10 steps to getting your home ready for you to age in place

Most of us want to grow old in our own homes, but is your home ready for it?

Probably not, says Erin Fay-Azzato, an occupational therapist with the Visiting Nurse Association of Cape Cod, part of Cape Cod Healthcare.

“A lot of the homes on the Cape, if they are Cape style, have a half-bath on the first floor and the bedrooms and full bath are located on the second floor,” she said. “If you are unable to use stairs, you cannot use the full bathroom, which includes a shower.”

A 2021 AARP survey reported 77 percent of adults over 50 would prefer to age in place. But aging in place requires space that is accessible and designed to minimize falls. Only about 10 percent of homes in the United States are aging-ready or fall avoidance with a step-free entry, a bedroom and bathroom on the first floor, and at least one bathroom accessibility feature like a grab bar, according to a 2020 report by the U.S. Census. And to be really prepared, you’ll also need features like proper handrails on steps and wider doors to accommodate a walker or wheelchair, Fay-Azzato said. And don’t wait to do something about it until you need it.

“The earlier you start to prepare your home for safety, the better” Fay-Azzato said. She was in her 30s when she bought her home on Cape Cod, but she asked the builder to make a few changes, which included widening and adding double doors to the dining room in case it ever had to be used as a first-floor bedroom. She also ensured all doorways were wheelchair accessible, installed a barrier-free shower, and added a washer and dryer on the first floor.

These additional features were put to good use a few years later when her niece, who was involved in a motor vehicle accident, was able to rehabilitate for three months in Erin’s home. Her niece, who broke both of her legs, was in a wheelchair, unable to stand, and was able to live on the first floor of Erin’s home with full access to a bedroom, bathroom, kitchen and laundry facilities.

New designs mean accessibility features such as safety grab bars that double as towel racks or toilet-paper holders and fit seamlessly into decor, Fay-Azzato said. “It doesn’t have to be so hospital-like.”

The cost of retrofitting a home can vary from a few hundred dollars to thousands but may seem worth it compared to the costs of not being able to live at home, she said. And for those who qualify, there are state programs to help with low-interest loans for accessibility improvements, according to the Cape Cod Commission.

“Compare living at home to the alternatives like an assisted living facility or a nursing home in Massachusetts,” Fay-Azzato said. “You have to compare costs of nursing homes, who offer more focused medical care including assistance with activities of daily living, like dressing, bathing, using restrooms and three nutritional meals a day, or an assisted living facility that focus on promoting independence and an active engaged lifestyle to the ability to remain in your own home.” Making changes to your home may be the determining factor in where you will reside towards the end of life.

The Steps to Take

In addition to widening doorways, ensuring all flooring has a smooth transition throughout your home, having a full bathroom and washing machine on the first floor, what steps can you take to make your home is more age-in-place friendly? Here are some suggestions from Fay-Azzato:

• Ensure there are handrails on both sides of the stairs and good lighting. Put light switches at the top and bottom of stairs so you can turn lights on before going up or down.
• Consider motion-activated lights in bedrooms, bathrooms and stairways that turn on automatically.
• Either remove throw rugs or make sure they are firmly fixed to the floor.
• Keep electrical cords away from pathways. Arrange furniture – low coffee tables, for example – so that you can navigate a room without bumping into things. Consider furniture that’s easy to get in and out of – no soft, low couches! And no standing on chairs or tables to change that lightbulb.
• Install grab bars in bathrooms near the toilet and both inside and outside your bathtub or shower. Make sure you have a nightlight in the bathroom.
• In the kitchen, remove any rugs and keep pans and utensils in places where they are easily accessible. Consider creating a spot where you can prepare food while seated or using a stool.
• Update your phone to accommodate hearing or sight issues. For example, when the phone rings, a light flashes.
• Keep outdoor entries in good repair. Make sure steps are broad enough to accommodate a walker. Add non-slip material to outdoor stairways or decks. And install a grab bar near the front step. Have motion activated outdoor lighting.
• Learn to use technology – smartphone apps, voice-activated digital butlers like Alexa, smart watches and personal emergency alarms. These can-do tasks are as simple as turning on lights or the radio or calling emergency services in the event of a fall.
• If you live alone, arrange a daily phone or text check-in with a family member or neighbor. Some Cape police departments, such as Mashpee, have a reassurance program for people who live alone. Residents call the department each morning, and if police don’t get a call, it instigates a call and/or visit by officers.