• Floors have non-slip surfaces

Kitchens:

• Built-in ovens are located at countertop height for easier food transfer
• Microwave ovens are located at counter top height for easier food transfer
• Sink and cook tops have knee spaces underneath for wheelchair access
• Stove and cook top controls are near the front of the device eliminating the need to reach over  flames or hot pots
• Roll-out shelves are utilized in pantries and lower cabinets
• Cabinets have easy-to-grip handles and corner cabinets utilize lazy susans
• Kitchens have a work surface where a person in a wheelchair can sit comfortably while working
• Suitable task lighting is installed over sink, stove and other work areas
• Side-by-side or drawer-style refrigerators are preferred for ease of access
• Floors have non-slip surfaces

Closets:

• Pull-down shelving is installed to make higher storage areas accessible
• Adequate lighting is installed in closets
• Clutter on shelves is eliminated to prevent avalanches
• Closet doors are selected that are easy to open

Laundries:

• Laundries feature easier-to-use front loading washers and dryers which sit on raised platforms to reduce bending requirements

Bedrooms:

• Beds are placed in such a way as to allow easy access to bathrooms

Living Rooms:

• Open spaces are preferred and furniture is arranged to allow for clear, wide passageways

III.  When to Modify Your Home for Aging in Place

The best time to start thinking about home modification is long before the need actually arises. Ideally, people in their fifties and sixties should prepare their homes for later installations while they are doing routine home improvements and repairs. Extra wide doorways that can accommodate a wheelchair can be an attractive feature in any home. Strong supports can be installed behind tile walls when updating bathrooms to later accommodate grab bars.

It is always best to undertake home modification before a crisis occurs so that the work can be carefully planned and budgeted. Before any changes in the home environment are considered, a thorough room-by-room assessment of the surroundings should be made. This should include consideration of the resident’s current and future needs, the way in which he/she uses the home and its contents and any barriers that might limit movement or access. A good general safety checklist that can be used for this purpose is available without cost from the U.S. Consumer Product Safety Commission (CPSC) in Washington D.C.

IV. What Is a Certified Aging in Place Specialist (CAPS)?

A Certified Aging-in-Place Specialist understands the unique needs of the older adult population and is knowledgeable about aging-in-place home modifications, common remodeling projects and solutions to common barriers. CAPS designees are often remodelers, but realtors, designers, occupational therapists, architects and others frequently achieve this designation as well.

A Certified Aging-in-Place Specialist can:

• Recommend facility updates that will help a person live independently, aging in place in his or her own home
• Work with you (and your spouse), an architect and your medical professional to ensure that all appropriate home modifications will be installed that address your medical requirements
• Co-ordinate the efforts of all involved parties, which could include an architect, all contractors and trades, an interior designer and an occupational therapist so that the entire project flows smoothly and seamlessly to completion.
• Provide estimates of the costs and time to complete all remodeling, and provide information about useful products and resources

V. Downsizing

If downsizing your apartment factors into your plans, which it commonly does for those contemplating aging in place, you can co-ordinate the closings for your old and new apartments to allow enough time for installing the aging in place modifications on the new, down-sized apartment.  Doing this will avoid the necessity of moving temporarily into a furnished apartment or a hotel room, or to crash the pad of a sympathetic soul.  And, you can find a CAPS person who is also a realtor (like me) who can co-ordinate and manage all aspects of your move.

V. Epilogue  

Too many people don’t wake up to the need for planning to remain in their long-term residence until their physical condition becomes compromised, and that’s too late.  Now, while you’re still active and influential, is the most important time to make plans for living happily in your later years while remaining in the long-term residence that you’ve grown to love and are loathe to leave.

The most effective way to do this is to consult with a specialist/realtor in the field of aging in place.  A specialist/realtor will guide you through the minefield of options to ensure that your home will be customized to accommodate your unique preferences and requirements.  He will remodel your apartment to underwrite your comfort and security for the foreseeable future.  And, if you prefer to down-size your apartment as part of your aging in place strategy, he can, as a licensed real estate agent, manage all aspects of the sale and subsequent purchase of your residences.

There are no other agencies I know of in New York City that offer the combined services of realty and aging in place remodeling.  I perform these services seamlessly, making for a single point of contact and control for my clients, and for effective and total co-ordination of all aspects of my clients’ projects.

This blog about aging in place is the first in a monthly series of related blogs, all dealing with some important aspect of aging in place.  I want to make this material as useful as possible for you so your comments, questions and requests are gladly invited.  Simply click here for information about our aging in place services, to make a comment, to ask a question, to arrange a consultation, or if you’re interested in attending an aging in place seminar.

Thanks and regards!