Creating a Forever Home: Aging in Place

This article appeared in the Fall 2021 issue of This Old House Magazine. Click here to learn how to subscribe.

Just about everyone wants to live at home, well, forever, says James Vitale, an Altadena, CA, architect who specializes in disability access. But fewer than half of those age 55 or older and planning to remodel in the next three years paid attention to making their homes age-proof, a recent study by Harvard’s Joint Center for Housing Studies found.

This mindset is changing, however, driving up the value of homes that are safe and comfortable for all, especially in areas that promote walkability and community ties. Call it universal design, accessibility, aging in place, or simply living in place; the goal is to make life easier for people of different ages and abilities, and it doesn’t have to mean adding an elevator (though some homeowners do).

How to Create a Home to Age in Place

Josh Safdie, an architect in Newton, MA, says, “A fair amount of what I typically recommend in terms of prepping a house to be adaptable over time is pretty invisible,” whether it’s a minor update or a whole-house remodel. Here are some worthwhile steps you can take now, with an eye toward the future.

Make Entry Access Easier

Aim for a no-step entrance, with a flat landing outside that’s sheltered from the weather.

Consider Options for First-Floor Living

“Begin by assessing what you have,” Steve Salley, an architectural designer in Orleans, MA, tells clients who say they want to move downstairs. “Eliminate any variations in level. Then get a good ‘as-built’ floor plan drawn, and have your designer use overlays on a computer or drafting board to see what can be done without building new space. Start with an open mind—you don’t have to go right to a full-blown addition.”

Of course, adapting existing space can mean “untangling the hold a room has on us,” says Deborah Pierce, an architect and author of The Accessible Home, pointing to seldom-used dining rooms as ripe for conversion. Must-haves include a well-designed full bath (at right); an efficient kitchen (see page 58); sleep space (small is fine, but away from public entries and preferably enclosed); and designated spots to pursue a hobby, read quietly, watch TV, work at a computer, or just gaze out a window. Pay attention to window heights—and views when you’re seated.

First-floor living also means a first-floor laundry. “Right now, move the laundry out of the basement,” says Pierce, who recalls claiming space under the stairs in one client’s home.

Open plans work for different age groups, allowing parents and grandparents alike to hear and see what’s going on in different areas. Pierce recommends creating roomy pathways around the perimeter of living spaces and adding chair rails chunky enough to offer a handhold. For added safety, consider some sturdy built-ins and carpets installed flush with the floor.

Some structural elements to keep in mind: Passageways ideally should be 3 feet or wider. If rooms need to be closed off, French doors can preserve sight lines; pocket or sliding doors can be easier to manage than hinged ones, and provide a wider clear opening. Casement windows may be easier to operate than double-hungs. Flooring should be a single unified plane, without thresholds or steps. “Whenever I open up a space, I say, ‘Let’s get rid of the threshold,’ ” says Pierce. “A level, flush floor improves mobility, while thresholds just collect dirt.” When unavoidable, step-downs should be flagged with accent strips or contrasting colors. When space allows, replace a handful of steps with an indoor ramp, designed to decline an inch per foot.

Create a Safer Bathroom

Slipping in the bath is scary at any age, and the cause of many injuries. Luckily, a bath designed with safety in mind can still feel luxurious.

Who says an accessible bath can’t look great? Curbless showers with oversize niches are not only aging-friendly but also evoke boutique hotels—especially when coupled with a handshower that slides on a rail, an inviting bench, and warm air from a ceiling heater. Bidet toilet seats, lever-style faucet handles, and entry doors that pocket or slide open like a barn door boost both style and function.

While some homeowners crave a spacious, all-in-one wet room, Safdie argues that a bath with enough room to eventually accommodate a caretaker or a wheelchair doesn’t have to be bigger than 80 square feet. Salley adds that “someone who feels unstable is better off in a smaller shower because he can put out a hand for support.”

Not ready to give up a tub? Drop a deck over it, Vitale says, with extra sit-down space along one side or at the end so bathers can perch and swing their legs in. Properly installed grab bars along the sides of the tub and one on the wall are essential with this setup.

“Put in grab bars with pretty finials,” suggests interior designer Toni Sabatino. Or go for ones that cleverly disguise themselves by doing double duty as toilet-tissue holders, towel bars, or shower shelves.

A sink with a wide rim and a lip can hold toiletries and contain splashes. Wall-hung and console models look sleek and open up space underneath.

In general, aim for shelves that fall between hip and shoulder height when standing—in a cabinet that sits on the vanity top, for example. If there’s a drawer, a slanted insert designed for spices can organize medications. Rocker-style light switches work for everyone.

Non-glare finishes are kind to aging eyes, and a ribbon of contrasting wall tile “steadies the eye, which steadies the mind, which steadies the body for balance,” says Sabatino.

Expert advice

Does Adding On Make Sense to Age in Place?

“The rule of thumb for an accessible addition in my area is about 600 square feet, at a rough cost of $180,000,” says Salley. “That sounds high till you compare it with the cost of five years in assisted living.” To create a buffer zone, he likes to design a connector space when adding on, he says, “so you don’t just pop open a door and look at a bedroom.”

Even if downstairs living is still in the far-off future, any addition should be designed for maximum flexibility, with passageways at least 3 feet wide, say, and blocking for grab bars hidden in walls. Aim for spaces that can be subdivided or adapted, or designed from the start with accessibility in mind: a rear addition, for example, with a no-barrier, ramped entry from the driveway, and a mudroom wide enough for a wheelchair to maneuver through.

Your designer should be able to provide a second, just-in-case floor plan showing the family room, say, subdivided to create a bedroom, keeping any exterior door in the public spaces. Rough plumbing can be hidden in a wall and tapped for a future full bath. “I designed one house so that if the buyer later wants a first-floor suite it won’t affect other areas of the house,” says Michael Nikolas, a developer in Norwalk, CT. “I built in extra space in the family room and included a home office, roughly twelve by ten feet, that could become the bath.” Similarly, a side addition that holds a downstairs den or home office can accommodate guests or boomerang children now, and a caretaker later.

If you are adding a TV room or home office, consider incorporating a wall bed—some are designed to function as desks by day—that can open to serve guests today and offer a first-floor-living option in the future. If a powder room is in play, plan for it to be able to expand into a full bath at some point. “We conceived one first-floor plan with an expandable half bath between the kitchen and living space,” says Grant Saller, an architect in Washington, D.C. “We added temporarily fixed pocket doors to conceal the shower compartment so that the doors could be opened one day and the powder room turned into a full bath.”

If keeping the main suite upstairs is a priority, a 5-by-5-foot shaft in an addition can do time as a stack of useful closets now, while holding an elevator later. Newer options for residential elevators­—including forklift-style and pneumatic models­—are putting them within reach for more homeowners.

How to Design a Kitchen for Aging in Place

An accessible kitchen is better for all—who doesn’t want essentials within easy reach, and appliances and prep space at a back-saving height?

“It’s about space planning and understanding how you want the kitchen to function in its future life, as much as it is about choosing the right products and finishes,” Safdie says of the accessible kitchen. “It can still look the way you want it to look—there’s no countertop material you can’t use, no cabinet style you can’t have.”

Open plans, already popular because they encourage socializing and keep the cook in the loop, also maximize the flow of light and sightlines. Layered lighting is pleasing as well as aging-friendly. Prep space at different heights also adds airiness to a space, as does a peninsula supported by a chair-accommodating pedestal.

Safdie encourages renovators to build in flexibility. Slide-in base cabinets, installed over flooring that extends to every corner, can come out to create open knee space. He likes KraftMaid’s Passport Series, which includes base cabinets with raised toekicks, cabinets sized to put the countertop at a good height for wheelchair users, and ones that situate sinks, microwaves, and cooktops within easy reach for all. Deep drawers and cabinet pullouts—a boon to everyone—ease the retrieval of heavy pots and dishes.

Frequently used items should be within reach of all; for someone seated, that’s generally no higher than 48 inches above the floor. U- or D-shaped drawer and cabinet pulls are easiest to grasp. Motion-sensing faucets can be a convenience, but they can be quirky, so try before you buy. Here are some other elements to keep in mind:

Layout

While wheelchair-accessible kitchens feature a T-shaped turning space or one with a 5-foot radius, a kitchen does not have to be large to be aging-friendly, Pierce points out. “A well-designed kitchen allows you to pivot from the sink to the stove to the fridge with ease, like in a cockpit,” she says.

Opt for pocket doors, as elsewhere, and bring in as much natural light as possible, with windows lodged low enough to frame seated views. Skylights can help, too. Add a pantry if space allows, with frequently used items on easy-reach shelves, an appliance lift, and backup prep space that can be tapped during holidays.

Appliances

“Certain ones are easier to use,” says Salley, “like side-by-side refrigerators with lower shelves within everyone’s reach, and cooktops with controls in front, so nobody’s reaching over hot food.” Also kinder to the cook: a wall oven that hinges on the side. Microwaves belong at countertop height or on a cart—not over the range, awkward no matter the height or agility of the user.

Prep Space

Work surfaces at varied heights can suit someone who is seated and also people of different heights doing different tasks­—say, kneading dough versus making sandwiches. Rounded corners—on countertops, open shelves, tables—make for safer, easier traffic flow.

Floors

Flooring should be durable, nonglare, and slip-resistant. Options include wood, laminate, rubber, and some vinyl and porcelain tile.

Expert Advice

Remember to Factor in the Subtle Stuff

Don’t overlook improvements that enhance peace of mind, says Afton, MN, architectural designer Georgiana Allan. She encourages clients who cannot get out as much as they would like to create “a suite of experiences” in their homes, including the following:

• Ways to engage with the world: This can be as simple as an inviting view from a window low enough to see through when one is seated—of a bustling street, a body of water, even a bird feeder. Building in a guest room can encourage others to visit; a home office with a computer and solid Internet access opens a path to virtual travel and museum tours.
• Private getaway space: This becomes important when two or more are living in close quarters. It can be as small as a window seat boxed off by closets, or as large as a room set aside for working, reading, meditation, or exercise.
• Dedicated hobby space: Whether you make quilts, pot plants, or build models, it’s another way to enjoy keeping the mind­­—and the hand—­engaged. “If your materials are all in one place you will gravitate to it,” Allan points out.

As with many aspects of home renovation, the payoffs of designing with your future in mind can be immediate, says Sabatino. “Make your home beautiful, safe, and comfortable for all—including that athletic nephew who broke his leg skiing—and you will age naturally and gracefully, never needing to have the aging discussion at all.”

Ways to Make Daily Life a Little Easier

Aging-friendly finishes, fixtures, and furnishings are easier than ever to find­, and the best have universal appeal­. The products here can work in any home, whether you’re starting a renovation or still at the planning stage.

Help on Wheels

Bring the microwave or cooking supplies into right-where-you-need-them territory with a well-built cart on locking wheels. This steel one comes in maple (shown) or walnut, with wide side handles. Armin Kitchen Island, from $1,999; Rejuvenation

Solid Footing

Luxury vinyl-plank flooring that mimics a variety of wood species while standing up to wear, tear, and water? Sounds good, and even better when it meets standards for slip resistance. Optoro Collection vinyl planks, from $2.95 per square foot; Tilebar

Slide-Out Table

Seated workstations build in flexibility in a kitchen. This pull-out table, part of a collection of universal-design cabinets with lots of options, disappears when not in use. Passport Series two-drawer cabinet with Pull-Out Table, from $1,000; Kraftmaid

Light the Way

Night-lights are useful in hallways, stairwells, and many other places. LEDs mean less bulb burnout. This lighted outlet cover directs a constant beam where it’s wanted while keeping receptacles clear for other uses. Guidelight 2 Plus, $19; Snap Power

Artful Support

A grab bar that serves as whimsical wall art can offer a handhold in the shower while adding a welcome color accent. Made of powder-coated die-cast aluminum in navy blue, neutral gray, or sunny yellow. Sabi In-Shower Brace, $60; Honey Can Do

Adaptable Spray

Hail the adjustable-height hand-shower that’s repositionable along a fixed rail. It can put the wand within comfortable reach of bathers, whether they’re seated or standing. Rain-shower SmartActive Shower Slide Bar in Starlight Chrome, $381; Grohe

Make Your Stairs Safer

If first-floor living isn’t in the cards quite yet, do yourself a favor and bump up the style and function of the existing staircase.

What is an Aging-in-Place Specialist?

Sensing a need—tens of millions of Americans are 65 or older, and the number keeps growing—the National Association of Home Builders created a program for architects, interior designers, and contractors to become Certified Aging-in-Place Specialists (CAPS). A mix of technical and business how-to, the certification requires mastering at least three courses. NAHB can recommend a specialist in your area; CAPS typically charge a flat or hourly fee.

Some homeowners prefer to consult a health professional, such as an occupational therapist with a background in aging in place. OTs have their own certification program, known as SCEM. You can add such an expert to your design-build team, or simply seek out an architect or designer who specializes in helping clients age in place.

Resources

Whether you’re looking for research, helpful products, or pros to help you renovate, there are many sources to draw from as you plan ahead. Here are some good places to start.

• AARP / The American Association of Retired Persons publishes the free HomeFit Guide for aging in place and other materials
• NAHB / The National Association of Home Builders offers an Aging in Place Checklist and runs a program to certify builders and others as specialists
• National Institute on Aging / An arm of the U.S. Department of Health and Human Services, the institute has tips on how to plan for aging in place
• Living in Place Institute / This private institute has a network of design pros who specialize in accessibility, and also runs its own certification program
• Need a Lift? / Find helpful overviews of home elevators and stair lifts at RetirementLiving

* Wheelchair-friendly measurements