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AGE-IN-PLACE HOME IMPROVEMENTS: A ROOM-BY-ROOM GUIDE

KRIS LINDAHL

As homeowners enter their golden years, some might prefer to stay in their homes as long as they can — commonly called “aging in place.” This can be a more complicated task than a lot of people realize, especially if they have older homes or houses with multiple floors. Taking a systematic approach to people’s needs for aging in place yields a long list of tasks. Completing most of them in advance can provide a better guarantee of accessibility for residents even decades into the future. This guide helps homeowners determine various aspects they should consider in each room, and ways they can improve their accessibility. Although most people might not require every measure in order to be able to remain independent in their homes, the knowledge will make planning the most important home improvements more effective. On the other hand, some may decide these modifications are not realistic for their current situation and will opt for moving to a new home or assisted living community. At the end of the day, housing choices are all about what makes the most sense for an individual's wants and needs, and knowledge can help us make these informed decisions with confidence.

Bathrooms

Grab Bars

Installing grab bars at a few different points in the bathroom can provide greater safety and stability for those that could benefit from assistance standing up or sitting down. Even if people do not need to rely on grab bars on a regular basis, they can be handy tools to use in recovery after injury or surgery. As a general rule, grab bars are not exceptionally expensive. Homeowners may need to install several near the toilet and shower or bathing facilities, in a variety of sizes. With a proper installation, a grab bar should support a person’s bodyweight as they sit on a toilet or climb in and out of a tub or shower.

Although installation can be completed by a savvy homeowner, some may choose to add grab bars as part of a professional bathroom remodeling project. This equipment should be rated to hold 250-300 pounds of weight. In order to do this, each end of the bar needs to be installed directly into a wall stud. In most homes, studs will be placed 16”-24” apart, which may affect the size of the bar homeowners can choose. Installation around a toilet may only take an hour or two. Placement in an existing bath or shower could require removing tiles or cutting into the shower surround. People should consult an expert before doing this, to confirm that they will not damage the fixtures.

There are a variety of sizes, colors and styles for grab bars. Ideal choices feature grips. The preferred length for the bar depends on its placement. Experts suggest using 32” bars for horizontal applications near toilets or inside the shower. Bars for vertical or angled installation range from 8”-24”. To promote safety, the equipment should leave no more than about 1.5” of space between the bar and the wall.

Flooring

The most trendy flooring for the bathroom may not always be the ideal choice as people get older. Providing a surface that is fairly easy to clean with the least likelihood of injury from falling is usually the preferred option. Many homeowners considering flooring upgrades for bathrooms think of hardwood or tile, because they provide a classic and contemporary look. However, any hard, smooth surface can become slippery and make for a much more uncomfortable landing during a fall.

Before making a choice, homeowners should look at their budget and the longevity of the flooring options they want. Professionals often prefer rubber flooring because it is non-slip and offers a softer surface (although it can be more expensive). As an alternative, vinyl tile or plank flooring can give the appearance of hardwood or tile, with easy maintenance and a slip-resistant surface. Cork may feel softer and warmer under feet, but it must be properly sealed to be appropriate for bathrooms. Some people choose to install carpet, which is also soft and warm. However, it is important to understand that carpet is harder to clean and can breed mildew or mold if it gets wet regularly.

Bathtubs

For people with joint or mobility issues, getting into and out of the bathtub can become a challenge. Homeowners can plan for this possibility by considering their bathing needs and expectations. Some people with multiple bathrooms decide to convert one bathtub into a shower-only space for convenience and accessibility. Others choose to install what is called a “walk-in bathtub.” This style of bathtub uses a small door that can be closed with a tight seal, allowing the person to get in and out with only a little clearance. People who select this option should keep in mind that they will have to wait until the bathtub is fully drained before they can use the door to exit.

Budget-conscious homeowners may prefer to look at additions to their existing bathtub layout. Besides installing grab bars into the shower surround above the bathtub, people might consider placing a non-slip coating to the base of the bathtub. There are also inexpensive grab bars that attach to the side of the bathtub with a clamp, providing a simple installation that does not require drilling into wall studs.

Showers

Sometimes, it is difficult for homeowners to anticipate the kinds of mobility issues they will face 20-30 years down the road. How to manage hygiene is very important for people who want to age in place, and an accessible showering facility is a vital part of personal cleanliness. Homeowners should start with a quick analysis of their current showering facility. Narrow showers may make it more difficult to step in or turn around, especially for people who use a walker or a wheelchair to navigate the bathroom.

Many people eventually need or prefer having a place to sit while showering as they get older. Although there are many portable shower chairs, homeowners should make sure that the chair can remain in the shower without impeding other use of the space. If the existing shower cannot offer this room, homeowners may want to consider expanding the shower size. They should measure the height of the curb and decide if they need to install a model that provides a roll-in entrance. The faucet and shower head should be easy to reach from the seat. Adjustable shower heads can make it simple to take a shower while sitting or standing.

Toilets

Access to toilet facilities can get more difficult over time, especially for people with orthopedic concerns in their backs or legs. Toilets can be fairly inexpensive to replace, but people should consider their options before they make a selection. The height, depth, and placement of the toilet can make it easier or harder for people to use.

Toilets generally come in two heights: comfort and standard. Standard toilets rise 15” above the ground, and may be ideal for shorter people or those without joint concerns. By comparison, comfort height toilets sit at 17”-19”, which can be easier placement for taller homeowners or those with limited flexion in their legs. People who have standard toilets but need something taller could buy and install a toilet extender, which makes the seat higher without having to purchase a new toilet.

Toilets also come in different shapes. Homeowners with older toilets may have those in a compact shape, which is round and about 16”-17” deep. Elongated toilets look more like an oval and will stand out about 18”-19”. People often prefer the elongated toilets because the bowl offers more space. These may be harder to use in smaller bathrooms because they extend out further from the wall. Before homeowners switch to a bigger toilet, they should confirm that they can still get around the toilet and that the door will open and close fully. A toilet position that inhibits full movement in the bathroom may call for a redesign of the room’s layout.

Vanities

The height and depth of the bathroom vanity and mirror could mean the difference between being able to use it and not having full access. Having a deep cabinet may be convenient from a standpoint of storage, but less practical for people who need to reach the faucet while sitting in a wheelchair or supporting themselves using a walker. The counter and sink should be no more than 34” high, with a depth shallow enough that residents can reach to the back.

People should also be able to see themselves from the mirror while seated, as well. Those who choose to move the medicine cabinet may want to consider keeping their medicines in a safe, locked cabinet or safe in a room that is less prone to moisture. Homeowners who have limited space may opt to install a pedestal or wall sink instead of a vanity to make more room to move.

Bedrooms

Beds

There are four essential functions that homeowners should consider for their beds. These include:

climbing in bed
getting up and out of bed
maneuvering while in bed
sleeping safely and comfortably

All of these functions must be accessible in order for a mattress and bed frame to be a practical choice. People should also keep in mind that the average mattress will last 7-10 years. This offers the opportunity to upgrade accessibility over time.

For climbing in and getting out, the top of the mattress should be no more than 20”-23” above the floor. People may also want to add a tension-based grab bar next to the bed that runs floor to ceiling. These bars are easy to install or move and can often support an adult’s full body weight. Bed rails may also be used for additional support or simply to prevent a fall. Homeowners should confirm that the bedrail is rated to support enough weight, if they plan to have it double as a grab bar. Bedding should be lightweight and minimal in bulk, for easy movement and removal for washing. Firm mattresses are typically best to support the spine, keep a person’s airway open, and make rolling over easier.

Closets

Practically anyone could benefit from a closet overhaul in one way or another. Some extra insight into what people need as they age will improve their contentment over time. Adequate lighting is vital for people adjusting to vision concerns. Options may include overhead lighting with a switch or battery-powered LED lighting inside cabinets and under shelves.

Accessibility to closet storage without extra reaching is key. Walk-in closets should have a doorway that is at least 36” wide. Reach-in closets need doors that are easy to grasp open and closed without risk of pinching. People should target the layout of the closet to put the most commonly-used items at arm level. Drawers can decrease overextension in a deeper closet. Many homeowners may decide to relocate the hanging rod to a lower level, or install a pull-down bar. Pull-down shelving simplifies the process of putting items up high and maximizes space without requiring a stool.

Communication

The ability to communicate in case of an emergency is vital to a person’s health and safety. Many people are accustomed to keeping a mobile phone and plug on a nightstand next to the bed. This can be an ideal option, as long as homeowners can manage the cord without turning it into a tripping hazard. Otherwise, people might consider keeping a landline phone plugged in next to the bed. Homeowners may wish to put an extra pair of glasses next to the bed if they need them to read the numbers.

Beyond basic communication, some homeowners may decide to arrange for additional emergency services accessible from the bed. A medical alert system provides a service to people, usually on a subscription basis. Depending on the subscription, residents may be able to push a button to access a person who can help them determine if they need medical assistance.

Furniture

When people consider furniture for the bedroom outside of the bed, they should ask the following questions:

Does this piece affect my ability to get around the room?
Will I be able to access all parts of this storage equipment?
Could it go in a place that does not hinder access to the bed?
Can I mount this furniture to avoid toppling?

Some people try to avoid installing support devices like grab bars, preferring to lean on furniture as needed. Many furniture pieces are not designed for this purpose, so homeowners should take extra care. A sturdy chair can make it easier to dress and undress. Tall furniture, such as a highboy dresser, should be anchored to the wall for safety. Nightstands need to be close enough for access while in bed without making it harder to get into or out of bed.

Floors

Experts often have mixed opinions on the best kind of flooring for the bedroom. The right choice depends on homeowners’ ability to move and maintain the material. Carpet is soft and warm, providing extra cushion in case of a fall. However, it is more difficult to clean and can slow down movement with mobility devices. Hardwood could be slippery and can feel cold to walk across in bare feet. Vinyl, laminate, or cork may be ideal for increased movement and a non-slip surface. People who choose solid flooring should usually avoid using floor rugs for comfort. They can dramatically increase the likelihood of a fall, especially for people who wear slippers or have restricted circulation. Using smooth mats with a beveled edge could provide additional support for homeowners who have trouble standing for longer periods without compromising safety or mobility.

Kitchen

Layout

Maintaining mobility throughout the main living areas in a home is an important aspect of aging in place. People must be able to navigate around the kitchen and use it as normally as possible to help preserve their independence. Many kitchens, especially smaller spaces, may not be set up to offer maximum mobility for someone who uses a walker or wheelchair. Homeowners should consider how frequently and heavily they intend to use the kitchen and plan accordingly. For starters, placement on the main floor is important to keep the kitchen easily accessible.

When designing the layout, including doorways and the position of doorways and seating, people should confirm they have enough room to maneuver. Doorways often need to be extended to at least 36” to guarantee access. Exterior doors may already meet that requirement, but many interior doors do not. Since people could need to turn around while using a mobility tool, experts recommend increasing clearance to 42”-48” between banks of cabinetry and countertops.

Countertops & Sinks

Kitchen countertops are an ideal place for storage, food preparation, serving, and sometimes eating. Setting the countertops at the right height could increase the amount of practical space. There are four essential size ranges for the kitchen:

Counter Height: 36”
Bar Height: 42”
Accessible Height: 28”-34”
Adjustable Counter: 28”-36”

In some cases, homeowners may wish to install countertops at various heights. This can improve use by residents of different heights or people who may want to stand or sit, depending on the occasion. Residents may need to find an alternate means of support for countertops that require seating or movement space underneath. Cabinets are usually built to standard or bar height, so homeowners should confirm that they get the right size to suit the desired counter height.

Deep sinks are popular at the moment, but they may not be particularly practical for those wishing to age in place. Instead, people might consider installing a wider sink that is not as deep. This could permit more room to maneuver a wheelchair underneath the sink. Contemporary faucets can also simplify the task of cleaning. For example, sensor-based faucets do not need someone to grasp and pull a lever to turn it on.

Cabinets

The placement and the function of cabinets can make them easier or harder for people to use. In many homes, the current trend places upper cabinets higher to extend the usability of the countertop. However, this can render many shelves out of reach, unless residents are willing and able to stand on a step stool. Many designers suggest lowering these cabinets by 3” to make access quicker and less likely to cause pain. Some believe that with a tighter organization of the base cabinets, homeowners may be able to forgo installing as many upper cabinets in the first place.

There are many features of kitchen cabinets that can aid accessibility now and in the future. Homeowners should consider how they want to use the kitchen, and tailor a design that will suit these expectations. Handles in a “D” shape can be easier to grasp than round pulls. Proper lighting under the cabinetry can decrease the likelihood of stumbling or stubbing a toe. Pullout drawers allow people to reach all the way to the back, to grab or put away food items without having to strain. Pull-down shelving may make those higher shelves reachable. Pullout shelves provide a convenient place to store larger items, such as small appliances, in a cupboard or pantry. This can create more space on the countertop for food preparation.