1. Introduction
Life,Unavoidable
As yearspassand we grow olderand wiser,we alsogothroughphysical changes thatmay leadto
difficultiesinteractingwithourhome environment. These kindsof changes mayinclude decreased
mobility, dexterity andflexibility aswell asreducedstrengthorsensoryacuity. Normal activitiessuchas
usingthe stairs, bathroom, or kitchen maybecome difficulttouse safelyoratall. Our normally-
comfortable place of restmayseemmore like ahazardous obstacle course insteadof asafe haven.
Because of these unavoidable life changesthat oftenaccompanyaging,asignificantconcernpeople
have as theygrow olderis thatthey will have toleave theirhome. Leavingone’shome canmean
leavingbehindasupportive network,acomfortable andfamiliarsetting,andoftentimes,asense of self.
However,agingandchangesinabilities(regardlessof how they occur) doesnotnecessarilymeanyou
have to leave yourhome orlose yourindependence—asyourneedschange,soshouldyourhome
environment. Modificationscanbe made toyour home to helpaccommodate the physical,mental and
psychological changesthatcancome withgettingolder. Thisisknownas “aginginplace.”
WhyAge in Place
The Centerfor Disease Control definesaginginplace as“the abilitytolive inone’sownhome and
communitysafely,independently,andcomfortably,regardlessof age,income,orabilitylevel.”
The main goal of aginginplace is tomake changestoyour home whichcreatesa safe,usable,and
enjoyable space thatyoucanreside ineasily. Remainingathome asyouage will allow youtomaintain
your dailyroutine,aswell asenjoythe independence towhichyouhave become accustomed. Youcan
choose to receive the care youwantin the mannerinwhichyouwant it. Putsimply,aginginplace will
allowyouto leada healthier,happierlife inasafe environment.
PlanningAhead
There are manybenefitstomodifyingyourhome to age inplace,butmost people don’tthinkabout
makingchangesuntil itistoo late,and theyare forcedto leave the place theylove. Earlyplanningwill
allowyouto explore all the optionsandmake the changesmostsuitedtoyourneeds. This strategic
planningwill reducethe overall amountof stressandcost to youand yourfamily.
Essentially,thisbook isalistof aginginplace ideas andguidelines tohelpmotivateand steeryou
throughthe various modificationsyoucanmake to your home. These ideasrange fromhome
remodelingprojectstomore simple do-it-yourself changes,butall are relevanttomakingyourhome a
safe,manageable,andhappyplace to reside nomatterwhatthe future holds.
2. Chapter 1: Home Exterior
Whenpeople thinkof aginginplace,theytendtoonly thinkaboutmodificationstothe interiorof the
home. However,limitedrange of motioncanmake gettinginandoutof your home increasingly
difficult,and exteriormodifications shouldbe made tohelp make accessibilityeasier. Makingthe
appropriate alterationsnowwill helppreventaccidents associatedwithimproperaccess.
Entrances
Fallingisone of the greatestdangerstoone’sabilitytoage in place. The CenterforDisease Control and
Preventionestimatesthateveryyearone outof three adults(overthe age of 65) will experience afall.
For olderadults,these fallscan oftenleadtocomplicationsandmore seriousinjuries.Therefore,fall
preventionisanumberone concernforagingin place,andthisparticularvulnerabilitycanbe easily
remediedwithproperplanning.
One way toalleviate future complicationsistoreduce the thresholdatyourmainentrywaytoa height
of ½ inchor lessinorderto help preventfallsandinjuries. Thiscanbe done byreplacingthe existing
door sill withalowerone,or by raisingthe porchto
meetthe sill.
The doorwayitself shouldbe aminimumof 36” wide to
allow foreasy entry by foot, bywheelchair,orassistedby
a walker.If the doorwaycannotbe changed,consider
usingoffsetdoorhingeswhichwill increasethe
clearance of a narrowerdoorway.
Rounddoor handlescanbe a challenge forpeople with
arthritisor a weakeninggrip. A lever-style handle takes
lessforce andenablesone tosimplypressdowntoopen,
as opposedtograspingand turning. Likewise,if steady
handsare an issue,usinganumerickeypadlockcanbe
easierthaninsertingandturningakey.
Stairs and Ramps
If you have stairsleadingupto yourentryway,theycan be veryunsafe if wetand notadequately
surfaced. There are several waystomake stepssaferfor everyone touse,regardlessof physical
condition. Simplesolutionssuchasapplyinga texturedsurface toeachstep andinstallingahandrail on
eitherside of the stairswill drasticallyreduce slipping.
However,forthose withimpairedmobility,astep-lessentry suchasramp ispreferable. While steps
pose a difficultyforthose withawheelchairorwalker,rampsprovide everyone with easyanduniversal
access. Rampscan be designedtocomplementthe style of yourhome while alsomakingitacinch to
enterandexit. If you choose toinstall aramp, it should slope gentlyandprovide plentyof walkingand
Figure 1: A grab bar combined with an easy-to-open
lever handle makes entering your house
uncomplicated.
3. turningroom. Ramps shouldhave nomore than an 8%
grade,thougha gentlerincline maybe preferredand
obtainedwitha5% grade,whichtranslatestoa 1 inch
vertical rise forevery20 inchesof horizontal distance.
The surface of the ramp shouldbe slightlyroughto
improve tractionandminimize slipping,anditshould
feature handrailsoneitherside.
While there are varyingfactors to considerwhen
installingaramp,the mostimportantisto have a
licensedcontractordesignandbuildittofityour
specificsituation.
Lighting
Adequate lightingisacrucial designelementingeneral safety. Installinglampsbyyourentryway isa
simple additionthatwill helpidentifyobstaclesandreduce falls. Betteryet, placingmotion-sensorlights
by all exteriordoorwaysandalongpathways isaneasy,inexpensive,andefficientwaytoimprove
overall safety.
Garage and Parking:
The garage is notjusta place to park and protectyour vehicle,but oftentimesisusedasa workshopor
for storage. These garage suggestionswill helpyouattainasafe and functional space.
Garage floorstendtobe slippery,sothinkaboutaddinganon-slipcoatingtoyourgarage floor. Thiswill
make maneuveringeasy andreduce chancesof injury. Anotherwaytoreduce accidentsisadequate
illumination,somake sure tobrightendarkgarages with plentyof motion-sensororoverheadlights.
Havingsufficientspace tomove,withorwithouta wheelchair,is alsoimportant. Youshouldhave a
minimumof 5 feetof roombetweenvehicles,and betweenvehiclesand the side walls,tobetter
facilitate gettinginandoutof your house andcar. This amountof space alsoallowsforthe use of lifts,if
needed.
If you do notpossessa garage door opener,considerhavingone installedtohelpmake accesstoyour
garage andhome much more convenientandsafe.
Figure 2: Ramps should have no more than an 8% grade
and should feature handrails on either side.
4. Chapter 2: Common Areas
Overtime,the common areasin yourhome can become dangerousplaceswithobstaclessuchasthrow
rugs,poor lighting,and longhallways. Bymakingthese areas easilyaccessibleandserviceableyouwill
create a more pleasanthome environmentforyourself andlovedones. Manyof these suggestionsfor
modifyingcommon areas(suchasthe livingroom, familyroom, orden) are applicable toall roomsof
the house.
Doors and Hallways
Your interiordoorwaysshouldbe large enoughtoaccommodate regularfoottrafficaswell asthe
potential use of awalkeror wheelchair.A minimumwidthof 32” will make yourdoorwayswheelchair
accessible,thoughaminimum widthof 36” is suggestedfor
maximumambulatoryease. Asmentionedpreviously,all house
doorknobsshould be replacedwithleverhandlestomake opening
any doorstruggle-free.
For longhallways, the additionof ahandrail will assistwithwalking
and the placementof achair at the beginningorend providesan
optiontorest. Ample overhead lightinginyourhallwayisalways
important,andan accessible lightswitchshouldbe installedatboth
ends.
Flooringand Furniture
Take a lookat yourfloor—isthe carpetloose orrippedinanyplaces?
Raggedcarpet or loose flooringincreasesthe chance of injury,and
shouldbe keptingoodcondition.If carpeted,use low-pile (lessthan½”high) density,withafirmpad
underneathto reduce the likelihoodof accidents. Whenchoosingnew flooring,keepinmindcolorand
texture contraststohelpindicate changesinsurface levels.
Arearugs are dangerous accessoriestohave inthe home astheycan easilybe trippedoverorslipped
upon. Insteadof troublesome rugs,optfornon-slipflooringapplicationsorcoverthe areawithlow-pile
carpeting.
Rearrange yourfurniture tocreate an openand navigable space. If transitioningbetweensittingand
standingposesadifficulty, youcanaddrisersto yourfurniture tolessen anystraininvolved.
Lighting
Low-lightinginside the house reducesvisibilityandincreasesthe chancesof accidents. Ideallyyou
shouldhave a lotof windowswitheasytooperate hardware toprovide natural light. Anotherimportant
elementistohave plentyof flexibilitywithyourlightingoptions. There shouldbe lightingchoicesfor
each roomand controlsinorderto adjustthe level of brightness. If you prefernotto addmultiple light
fixturesthroughoutyourhouse,considerusingtasklightinginworkareasand closets, whichwillhelp
Figure 3: The simple addition of a
handrail to your hallway makes it
easy for anyone to navigate.
5. withspecified illuminationwhere youneedit. Also,easilyaccessible lightswitcheswill helpensuresafe
entryintoa room. Rockeror touch lightswitchesare the mostconvenientandsimplest touse,and
some evenhave lightedswitchplateswhichmakes themeasiertofindinthe dark. Considerpurchasing
a couple nightlightstopluginaround the house forextraillumination.
6. Chapter 3: Kitchen
For manypeople,spendingtime inthe kitchenisafavorite andjoyous pastime. Notonly canthe
kitchenbe a social place,itisnecessaryfordailyfoodpreparation,sodon’tletgettingolderpreventyou
fromusingyour kitchentoitsfull potential. Withafew modifications,youwillbe able tomaneuver
safelyanduse all yourkitchenapplianceswithease.
KitchenAppliances
The most commonkitchenmodifications foraginginplace are heightadjustmentsof often-used
appliances. These changeswill help preventinjurybyreducing the amountof time spentbendingand
leaning. Raisingthe heightof yourdishwasheror lowering
your sinkwill make yourkitchenexperience easierandmore
enjoyable. Motorizedandadjustable-heightcountersand
sinkscan be installed tomake the kitchenmore user-friendly
for those whouse wheelchairs.
You should provide sufficientcounterspace fordishlanding
adjacentto or opposite all appliances. Accented colors onthe
edge of countertopswill increasevisibilityand provide clear
orientationtothe workspace.
Utilize microwavesanddishwasherswitheasytoreadcontrols,
convenientfunctions,anduniversal designs. Side byside
refrigeratorsprovideeasyaccesstobothcompartments, plusthe narrowerdoorsare simplertouse
witha smallerswingradius.
KitchenCabinets
Make uppercabinetsmore accessiblebyaddingpull-downshelving.
These innovativeadditionscangreatlyreduce the amountof reaching
requiredtoaccesstop shelf items. Anotherbasicwaytoimprove
kitchencabinetaccessibilityistochange the handles. Using“D”
shapedhandles anddrawerpulls make themeasiertograspand will
allowyouto openandclose themeasily. Replacinglowercabinet
shelveswithpull-outdrawers andaddingalazysusanto hard-to-reach
corner cabinetswill alsomake iteasiertoreachitemswithout
strainingwhile alsoincreasingthe amountof storage available.
Figure 5: Pull-down shelving brings top
shelf items safely to your fingertips.
Figure 4: The combination of a raised
dishwasher and lowered sink significantly
reduces back strain.
7. CHAPTER 4: The Bedroom
The bedroom isa place of restand retreatand shouldbe treatedaccordinglyasyouplanyour future. A
clutter-free andopenfloorspace will make movement uncomplicatedandkeepinjuriestoaminimum.
Be sure to leave plentyof space aroundbeds,dressers,andnightstandstoaccommodate mobility.
Bedroom Access
The ideal locationforthe bedroomwouldbe onthe mainlevel of the home. Thisway,youhave
unhinderedaccesstoyourroomas well as all other roomsinthe house. If thisisnot the case inyour
home,consideraddinganadditional bedroomtothe mainfloor,convertinganotherroomtoa
bedroom,orinstallingachairlifttofacilitate aneasier journeyupanddownthe stairs.
The Bed
You begin,andend,everydayinyourbed. As youage, you
may findgettinginandoutof bed becomes difficult,buta
few small changescanhelp. Aninexpensive installation of
a side rail or safetyhandleswillallow easieraccessand
reduce the possibility of falling.Clearingapath and
rearrangingyourfurniture tocreate a wide berthof space
aroundyour bedwill helptoaccommodate forany
adaptive equipmentthatmaybe neededinthe future.
A goodmattressisimportantand shouldbe at a
comfortable height—if youuse awheelchairyouwill want
the mattressheighttobe flushwiththe heightof the
wheelchairforstress-free movementinandoutof bed. If you have circulatoryor respiratoryissues,
consideranelectricbedthatallowsyouto raise the topand bottomportionsof the bedindependently.
The Closet
A disorganizedclosetcanleadtoaccidentsif heavyitemsare storeduphighor if you have to strainfor
frequentlyuseditems. Organizingyourclosetisaneasyand cost-effectivewaytopreventfuture injury.
Adjustable closetsystemsare availableatmosthome improvementstoresandcanbe easilycustomized
and installedforyourspecificneeds. Lighting,of course,isanimportantfeature topreventmishapsand
a dark closetcan be easilyremediedwithLEDstick-onlights,orthe installationof anoverheadlight
fixture.
Figure 6: Easily installed safety handles can help
you get in and out of bed without trouble.
8. CHAPTER 5: The Bathroom
The bathroomcan be a verydangerousplace for
agingseniors,asmore fallsandaccidentshappenin
the bathroomthan inany otherroom of the house,
but there are simple andinexpensivewaystoguard
againstinjuries. Whenyoudesignasafe environment
inthe bathroom,youdesignasaferfuture for
yourself andyourlovedones.
The Shower and Bathtub
The floorof a showeror tub is slipperyandthe riskfor
fallsisgreat. Placinga non-skidmatinthe shower
will reduce slippingandthe installationof grabbars
inside andoutside of the showerwill ensureasafe
entrance andexit. A mountedshowerseatisa
practical solution,aswell asmakingsure the shower
doorsare made of safetyglassorplastic.
If needed,manycompaniesofferalarge varietyof walk-
intubs that can replace yourexistingtub. Roll-inorno-thresholdshowersare anothergreatoptionfor
those whouse mobilityequipment. These special showershave awide openingwithalow threshold
that providesplentyof roomto maneuver withorwithoutawheelchair.
The Toilet
The heightof the toiletcan make a large differenceinhow safe andcomfortable yourbathroomcanbe.
By havinga toiletthatsitshigheroff the ground,youwill putlessstrainonyourlegs,knees,andback.
You can achieve propertoiletheightbyreplacingyourtoiletaltogether, orbyinvestinginaless
expensive seatextender. These extendersattachtothe topof yourtoiletandcan raise the seat height
by 4-6 inches. Installinggrabbarsby the toiletisanothersimple
wayto helpyousafelystandandsit.
Other Bathroom Considerations
Wall supportsand grab bars throughoutthe bathroomisan
excellentwaytoguarantee asafe bathroomexperience from
beginningtoend. Addingacontrastingedge bordertoyour
countertopsmayhelpwithvisibilityandreduce fallsaswell.
A telephoneinstalledinthe bathroomcanbringhelpfastif youslip
and fall inthe bathroom. A wall phone hungnearyourshower,tub,
Figure 7: This is a great example of a no-threshold
shower, complete with safety grab bars and a
mounted shower seat.
Figure 8: Well-placed grab bars in the
bathroom can be functional as well as
stylish.
9. or toiletisideal,butbe sure topick a place that youcan reachevenif youare lyingonthe floor.Write
downor store importantnumbersinthe phone sothat youhave the optionof callingforhelpwiththe
pushof one button.
Water burnsare anotherconcern,as theycan happenina matterof seconds. Keepyourwaterheater
dialedinto120 degrees,orinstall ananti-scalddevice thatwill preventyourwaterfromgettingtoohot.
CHAPTER 6: Laundry
Laundryrooms are oftenbasicwithminimal amenities,butthatdoesnotmean doinglaundryneedsto
be difficult. There are manywaysto make yourspace work for
youand to make the chore of washingclothesaseasyas
wearingthem.
Layout and Appliances
Move anyobjectsthat hinderaccess,andalwaysmake sure
that youare able to getin andout of the roomeasily. Also,
often-useditems(suchasdetergentsanddryersheets) should
be in close proximityandeasytoreach.
Roll-out,adjustable,oropenshelvingare all greatwaysto
make everythingeasiertoaccess. Fold-downshelveslocated
nextto the dryeror by countertopsare convenientandcan also
be collapsedwhennotinuse.
Front-loadingwashingmachinesanddryersare the bestchoice
whenplanninga
manageable laundryroom. Since theyrequire lessmovement
to loadthan otherkindsof machines,theyreduce strainon
your back. Considerpurchasinglaundrypedestals,withor
withoutbuilt-incabinetry,toraise the machinestoa more
accessible level.
Figure 9: Front-loading machines are the
easiest to use, and pedestals can be added
to increase the height of the machines and
reduce back strain even more.
Figure 10: Corner grab bars can help you navigate
and maintain balance in a small laundry room.
10. CHAPTER 7: In-Home Mobility Devices
Most expertswill tellyouthatlivinginaone-storyhome isthe bestwaytogo, but that’snot alwaysan
optionforeveryone. If youhave atwo-storyhome andbelievethatthe staircase maypose a problem
for yourmobilityneedsinthe future,there are severalwaysthisissue canbe resolved. The simplest
solutionistoadd sturdyhandrailson bothsidesof the stairway,butoftentimesmore thoroughand
accommodatingchangeshave tobe made.
Dumbwaiter
A dumbwaiterisagreat solutionforthose whohave relativelyminormobilitychallengesandjustneed
helptransportingheavyitemsbetweenfloors. Most dumbwaiters take upverylittlespace andcan
carry loadsup to 200 pounds. Theyare relativelyinexpensivecomparedtotheirmore involved
counterpartsandsome come withDIY kitsfor easyinstallation.
Stair Lift
A stairliftis a motorizeddevice designedtotransportyouup anddowna staircase easily. Itis one of
the most commonpiecesof aging-in-place equipmentasitisa
practical and affordable way todeal withthe issue of staircase
mobility. Theycanbe tailored toanytype of staircase,though
the installationmaybe more expensive if yourstaircase is
curved.
While the liftscanbe customizeddependingonyourneeds,
there isgenerallytwodifferentstyles—the firstis builtwitha
chair that youride up (see figure 11) andthe otherhasa
platformthatyou can eitherstand onor roll a wheelchaironto.
The platformvariationusuallyhas foldingedge flapswhichdrop
downand act as ramps to allow forvariationsinfloorlevels.
These flapsalsopreventthe wheelchairfromgoingoverthe
edge of the platform. Most come witha safetystrap to ensure securityandare usuallyself-operated,
but if needed,youcanpurchase one that requiresanotherpersontooperate.
Elevator
If you needsomethinglargerandroomierthana chair lift,the nextoptionisanelevator. Byinstallingan
elevator,youcansignificantlyreduce timeonyourfeetwhile alsosafelytransportingheavybags,
laundry,andpackagesinsteadof carryingthemup the stairs. Elevatorscan be expensive toinstall,but
are considerablycheaperthanpayingfora homecare assistantorrelocatingtoa one-storyhome. If you
have sufficientroom,anelevatormaybe the mostversatile andpermanentsolutiontomobility
challenges. If youdon’thave adequate space inside the house,considerbuildingashaftalongthe
Figure 11: Self-operated chair lift
11. exteriorof yourhouse withthe doorsopeningintoyourhome. Thiswouldprovideease of access
withoutcrowdingthe interiorof yourhome.
Conclusion
As youhave seenthroughoutthisguide,the waysinwhichyoucanprepare foryour future are
numerous,andthe advantagesfromdoingsoare wide-rangingandabundant.
Preparingtoage inplace provides peace of mind whileofferingadditional financial andsocial benefits.
All the changesyoumake to your home are investmentstowardahappierandsaferfuture foryouand
your family. Modifyingyourhome to age inplace will alsoincrease the value of yourhouse while
makingthe propertymore marketable whenitcomestime tosell.
Additionally,the increasingdemandof people whowantto age in place hasledto innovative home
designs,sleekequipment,andtailor-madeoptionstomake yourhome suityourpersonal style. Itisno
longernecessaryto sacrifice elegance forsafety,norformforfunction.
Regardlessof yourage or physical condition,itisnevertooearly toprepare forthe future youdesire. I
hope that thiscomprehensive guide hasencouragedyoutotake control of yourown qualityof life at
home,sothat you can make changesnow that will helpyoulater.