While we have helped to meet the unique needs of older adults by designing comfortable and efficient senior housing  on a dedicated senior living campus, there is another option available to those not ready to move out of their family home. Many “empty-nesters” have come to us to improve their living spaces to meet their unique desires and physical challenges. Home renovations can include features that support the growing trend of Aging In Place, allowing those with mobility and minor medical needs to safely remain at home.

In years past, it was more common to hear talk about downsizing, as older homeowners would opt to leave a long-time home for something smaller that meets their current needs. Today, the escalation of housing prices together with difficulty in matching existing lower mortgage rates mean that there is less incentive to move, and more reasons to keep one’s home and renovate it.

Aside from remodeling to address specific medical conditions, there are some home design trends that can have surprising benefits to homeowners as they age. The recent pandemic taught us all that we can do many things from home. While a home office space might enable a resident to stay productive, repurposing such office and adjacent space as a bedroom suite on the main accessible floor could reduce the impact of stairs. A home theater system, or even a purpose-built home theater room, can allow the enjoyment of current movies and other streaming content without going out, while also making the home inviting to others to encourage extended family and social interaction. Childress & Cunningham Architects frequently design additions and renovations to homes to meet the dreams of their owners, taking into consideration certain design features. Such remodeling can also be an opportunity to prepare the space for aging in place.

Design Considerations

Designing with accessibility in mind (for those with mobility challenges) can minimize the risk of falls, a common cause for worry among older adults. Even for someone who doesn’t currently have a mobility impairment, following accessibility guidelines can create easier access when they might need to use a wheelchair or other assistance, such as while recovering from a medical procedure. Should a wheelchair or other aid become necessary, the home can already be configured to support ease of use in a variety of ways.

There may be changes in floor level that need to be accommodated with ramps, when the vertical change is not too great. This could mean a new exterior ramp to the front door, or one inside the garage where there is commonly a step or two up to the main floor level. The functions of some rooms could be changed, and maybe an addition could be constructed, in order to locate a bedroom along with all primary living, dining, and bathroom functions on the main floor level.

Where access to another story is needed, a stair lift or residential elevator can be designed. For new homes considering an elevator, installing the shaft at the time of initial construction is efficient, and cost conscious when considering the home might be the final owned home for the resident. A planned elevator shaft can be used initially as closets at each floor, with the ability to remove the floor in the future and install the elevator equipment.

Hallway, stair, and door widths should be sufficient for wheelchair passage or to accommodate assistance from another person. Commonly, residential doors are 30 inches wide, but for a wheelchair 32 inches of clearance is needed, so the door should be at least 34 inches wide. A stairway that is at least 42 inches wide can allow a second person to help a resident up and down. Hallways that are nominally wide enough for wheelchair passage might nonetheless prove difficult when turning at a corner, or when opening a door that is at the end of the hall, without designing the hallway to be more gracious at specific locations.

Fall prevention comes in the form of handrails and grab bars, as well as non-slip floor surfaces. A homeowner can choose to follow accessibility guidelines that call for grab bars in bathrooms, both around the water closet and in a shower or tub. The walls where bars are installed must be reinforced for this installation, if the mounting points do not coincide with existing wall stud locations. If the space is lacking for full-sized grab bars, it should be noted that compliance with accessibility guidelines is not required in the context of a single family residence, so shorter bars are an option. A swing-up type of side grab bar can be used where there is a lack of adequate side wall space. Flooring materials can be changed to be less prone to slipping, especially in wet areas, as well as to require less maintenance.

A combination shower/tub can be replaced with a walk-in tub that does away with the need to step over the tub edge while also making it easier to bathe while seated. An alternative to a walk-in tub would be a roll-in shower, with a low threshold and a fold-down or removable seat. Even if a conventional tub is left in place, the addition of grab bars can help greatly when stepping in or out. A hand-held shower head can further ease the bathing process, while still functioning as a conventional shower for those able to use it as such. Another bathroom feature that can be changed is the toilet or toilet seat height, which can be raised from the common 15 inches up to the range of 17 to 19 inches.

Other fall prevention measures include the provision of handrails on both sides of a stair, rather than just one, and if possible extending the stair handrail past the top and bottom nosings. Lighting at a stair should be automatic on a motion sensor, or at least provided with controls at both top and bottom, and should be bright enough to make the tread nosings clearly visible. Electrical outlets at the top and bottom of a stair could be tapped later for the installation of a stair lift, as well as being used for motion-sensing lights.

Other Modifications

A dedicated exercise space can support various kinds of physical therapy without the need to go out to a gym. Equipment such as a treadmill or recumbent bike require significant dedicated space. A full-height mirror and scale are commonly desired by our clients for a personal gym. Consider television mounting locations for entertainment while working out. Other equipment may be portable and could be taken outdoors during good weather, including yoga mats, weights or resistance bands, and stability balls. The space should be well-lit and spacious, with non-slip, cushioned flooring that could be composed of rubber mats or interlocking foam tiles to reduce the risk of injury. Wall-mounted support bars should be firmly anchored into the structural stud framing. Designing with all of these issues in mind will lead to an exercise space that is enjoyable to use regularly.

The workout room could be adjacent to, or part of, an “adult gaming area” with an inviting home bar and billiards table, or other recreational elements like a poker table, pinball, arcade machines, bumper pool, or ping-pong. Supporting hobby interests keeps families engaged, energetic, and building community with each other.

Current building codes mandate smoke detectors throughout the building that are interconnected and hard-wired, but many homes have independent battery-operated detectors that might not be optimally located. For an aging homeowner, it may be difficult to keep up with changing batteries, running the risk that they will simply disable the alarm, and if hearing is a challenge then an alarm in one part of the house may not be heard elsewhere. Any home modification should include bringing smoke detection, and carbon monoxide detection, up to full code compliance.

Kitchen makeovers present many opportunities to improve conditions for the use of mobility challenged residents. Cabinet and drawer pulls can be of a bar style or D-shape, rather than smaller knobs that require grasping. The overall kitchen layout can be planned to allow maneuvering and usage of appliances by someone in a wheelchair. The oven/range can be selected to have its controls toward the front, to avoid reaching over the heating elements. Rather than wall cabinets with doors, open shelving affords the benefit of being able to see its contents and avoids the potential for collision with opened doors. A desk with clear knee space under it, or a countertop with sufficient overhang, can permit food preparation tasks while seated.

Additional lighting throughout the home has been made more affordable in recent years thanks to LED technology. It is possible to replace incandescent fixtures to achieve much greater brightness without taxing the existing circuits. Dimmable circuits can provide cozy or intimate lower lighting levels while still being able to brighten the space for those with poor vision. One must pay attention to the lamps used, as they must be rated for dimming. Motion sensors can automatically control lights in hallways, at stairs, and other places like the garage. Rocker-style light switches make it easier to activate when hands are full, or for hands that may lack the dexterity to manipulate a conventional toggle. Lights can be angled to shine into a closet, or simply be added inside the closet and placed onto a switch that turns on when the closet door is opened.

At the main accessible entry door, it is a good idea to have some covering for weather protection. A ledge, table, or bench can be useful as a way to set things down while unlocking the door. Door hardware can be a lever-style handle that is easier to operate than a knob, and the keyed lock can be separate from the handle. If the front door does not already have a peephole, then a video-enabled doorbell device can help promote a sense of security.

Laundry appliances can be challenging, especially a stacked washer and dryer which may be hard to reach due to height for one or the other portions. Side-by-side units can be elevated to reduce the need to bend over. If laundry is not located on the same floor as the bedroom, then a laundry chute can remove the need to walk down stairs while carrying a full basket. Many of these modifications add value even for those without health or accessibility issues.

Potential Pitfalls

While the Age-In-Place approach seems to offer many benefits in comparison to an assisted-living community, there are some potential drawbacks that should also be understood. Psychologically, it might be an approach that is enabling to someone who is reluctant to face their real need for oversight and care. A person living on their own may need others who will check in on them at regular intervals. The lack of immediate attention means there is a reliance on communication devices and the ability of trusted individuals nearby to respond to their call.

Financially, the money spent on home upgrades may have the effect of raising the home’s appraised value, which can mean an increase of property taxes for someone who is on a fixed income. Conversely, if remodeling is too highly customized towards a resident with specific disabilities, it might reduce the home’s actual resale value.

Property maintenance remains the responsibility of the homeowner, who may need to employ services to mow the lawn, shovel snow, or other common duties. Benevolent neighbors might be able to help with taking trash to the curb or changing HVAC filters, but all of these tasks must be accounted for, where these would be the responsibility of others in a senior care facility.

Significant health care issues still require supervised care, and that is why we design senior living with a continuum of care levels. It may be the right choice to move to an independent living condominium or assisted living apartment, where there is easy access to attentive nursing care. If that decision still seems like it should be far off, though, it can be wise to consider how your next home addition or renovation can incorporate some of the features described above to support aging in place.

While this article has focused on architectural features that Childress & Cunningham Architects could design into your next project, there are many more lifestyle efforts (such as getting rid of clutter) that are recommended for someone intent on remaining in their home as their physical support needs increase. Collected below are some links to various publications which include these kinds of recommendations:

National Institutes of Health overview
https://www.nia.nih.gov/health/aging-place/aging-place-growing-older-home

To find an Aging Life Care Expert
https://www.aginglifecare.org/

Home Modification Guide – from usaging.org
https://www.usaging.org//Files/Home%20Mod%20Action%20Guide-2%20(508_cleared).pdf

Home Hazard Removal Program (HARP) flyer
https://starklab.wustl.edu/app/uploads/2024/10/HARP-Information-Handout-Teal_General.pdf

Fall Prevention Center of Excellence (FPCE) – https://homemods.org
National Council on Aging list of home assessment tools
https://homemods.org/wp-content/uploads/2021/06/USC.NCOA_.HomeAssessment.Inventory.2.-1.pdf

AARP HomeFit Guide
https://www.aarp.org/livable-communities/housing/info-2020/homefit-guide.html