Nearly 90 percent of older Americans want to stay in their own homes as they age, but common features in their homes present significant obstacles to remaining independent − especially since many senior citizens live in old, poorly designed structures that contribute to falls and injuries. Falling is the leading cause of death from injury in adults over age 65, and it’s estimated that at least 60 percent of falls occur in the home.
The National Centers for Disease Control (CDC) suggests that one-third of accidents in the home could be prevented by structural modification and repair. Fortunately, there are numerous changes you can easily make to improve the comfort and safety of your parents’ home.
General Changes with No Economic Cost
- Secure the edges of carpet and area rugs with double-sided tape or non-slip carpet mesh.
- Remove all scatter and throw rugs that can slip and cause falls.
- Remove all rugs from the top or bottom of stairs.
- Remove wax from solid-surface floors.
- Use non-skid, no-wax floor finishes.
- Raise shades and open window blinds and curtains during the day to increase natural light.
- Clean windows to let in maximum light.
- Use brighter light bulbs in all settings.
- Use at least 60-watt bulbs in stairways.
- Use lampshades to reduce glare.
- Reposition electrical, phone, and computer cords out of the way (along the walls). However, do not run wires under carpeting, which is a fire hazard.
- Make sure lamp cords aren’t frayed and don’t have exposed wires.
- Set the hot water heater to 120 degrees to prevent scalding.
- Remove clutter from the staircases and hallways to prevent falls.
- Place a bench near entrances for setting down packages and resting.
- Arrange furniture so your parents can easily get around it.
- Remove unnecessary items and simplify: Keep only what is regularly worn or used.
- Make items used regularly accessible (dishes, foods, toiletries in easy reach).
- Conduct a home safety check to prevent potential problems that could lead to injuries.
A To-Do List of Low-Cost Improvements
- Choose sturdy step stools with handrails; discard others.
- Place a properly-rated fire extinguisher in the kitchen.
- Make sure electrical outlets in baths and the kitchen are GFI (ground fault interrupted).
- Install fire and carbon monoxide detectors on all levels of the house; verify they are functioning properly; check batteries every six months.
- Repair or replace worn carpet.
- Make door thresholds even with the floor.
- Install offset hinges on all doors to add 2 inches of width to doorways for easier access.
- Replace knobs on cabinets and drawers with handles shaped for easy grasping.
- Install adjustable rods and shelves in closets.
- Install lever handles on all doors and faucets.
- Replace enough seating throughout the house for your parents to have use of stable chairs with armrests to help them get up in every room. (Adjustable-height and locking casters are also good ideas.)
- Replace appliances for easier, safer access (side-by-side refrigerator, raised dishwasher, raised and front-loading clothes washer and dryer, cook-top with controls in front).
- Replace difficult-to-open windows (at least a few, strategically-placed ones).
- Create a covered entryway.
- Add lighting where needed (including closets).
- Put switches and electrical outlets within easy reach.
- Install light switches at the top and bottom of each indoor staircase.
- Install automatic nightlights in all areas of night activity, especially in hallways between bedrooms and bathrooms.
- Replace traditional light switches with rocker-style switches (easier to use when hands are full or weak).
- Consider illuminated switches in areas where switches may be difficult to find.
- Mount lights under kitchen cabinets to brighten counter space.
- Install a light to shine on the house address in case of an emergency.
Changes to the Stairs
- Install handrails on both sides of all steps (inside and outside.)
- Make sure stair steps are even and in good condition.
- Add reflective, non-slip tape or rubber treads on all non-carpeted stairs.
- Add contrasting tape to the step edges to distinguish the beginning of each step.
- Attach wide, contrasting or brightly colored tape on the rise of a single step as an attention-getter (people often trip when there is only one step).
Changes to the Bathroom
- Add anti-slip strips in the bathtubs and showers.
- Mount grab bars for use by the toilets, bathtubs, and showers.
- Install a handheld, adjustable shower head.
- Place an adjustable shower seat in the shower and tub.
- Add anti-slip strips in the shower and tub.
- Used raised toilet seats.
- Install a phone in the bathroom for emergencies.
- Modify the shower stall to a low- or no-threshold entry.
Suggestions for Outside
- Make sure all paths and stoops are brightly lit.
- Keep sidewalks, decks, and porches clear of objects and debris (newspapers, sticks, rocks, wet leaves).
- Remove roots that protrude from the ground.
- Clean oily spills on concrete or asphalt immediately.
- Spread sand or salt on icy walkways.
- Repair broken or uneven pavement on walkways and driveways.
Tips for Your Parents to Follow
- Take your time and pay attention, especially on the stairs.
- Always hold the handrail.
- Be particularly careful when carrying a load.
- Don’t wear shoes that you can slip in.
- Don’t leave anything on the floor or stairs.
- Look across the floor for misplaced objects before crossing.
- Always turn the lights on before entering an area.
- Watch out for single step-ups or step-downs (curbs, raised porch).
- Keep windows clean to let in maximum light.
- Try not to use extension cords.
If Your Parents are Resistant
If your parents are resistant to necessary changes because of “looks” or because it might make their home feel like a hospital or nursing home, use “I” statements to express your feelings on the matter. Let them know you worry about them and want them to be safe in their own home. Reassure them that things like grab-bars are no longer institutional-looking or that the changes won’t even be noticeable to someone else.
More Extensive Changes
- Install pull-out shelves and drawers in for easier access to the contents and to minimize bending and reaching.
- Alter heights of countertops and work areas to be more accessible and comfortable.
- Create at least one no-step entrance to the main living area of the home.
- Modify floor plan to one-story living (master bedroom and bath on the main floor).
- Add skylights to the kitchen, bathroom, or family room.
- Modify all doorways to achieve 32” to 36” clear passage.
Getting Professional Help
When executing modifications, you can 1) do it yourself with a friend or relative’s help; 2) hire a handyman or contractor; or 3) contact a home modification and repair program. For safety reasons, modifications involving electrical work or rewiring should be handled by a licensed professional.
The following links can help you locate home modification and repair programs who specialize in making homes suitable for aging:
- Local Area Agency on Aging
- State Department on Aging (Google for your parent’s state)
- Department of Public Welfare (Google for your parent’s state)
- Department of Housing and Urban Development (HUD) − The Community Development Block Grant (CDBG) program pays for various kinds of home modifications.
- NeighborWorks − A national network that helps low- and moderate-income families to maintain safe, affordable homes. To locate a NeighborWorks partner in your parent’s community, visit their website and click on “Network Directory.” Type in the city and select the state, then click on “Organization Search.” You can also call the Neighborhood Reinvestment Corporation at (202) 220-2300.
- Rebuilding Together − directs 206 offices nationwide in the enlistment of 250,000 volunteers to complete 10,000 home improvement projects for senior homeowners (installing wheelchair ramps and grab bars, replacing doors and windows, performing minor plumbing and electrical work, etc).
- If you decide to hire someone to do the work, consider these precautions:
- Ask friends and family (who have had similar projects completed successfully) for contractor recommendations.
- Consult the Better Business Bureau regarding the contractor’s reliability and performance record.
- Hire a licensed and bonded contractor.
- Insist on a written contract with detailed work, materials, and cost specifications.
- Pay a small, initial down payment, with additional payments made at pre-designated stages of completion.
- Don’t sign-off on project acceptance and completion until after a final inspection by you and the local building authorities.
- Make the final payment only after the project is satisfactorily completed and the contractor provides a written statement that he/she has paid all subcontractors for their work (to prevent possible liens on the property).
Certified Aging-in-Place Specialist
The AARP and the National Association of Home Builders (NAHB) collaborated to develop a certification program for builders, remodelers, and developers who concentrate on the needs of aging people. The Certified Aging-in-Place Specialist (CAPS) program teaches building professionals about the changing needs of people as they age. It also presents information about building techniques and a wide range of products better suited for remodeling a home for aging-in-place.
- For more information, search "CAPS" on the NAHB site. They also provide a directory of certified CAPS home builders .
- For related articles, browse through back issues of the CAPS Connection newsletter.
AARP and NAHB also sponsor an annual contest (“Livable Communities Award”) for recognizing excellence of workmanship and design among these specialized builders, remodelers, and developers. A list of past winners is available online.
- A number of organizations promote home modifications for successful independent living and aging at home. Check out the following websites for related articles, directories for certified builders, and company listings for various adaptive products.
- AARP provides a list of assistive devices available in today’s market to aid various disabilities or physical/mental challenges. Visit their website for ideas to make your parent’s life easier.
- The Wall Street Journal writes about new products that address the vision problems, memory slips, and motor-skill issues common to aging.
- Homemods is a website dedicated to promoting independent living for people of all ages and abilities. Navigating through the site, you’ll find an extensive list of companies that sell particular products, in addition to related links.
- In several states, an “Easy Living Home” certification distinguishes builders and remodelers who focus on home design that accommodates first-floor living, at least one no-step entrance to the home, and maximum clearance in all doorways. A list of these builders is available online.
- The Universal Design Alliance creates awareness for designing homes to accommodate everyone − regardless of individual disabilities − through education, services, and resources.
- The National Resource Center on Supportive Housing and Home Modification (nrcshhm) provides state-by-state resources.
- The Family Village website lists all types of adaptive products and assistive technology.
- If you don’t find what you need there, visit the Caregiver Products site.