Aging-in-place features can keep you at home longer

Middle-age isn't too soon to start thinking about where and how you want to live as you get older. If you're like most Americans, the place you want to be long-term is at home.

A survey conducted by AARP in 2021 showed that 77 percent of adults 50 and older want to remain in their homes, a number that has been consistent for more than a decade. In general, we're living longer, more active lives thanks to advances in public health, medical innovation and increased screenings. Conditions that would have curtailed productivity and lifestyle decades ago, like arthritis and diabetes, have better treatments. So it's likely that more older Americans will be able to live at home longer.

I like to see as many seniors as possible remain in their homes and avoid long-term care facilities, for a variety of reasons. Many have paid off their mortgages, reducing monthly housing expense. It's good to remain in a familiar neighborhood with neighbors they've come to know and services — grocery stores, doctor's offices — that are nearby.

Technology is also making it easier for people to remain at home. Telehealth appointments, remote monitoring, fall detection, video communication and other innovations make it easier for family, health care providers and emergency services to keep tabs on an older loved one.

But only about a third of the respondents in the AARP poll said their homes had the necessary features that would allow them to age in place. While some fixes are easy — for example, better lighting and lever-style doorknobs — some require more planning and money, and not all homes are suitable for aging-in-place modifications.

Diana Melichar, of Melichar Architects in Lake Forest, is an aging-in-place design specialist. These are some of the ways she helps her clients prepare to age at home.

The first problem, she says, is getting into the home. “If there's even one step up to the front or garage door, it's harder to get in,” she said. “So we can make space for a ramp in the garage, and we can slope the ground or porch up to the front door.” A ramp can always be installed later, she said.

Bathrooms are well-known trouble spots for older adults. Melichar suggests showers that are zero-clearance — in other words, there's no step or curb — and sized to allow wheelchairs or shower chairs, with appropriate grab bars. You can even find prefabricated shower units with built-in grab bars and seats.

If it's possible, a ground-floor room can be turned into a main bedroom. “If stairs have to be used, the treads and heights of each step should be optimized for safety,” she said. “They can also be configured to easily handle a chair lift in the future.”

For kitchens to remain accessible, she said, appliances should be neither too low nor too high. Cabinet handles and drawer pulls should contrast in color with cabinets so they can be easily seen, not require tight grasping or twisting of the wrist, and be operable with one hand. An under-sink cabinet can be made removable if wheelchair accommodation is needed.

Door openings should be at least 32 inches or wider.

“It's also important to select floor finishes that are slip-resistant and are not tripping hazards,” Melichar said. “If you're in a wheelchair, a rug that is an inch higher than the adjacent wood floor poses a problem.”

Lighting can easily be added in strategic spots, like under kitchen cabinets, under a bathroom sink and in staircases, and will make for better vision.

“Color is another easy accommodation. It should facilitate navigation and orientation,” Melichar said. “For example, painting door frames a contrasting color from the walls or having switch plates that stand out.”

Creating these accommodations is only part of the aging-in-place equation. Among other considerations:

• Availability of high-speed internet to facilitate telehealth appointments and video calls, and cellular coverage that's strong enough to operate fall detection systems

• Availability of transportation for seniors who can no longer drive. Public transportation is one option; today's seniors are also savvy enough to use Uber or Lyft on their smartphones

• Ensuring that the person who is aging in place doesn't experience loneliness or isolation. During the pandemic shutdowns, we saw that isolation is a mental health risk.

As we age, we can't count on our current living situations continuing indefinitely. But we can prepare for the inevitable challenges of aging in order to stay in our homes longer.

• Teri Dreher is a board-certified patient advocate. A critical care nurse for 30+ years, she is founder of NShore Patient Advocates (www.NorthShoreRN.com). Her new book, “How to Be a Healthcare Advocate for Yourself & Your Loved Ones,” is now available on Amazon. She is offering a free phone consultation to Daily Herald readers; call her at (847) 612-6684.