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What's Needed to Help Americans Age in Place

Many of us want to grow older where we now live. Will our homes let us?

By Richard Eisenberg and SCAN Foundation

I’ve been thinking a bit lately about aging in place — the ability to live in your own home and community safely, independently and comfortably as you get older. Maybe it’s because my 93-year-old dad just broke his arm, has nearly no leg strength and is now pretty much bound to the confines of his apartment. Or maybe it’s because my wife and I, who love our suburban split-level, recently talked about how suitable it would be as we age.

If you’re in your 50s or 60s — especially if you’re that age and your parents are still living in their homes — maybe you’ve been thinking or talking about aging in place, too.

Most Want to Age in Place

According to AARP, 73 percent of people 45 and older say they want to stay in their current residence as long as possible and roughly 90 percent of those over 65 do.

But will they be able to? And are we, as a nation, doing enough to help let them? After attending a recent HomeAdvisor Insights Forum in New York City on aging in place, I’m dubious.

The Need for Better Information

“To most seniors, aging in place is a dream and it needs to be a plan,” said panelist Marty Bell, executive director of the National Aging in Place Council. His timely question: “How can we work together to make it happen?”

We’d better start soon.

The new Aging in Place Survey Report from HomeAdvisor, an online marketplace that connects homeowners with home service professionals, noted that the number of U.S. residents 65 and older will grow from 35 million (in 2000) to about 73 million in 2030. And, said National Association of Realtors Chief Economist Lawrence Yun at the Forum: “There are now 12 million people 80 and older; that number will be 27 million in 15 years.”

Duo Dickinson, an architect and designer, offered this warning to the audience: “The undeniable reality is that the largest demographic bulge in America is processing through to a place where their homes will become a threat.”

Many Homes Will Be Unsafe

As the Bipartisan Policy Center recently wrote in its report, America’s Growing Senior Population, “many of today’s homes were designed at an earlier time, before the demographic changes now transforming the country were even recognized. Most lack the necessary structural features that can make independent living into old age a viable, safe option.”

That’s why the quiet aging-in-place mobilization has slowly started to begin.

Said Dickinson: “For the vast majority of people we deal with as consumer architects, it’s ‘I’m great now, but my father is miserable and in 10 years, I don’t want to be miserable living in a misfit home.’”

According to the National Association of Home Builders, more than 70 percent of homeowners completing a remodeling project are making aging-related improvements for themselves or their parents.

And in HomeAdvisor’s survey of 250 home service professionals, 56 percent of homeowners who hired a pro for an aging-related home improvement project were younger than 65; 10 percent were younger than 50.

Most Common Aging in Place Projects

The most popular aging-in-place projects are all about safety: HomeAdvisor’s survey found that 76 percent of the most frequently completed projects for homeowners looking to age in place were “adding grab bars” and 64 percent were “adding a ramp to the entrance” for wheelchair accessibility. One in three added a bathroom on the main floor.

Problem is: There’s a huge lack of knowledge by the public, contractors, remodelers and other home pros about how to age in place and how to pay for it.

“Helping people figure out how to live out their lives in their homes is a terrific business opportunity,” said Fortune Assistant Managing Editor Leigh Gallagher at the HomeAdvisor Forum.

What the Public and the Pros Don't Know

Bell noted that older Americans are not very familiar with universal design — ways of making buildings more accessible to older people and people with disabilities.

And in HomeAdvisor’s survey, just 17 percent of the professionals were familiar with all the Medicare and Medicaid benefits available for in-home services and care; only 25 percent knew about the National Association of Home Builders Certified Aging-in-Place Specialist program. (An excellent source of information about Medicare and Medicaid aging-in-place benefits, incidentally, is the Paying for Senior Care website from the American Elder Care Research Organization.)

“These numbers suggest that, as we prepare for homeowners to age in place in the future, better-informed home service professionals could do a great service to homeowners — as well as homeowners’ daughters and other caretakers — in helping them find and access resources to make the best possible home modifications and improvements,” said Marianne Cusato, HomeAdvisor’s Housing Expert and professor of practice at University of Notre Dame’s School of Architecture.

One-Stop Shopping


At the Forum, Bell said he wants to see a coalition of the for-profit, not-for-profit and government worlds “form a system of one-stop shopping for aging in place, so older Americans can go to one place and find and access all the things they need.”

As Bell noted: “It’s one thing to want to stay in your home. It’s another to say: ‘Here’s how to do it.’ That’s the piece we’re missing.”

I was pleased to hear at the Forum that the missing piece is slowing starting to come into position.

Last year, the Aging in Place Council held a thought-leader summit to discuss what kind of information would be most useful to help people age in place and the attendees agreed on these five areas:

  • Home/home modification
  • Personal finance/aging in place benefits
  • Transportation
  • Health and wellness
  • Social interaction and entertainment

The Aging in Place Council will continue chipping away at this at its Dec. 2 and 3 meeting at Georgia Tech Research Institute in Atlanta called Creating a System for Aging in Place in America.

This group is also working with deans at social work schools to train social workers about aging in place so they can advise people. “That topic is not part of their thought process right now,” Bell notes.

Places That Get It

A few — very few — communities around the country are trying hard to become more age-friendly and help their older residents age in place. I wrote about some in my earlier Next Avenue blog, Why Are There So Few Age-Friendly Cities?

Dickinson noted at the Forum that any project he does in Westchester, N.Y. (New York City suburbs) “has to have a component of handicap accessibility.” That’s not because people are tripping and falling, he said. “It’s because people are getting older,” noted Dickinson.

Ohio, Virginia and two Maryland counties offer “Livable Home” tax credits for builders and homeowners who implement universal design elements in new or retrofitted homes.

And groups have popped up in a few New York City suburbs specifically aimed to make their towns better ones for aging in place. In Connecticut, there’s Staying Put in New Canaan and At Home in Greenwich; in New York, there’s Staying Put in Rye and Environs or the aptly-named SPRYE.

What Homes Need for Older Residents

The Bipartisan Policy Center says five universal design features can help make homes safer for older residents: no-step entries; single-floor living; switches and outlets accessible at any height; extra-wide hallways and doors to accommodate walkers and wheelchairs and lever-style door and faucet handles. But only 57 percent of existing homes have more than one of those features, according to Harvard’s Joint Center for Housing Studies.

The U.S. Department of Housing and Urban Development has a handy two-page guide describing a variety of home modifications (some low-cost and simple, others complex and more expensive) to let you more easily age in place.

Bell believes more middle-class Americans in their 40s and 50s should be coming up with their own ways to age in place. “Look at your housing situation and ask yourself: ‘If I can’t climb the stairs in 20 years, would I build a bedroom downstairs or move?’” And every five years, he says, “You need to go over your plan and ask yourself: ‘Does it still work?’”

Photograph of Richard Eisenberg
Richard Eisenberg is the former Senior Web Editor of the Money & Security and Work & Purpose channels of Next Avenue and former Managing Editor for the site. He is the author of "How to Avoid a Mid-Life Financial Crisis" and has been a personal finance editor at Money, Yahoo, Good Housekeeping, and CBS MoneyWatch. Read More
By SCAN Foundation
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