What are Home Modifications for Older Adults & How do they Help?

Home modifications are changes made to adapt living spaces to meet the needs of people with physical limitations so that they can continue to live independently and safely. These modifications may include adding assistive technology (see the fact sheet on Assistive Technology for details) or making structural changes to a home. Modifications can range from something as simple as replacing cabinet doorknobs with pull handles to full-scale construction projects that require installing wheelchair ramps and widening doorways.

What is the benefit?

The main benefit of making home modifications is that they promote independence and prevent accidents. According to a recent AARP housing survey, "83% of older Americans want to stay in their current homes for the rest of their lives," but other studies show that most homes are not designed to accommodate the needs of people over age 65.

Most older people live in homes that are more than 20 years old. As these buildings get older along with their residents, they may become harder to live in or maintain. A house that was perfectly suitable for a senior at age 55, for example, may have too many stairs or slippery surfaces for a person who is 70 or 80. Research by the national Centers for Disease Control and Prevention shows that home modifications and repairs may prevent 30% to 50% of all home accidents among seniors, including falls that take place in these older homes.

Will they be right?

The best way to begin planning for home modifications is by defining the basic terms used and asking some simple questions. According to the Rehabilitation Engineering and Assistive Technology Society of North America (RESNA), home modifications should improve the following features of a home:

• Accessibility. Improving accessibility means making doorways wider, clearing spaces to make sure a wheelchair can pass through, lowering countertop heights for sinks and kitchen cabinets, installing grab bars, and placing light switches and electrical outlets at heights that can be reached easily. This remodeling must comply with the Fair Housing Amendments Act of 1988, the Americans with Disabilities Act accessibility guidelines, and American National Standards Institute regulations for accessibility. The work must also conform to state and local building codes.

• Adaptability. Adaptability features are changes that can be made quickly to accommodate the needs of seniors or disabled individuals without having to completely redesign the home or use different materials for essential fixtures. Examples include installing grab bars in bathroom walls and movable cabinets under the sink so that someone in a wheelchair can use the space.

• Universal Design. Universal design features are usually built into a home when the first blueprints or architectural plans are drawn. These features include appliances, fixtures, and floor plans that are easy for all people to use, flexible enough so that they can be adapted for special needs, sturdy and reliable, and functional with a minimum of effort and understanding of the mechanisms involved.

• Visability. Visability features include home modifications for seniors who may want to entertain disabled guests or who wish to plan ahead for the day when they may require some extra help in getting around their own homes. For example, installing a ramp to the front door of a house and remodeling the hallways and rooms to allow wheelchair access would make a home easier to visit for disabled family members or friends. Such changes may also give seniors a head start on home modifications they may need later in their lives.

Where do you begin?

Before you make home modifications, you should evaluate your current and future needs by going through your home room by room and answering a series of questions to highlight where changes might be made. Several checklists are available to help you conduct this review. The National Resource Center on Supportive Housing and Home Modifications is a good place to start. Go to the center's website at http://www.homemods.org/ and click on the link to the "Safety Checklist and Assessment Instrument."

In addition, Rebuilding Together, Inc., has an excellent home modification checklist:

Modification Checklist
http://www.rebuildingtogether.org/home_modifications/house_assessment_checklist_content.htm

You can begin your survey by examining each area of your home and asking the following questions:

Appliances, Kitchen, Bathroom

• Are cabinet doorknobs easy to use?
• Are stove controls easy to use and clearly marked?
• Are faucets easy to use?
• Are there grab bars where needed?
• Are all appliances and utensils conveniently and safely located?
• Can the oven and refrigerator be opened easily?
• Can you sit down while working?
• Can you get into and out of the bathtub or shower easily?
• Is the kitchen counter height and depth comfortable for you?
• Is the water temperature regulated to prevent scalding or burning?
• Would you benefit from having convenience items, such as a handheld showerhead, a garbage disposal, or a trash compactor?

Closets, Storage Spaces

• Are your closets and storage areas conveniently located?
• Are your closet shelves too high?
• Can you reach items in the closet easily?
• Do you have enough storage space?
• Have you gotten the maximum use out of the storage space you have, including saving space with special closet shelf systems and other products?

Doors, Windows

• Are your doors and windows easy to open and close?
• Are your door locks sturdy and easy to operate?
• Are your doors wide enough to accommodate a walker or wheelchair?
• Do your doors have peepholes or viewing panels? If so, are they set at the correct height for you to use?
• Is there a step up or down at the entrance to your home? If so, is the door threshold too high or low for you to get in or out easily?
• Is there enough space for you to move around while opening or closing your doors?

Driveway, Garage

• Does your garage door have an automatic opener?
• Is your parking space always available?
• Is your parking space close to the entrance of your home?

Electrical Outlets, Switches, Safety Devices

• Are light or power switches easy to turn on and off?
• Are electrical outlets easy to reach?
• Are the electrical outlets properly grounded to prevent shocks?
• Are your extension cords in good condition?
• Can you hear the doorbell in every part of the house?
• Do you have smoke detectors throughout your home?
• Do you have an alarm system?
• Is the telephone readily available for emergencies?
• Would you benefit from having an assistive device to make it easier to hear and talk on the telephone?

Floors

• Are all of the floors in your home on the same level?
• Are steps up and down marked in some way?
• Are all floor surfaces safe and covered with non-slip or non-skid materials?
• Do you have scatter rugs or doormats that could be hazardous?

Hallways, Steps, Stairways

• Are hallways and stairs in good condition?
• Do all of your hallways and stairs have smooth, safe surfaces?
• Do your stairs have steps that are big enough for your whole foot?
• Do you have handrails on both sides of the stairway?
• Are your stair rails wide enough for you to grasp them securely?
• Would you benefit from building a ramp to replace the stairs or steps inside or outside of your home?

Lighting, Ventilation

• Do you have night-lights where they are needed?
• Is the lighting in each room sufficient for the use of the room?
• Is the lighting bright enough to ensure safety?
• Is each room well ventilated with good air circulation?
• Once you have explored all the areas of your home that could benefit from remodeling, you might make a list of potential problems and possible solutions.

Source: US Dept of Health and Human Services, Administration on Aging, www.AoA.com