Aging in Place

Studies show that most people want to stay in their current homes as they age. But modifications may be necessary to accommodate changing needs, and you may need people and services to help with many tasks that you are no longer able or willing to do.

The common desire to stay in the same home is often called “aging in place.” This is a term most often used by professionals and policymakers, although not by older adults themselves. It may be misunderstood as being unable to leave your home or having other negative implications. When people say they want to stay at home, they often are thinking not only of their physical home but also their familiar surroundings. When you think of staying in your home, think, too, of your community. The home may be quite comfortable but not safe. Or the home may be safe, but only with help. Or all those conditions may be met, but you don’t have enough income or assets to support the arrangement.

What if the home is safe but the neighborhood is not? What if the person doesn’t have a community of people nearby who can help as needed? Living alone shouldn’t mean living in isolation. What seems to be a straightforward definition turns out to be complicated. You can do a lot to make sure all these elements are in place, but some things are beyond any individual’s control.

An important first step in deciding whether staying in the same home can work is taking a hard look at the home. Looking past a cherished home’s attractive features and focusing on its flaws and hazards can be hard to do. Having someone with fresh eyes with you as you survey the premises can be helpful, preferably someone with experience in home modification for older people, such as a physical or occupational therapist, a geriatric care manager, or a contractor who has done similar jobs.

If you’re trying to improve the home for a relative, be aware that older people often downplay concerns about safety and resist change. Be tactful but firm. Safety is not the only issue, but it is a prerequisite for enjoying a good quality of life.

Falls and burns aren’t the only sources of injury at home, but if you address them, you’ll likely prevent other kinds of injury. Your first priority should be preventing falls. Falls are among the most common accidents in homes. Older people are at risk for falls because keeping your balance as you age is more difficult, and it’s harder to readjust your feet to regain your balance if you slip. Arthritis can limit your range of motion. Many older people suffer bone loss, or osteoporosis. Hips are the most likely joints to be injured because people tend to fall on their sides.

Falls are often the first step in a cascade of decline that ends up with a hospital stay and eventual placement in a nursing home or death. Fortunately, many fall-prevention measures are easy to take and are not expensive.

Burns are a common problem in the home. Even a minor burn can lead to infection and serious consequences. Older people literally have thinner skin that’s more susceptible to scalding from hot water or burns from electrical appliances.

Many houses and apartment buildings were constructed before universal design features were common. Ramps in public places, doors marked for wheelchair entrance, and buses with lifts and special seating for people with disabilities have become so common that they are scarcely noticed (unless of course you have a disability and need these accommodations). Yet the need for similar accommodations in private homes is less visible although equally important.

Some items that need correcting can be done by you or a friend or family member, but if you have determined that major changes are necessary — for example, widening doorways or replacing kitchen cabinets or appliances — you probably need to find a contractor to tackle the modifications.

Remodeling is a messy and often frustrating experience. The first phase, demolition — even if it’s limited to one room or area — is unsettling. Delays are common. It may be a good idea to move to another setting while the work is being done, especially if you expect a lot of dust, noise, and disruption.