Living in Place vs. Aging in Place
For many, the term “aging in place” brings to mind institutional-looking grab bars. Clunky shower seats in the bathroom. Unsightly mobility aids. And the looming fear of what comes after. But “living in place” takes the focus away from aging. It strives to find ways to enable people of all ages and abilities to live their best lives without having to move into a senior living community.
So what exactly is the difference between “aging in place” and “living in place”? Often the answer lies in preparation.
By utilizing universal design principles to implement home modifications that provide utility and safety. And also comfort and style for Boomers entering this stage of life.
What’s Universal Design – and Why Does It Matter?
Here’s what the Centre of Universal Design website has to say:
“Universal design is the design and composition of an environment so that it can be accessed, understood and used to the greatest extent possible by all people regardless of their age, size, ability or disability.”
The site goes on to say that:
“An environment (or any building, product, or service in that environment) should be designed to meet the needs of all people who wish to use it. This is not a special requirement for the benefit of only a minority of the population. It is a fundamental condition of good design.”
This means that implementing living in place modifications will benefit not only your aging family member but also you, your spouse, your children. Basically everyone, all ages and all abilities!
That’s what you get when you work with building and design professionals experienced in helping people implement living in place home modifications. Not an institutionalized space, but an open, welcoming, and, yes, stylish environment. One that can make everyday living better for everyone, while complying with ADA guidelines.
The best part? No moving into a new home required.
If you’re thinking about helping a senior loved one avoid moving into a retirement community, nursing home, or other types of long-term care facility, living in place modifications can be made in their current home. Or your home if you decide you want to move them in with you.
Would you really want to make these changes to your own home? There are many reasons to do so.
Why Having an Accessible Home Is So Important
For homeowners in their 40s or 50s thinking about moving an elderly parent into their home (or even recent retirees who are now looking at what’s next for them), now is the perfect time to start looking at modifications. Not only will your aging family member get to enjoy the benefits of the change, but also you, your spouse — and the rest of your family!
Accidents (transportation-related or sports/hobby-related) resulting in broken bones or causing permanent disabilities. An unexpected or chronic medical condition, such as arthritis. Stroke and other cardiovascular diseases. Degenerative muscle diseases. Loss of sight or hearing. Memory issues. Children moving back home. An older adult requiring extra care.
All these things can result in physical limitations that make it difficult to successfully complete many activities of daily living in a house that wasn’t designed with those types of issues in mind.
What the Research Says about Living in Place
Research shows that often where permanent disabilities newly surface, a few of the most important and effective elements of recovery and/or maintaining some sense of normalcy have to do with what we may otherwise consider mundane.
Establishing a daily routine (especially when memory loss and early signs of Dementia are present), and incorporating regular social interaction (daily visits with friends and family, and even regular caretakers make a huge impact) are two ways of doing that.
These things provide the foundation for a strong sense of wellbeing, and studies show this goes a long way toward overall health, wellness, and recovery.
One popular answer to this kind of positive experience in senior care is with a move to an assisted living community. These liveable communities are specifically designed for older people, and often have age stipulations (no one younger than 50, for instance). They offer a variety of activities at centrally located senior centers, and typically host community events regularly.
Note, these facilities do only offer a limited level of senior care. And generally speaking, all residents must be able to function relatively independently while living in them.
While assisted living facilities can provide a lot of the things our older population needs to remain autonomous and active, there are social and emotional benefits for people who choose to live in place that cannot go unnoticed as well.
This is especially true for those entrenched in their communities through a church, philanthropic activities, and extended family. And the availability of home health services and other types of home care plan gives homeowners even more motivation to stay put.
And simply put, most residential buildings are ill-equipped to handle the needs of differently-abled individuals — older people or otherwise.
You Should Also Consider the Costs of Independent Living vs. Other Options
Furthermore, the rising costs of healthcare in the United States have many people worried about their future as they get older. Senior independent living, assisted living community options, and nursing homes tend to be incredibly expensive. In most cases, even social security plus a monthly draw from say, a 401k simply aren’t enough. Living in place home modifications typically provide a far better cost-benefit vs. the assisted-living model.
Quite simply, it’s about quality of life. Those who are able to live in place will get to enjoy a whole host of benefits to make their lives just a little bit better.
What kinds of things should you look at modifying? First, you need to understand the general design principles used in universal design to bolster accessibility.
General Design Principles for Accessibility
- Equitable use. The design is useful and marketable to people with diverse abilities.
- Flexibility in use. The design accommodates a wide range of individual preferences and abilities.
- Simple and intuitive use. Use of the design is easy to understand, regardless of the user’s experience, knowledge, language skills, or current concentration level.
- Perceptible information. The design communicates necessary information effectively to the user, regardless of ambient conditions or the user’s sensory abilities.
- Tolerance for error. The design minimizes hazards and the adverse consequences of accidental or unintended actions.
- Low physical effort. The design can be used efficiently and comfortably and with a minimum of fatigue.
- Size and space for approach and use. Appropriate size and space are provided for approach, reach, manipulation, and use, regardless of the user’s body size, posture or mobility.
So, what kind of accessibility issues typically need to be addressed in order to help a senior family member live in place or move in with you?
Common Live-in-Place Accessibility Issues
“The Joint Center [for Housing Studies of Harvard University] projects that by 2035, 17 million older households will include at least one person with a mobility disability for whom stairs, traditional bathroom layouts, and narrow doors and corridors may pose challenges, a 77 percent increase from today.”
That’s from the “Four Challenges to Aging in Place” blog by Jennifer Molinksy, a senior research associate at the JCHS. She continues, “Yet only 3.5 percent of U.S. housing units offer a zero-step entrance into the home, single-floor living, and wide doorways and hallways that accommodate someone in a wheelchair.”
But she says there’s potentially good news if you plan ahead. Making accessibility changes before anyone “in the household has limited mobility disabilities…can help lower the financial and emotional cost.”
The JCHS, in “Housing America’s Older Adults—Meeting the Needs of an Aging Population”, reports: “A major challenge to aging in place is ensuring that homes are safe and accessible. The goal of this design movement is to make the environment more accessible to people of all ages and abilities.
“Of specific focus here are five features that make homes accessible to those with impaired mobility and who have difficulty grabbing and turning knobs: no-step entries and single-floor living, which eliminate the need to navigate stairs; switches and outlets reachable at any height; extra-wide hallways and doors to accommodate those in wheelchairs; and lever-style door and faucet handles.”
Add Accessibility Features Now, You Won’t Have to Later
While many existing homes have at least one of these five features, only 57 percent have more than one. “Single-floor living is most widely available (found in 76 percent of housing units), followed by accessible electrical controls (44 percent) and no-step entries (42 percent),” it says. “The least common amenities are extra-wide doors and hallways and lever-style door and faucet handles (both available in only 8 percent of units).”
Living in place home modifications can include:
- Widened hallways and doorways and exterior ramps to allow for easier access of walkers and wheelchairs
- Stylish handrails to provide stability
- Better lighting and more accessible/ergonomic light switches to help prevent falls
- Replacing carpet with flooring that is easier to navigate
- Lowering cabinets
Assistive technology can also include adding smart home features that enable people to perform everyday tasks with the push of a button on a smartphone app. There are even smart appliances that can make previously challenging tasks far easier. New technology could also include a sensor to automatically turn lights or faucets on and off or a stairlift. (Think of the savings on utilities you can rake in, too!)
Many of these updates relate to mobility. These types of issues are a common problem for older adults. But younger people recovering from an accident or a diagnosis of ALS or MS may also experience them.
For example, a fall from skiing could make living at home difficult once you leave the hospital. Homes with open floor plans are easier to navigate, but older houses with many small rooms require more planning.
Again, making these changes now can prevent you from rushing them later. Something that could run up the cost even as you’re forced to bear the emotional and physical toll of not being able to get around your home.
Living in Place Home Modifications Make Financial Sense
Universal design is in and is predicted to continue to trend, even according to Forbes magazine recently. A quick internet search of the latest and upcoming architectural design must-haves won’t disappoint you either if you’re considering living in place home modifications for yourself or a loved one.
Architect magazine predicts continued growth of currently trending accessibility features following universal design principles in the coming decade, primarily due to the next generation’s keen awareness of its own housing needs in the coming years.
When nearly 90 percent of older Americans (age 65+) prefer to age in place, the industry listens. After all, our elders account for a market segment of 49.2 million strong at last census. As the next ten years will see most Baby Boomers through their 65th birthday, those boomers still actively making home improvements will increasingly seek to incorporate accessible features.
Besides the immediate needs of our older population, universal design trends are simply in high demand for every American family right now, as well.
2020 Remodeling Projects with High Return on Investment
For instance, Remodeling Magazine reports that here in the MidAtlantic, you can expect to see the same levels of ROI as we saw last year on the following 2020 projects like these:
- Minor Kitchen Remodel: 79.7-percent ROI which can include cost-efficient adjustments like smart technology upgrades, door and cabinet pulls that are easier to use and reach, and updating to flooring and thresholds for fall prevention.
- Universal Design Bath Remodel: 62-percent ROI to include updates such as wheelchair-accessible footprint, a comfort height fixture toilet, replace a dated tub with a modern zero-entry shower, and an adaptive living vanity, among other elements.
- Entryway Updates: 56-percent ROI for updating your front door from a standard size to a wider width. Not only are you increasing accessibility by creating a wider entrance and adding in-style indoor threshold ramps you are increasing the overall curb appeal of your home with a “grand entrance.”
If your loved one should ever choose to move, they can rest assured that the design choices they are making now with living-in-place remodel projects won’t decrease, but in fact, increase the resale value of their home.
Moreover, it’s not just architectural design firms, home builders and remodeling companies who are listening. Since the enactment of the Fair Housing Act (also known as the “disabilities act”), the U.S. government has done its best to continue improving the quality of life for our senior citizens. Part of those efforts takes place through coverage of these important home modifications.
Government Programs Help Pay for Live in Place Home Updates
The Fair Housing Act (or disabilities act) was created in order to protect tenants from discrimination based on a number of things, including disabilities. The federal law requires fair treatment as well as reasonable accommodations to be made for those facing a disability so that they may “enjoy housing on an equal basis” as those without the same disabilities.
At the heart of the Act is a notion that every senior live with dignity and independently as long as safely and reasonably possible is a right, not simply a luxury. As an extension of this right, there are government-based financial assistance programs that your loved one may be eligible for — or even already participating in — that include home modifications geared toward living in place.
Please note, before you or your loved one undertakes any major renovations, it is important to understand exactly what your specific coverage entails. This is because, as with any governmental program, requirements can sometimes seem complicated.
Medicare Coverage Options
The original Medicare program doesn’t cover much in the way of home modifications. But did you know that there are specifically related devices and services that are?
For example, when evaluations of your elderly loved one’s home is performed by qualified healthcare providers based on health conditions, each evaluation cost may be covered.
Or should an in-network occupational therapist deem a bathroom remodel to incorporate components such as grab bars, walk-in tubs, and hands-free faucets or other assistive technology devices is medically necessary, then the actual devices and hardware costs are likely to be covered, but construction and contractor costs may not be covered.
Some other items often covered include elevators, stairlifts, and modifications to entryways (ramps, thresholds, etc.).
If you or your loved one intends to live in place and is already participating in a Medicare Advantage plan, that coverage may bridge the gap on anything not covered. This is because starting in 2019, the Centers for Medicare and Medicaid Services (CMS) began covering home renovations for enrollees who demonstrated a medical need for them.
Even for those who are not currently on a Medicare Advantage Plan, check into available options during the next period of time for enrollment. A quick cost evaluation may show that it makes better financial sense to make the switch.
Medicaid Waivers Available to New Jersey Residents
Senior homeowners in New Jersey also have the advantage of local programs designed to incorporate Medicaid benefits for home adaptations. Two of them are The New Jersey Medicaid Managed Long Term Services and Supports (MLTSS) and The New Jersey Medicaid Personal Preference Program (PPP).
Property Tax Incentives
For New Jerseyans who decide on a reverse mortgage loan, there is likely a property tax deferral available. This property tax deferral program was created to assist low-income seniors with exactly these kinds of home modifications.
Please note, reverse mortgages are not an advisable option for every senior. A seasoned tax professional can provide the information needed to make that kind of financial decision.
Coverage Options for Military Veterans
If you are a member of the Veterans Administration (VA), you have more options. The organization provides special grants for home modifications for disabled veterans. Here are a few:
- Specially Adapted Housing Grants Program (SAH Grants)
- Special Housing Adaptation Grants (or SHA Grants)
- Home Improvement and Structural Alteration Grants
- Veterans Directed Home and Community Based Services (VD-HCBS)
These benefits are available to our nation’s finest to help with everyday tasks. Sometimes these organizations even award additional pension benefits. And a number non-profits are also willing to serve U.S. military veterans. Learn more about financial assistance for home modifications.
Where to Start with Live at Home Modifications in Your Current Home
If mobility is not an immediate issue, a bathroom remodel may be the best place to start. In 2008, the CDC reported an estimated 234,094 nonfatal bathroom injuries among people older than 15 were treated in U.S. emergency rooms.
Falls were the most common cause of injury (81.1 percent). The most frequent diagnosis was contusions or abrasions (29.3 percent) to the head or neck (31.2 percent).
Today, there are countless fixtures and finish options that pair safety with style. And while the ADA legislation covers nonresidential buildings, many of those products are also suitable for residential remodels as well.
These make bathrooms handicapped accessible, such as wall-hung sinks and toilets, or higher, “comfort-height” toilets. Grab bars, towel bars, even toilet paper holders are available in extra-strength versions with high-end finishes.
Walk-in showers can replace a bathtub footprint and incorporate multiple amenities. Examples include a variety of body sprays, aromatherapy, and chromotherapy for a spa-like feel.
Living in Place Home Modifications: Hiring the Right Contractor
Once you decide to make the necessary living-in-place changes to your home or build an addition for children or parents moving in, you have to hire a remodeling contractor — and no one likes this process. But you have to vet the people who will be entering your home to ensure they build everything to code.
Steps to Vetting Your Contractor
First, ensure the remodeling contractor has certification in aging in place through the Living in Place Institute or universal design. The National Association of Home Builders offers a Certified Aging-in-Place Specialist program. The National Association of Remodeling offers a Universal Design Certified Professional program.
A contractor certified in these disciplines understands how to ask the right questions of potential clients. This helps them ascertain their specific needs. So they can recommend the right type of modification and apply the correct design principles to meet those needs.
Next, ask them how many years of experience they have doing this type of work. Whether you’re dealing with an architect or an interior designer, you should work with a renovator who understands your concerns. Things like materials cost and what will be most durable in the long run.
Finally, talk to them about your financial situation and what you can realistically afford. An experienced living in place contractor should be able to point you toward programs to help. For example, programs offered by the federal government and other organizations designed to aid low-income older adults.
You may qualify to receive free or low-cost home repair, medical equipment, social services, or other support services. Some people are able to secure a housekeeper, home caretaker, home health aide, or other caregiver.
A non-profit organization like AARP is another place to check. There you can learn about helpful community resources at the local level for home care.
Start Your Journey to Living in Place Now
Living in place is a decision many of us would prefer to make for ourselves and our senior family members.You can ensure everyone’s needs are met with dignity, compassion, and quality of life through proper planning with a certified living-in-place professional.
So you’ll have the comfort, safety, and control needed to stay in your home as long as you like. The first step is to reach out to an Aging in Place Specialist. Contact Live in Place Designs to learn more.