Protecting Your House After You Move Into a Nursing Home
While you generally do not have to sell your home in order to qualify for Medicaid coverage of nursing home care, it is possi...Read more
By Deborah Pierce, AIA
Rebalance portfolio: check! Update the will: check! Adjust insurance coverages: check!
Estate planning is an ongoing process, one we should re-visit during life’s milestones, such as marriage, divorce, inheritance, or retirement. A “home access audit” should be on this checklist as well. This audit is a review of the physical environment so that it can be adjusted to make living easier. After all, a home is one of the most significant investments most of us ever make, and one that can continue to serve us well into the later years with thoughtful accessible features.
Accessible means useable, without impediments or barriers. For someone who has difficulty walking due to injury or illness -- or simply as a result of normal aging – steps can be barriers. Dim lighting is an obstacle to communication for people with low vision or hearing loss and who need to read a speaker’s body language.
You may already conduct a periodic building review in the process of doing routine maintenance. A leaky roof or foundation, peeling paint and loose tiles, or malfunctioning appliances and hardware can lead to a variety of remodeling projects. These projects offer a golden opportunity to improve the home’s accessibility.
Accessibility Opportunities, Both Inside and Out
Time for a bathroom face-lift? Choose a wall-mounted sink and add grab-bars, which now come in an array of attractive styles, and switch out the tub for a curb-less shower with a fold-down teak seat. Have your builder fashion built-in cabinets to fit between studs for a super-sized medicine cabinet. Choose a “washlet” toilet to manage personal care in privacy and comfort. And while you’re at it, widen the doorway and opt for wall sconces (it’s easier to change light bulbs when the fixture is not at ceiling height!) and rocker-type light switches (simpler to operate than old-fashioned toggles).
The opportunities presented by a kitchen remodeling are even greater. New “smart” appliances are safer, easier to use, and more energy efficient than the old ones. Some even have voice-activated controls or are linked to the Internet for remote operation using an iPhone. Choose induction cooktops (cool to the touch but hot under pots) and fridges with a low freezer-drawer. Cabinet hardware options include pull-down shelves, soft-close doors, full-extension drawers, and a variety of other handy devices that reduce the amount of reaching and stretching needed – and therefore lower the risk of injury.
Putting a sleeping area and accessible bathroom on the main floor is one of the single most important things you can do to make a home more comfortable, and sometimes it’s more about re-using than adding space. Make a den or family room more private with a door. For accessibility, make them a pair of pocket doors that slide inside the wall. If you favor casual meals at the breakfast bar or in front of the TV, make the dining room into your swing-space with a sleep-sofa and armoire (but don’t forget to widen the doorway!). Doing some landscape work? Have your earth-movers re-grade ground levels to substitute gentle ramps for stairs. Rebuilding a rotted porch? Place the new one level with the first floor for a step-free entrance. Even if you don’t have to use a wheelchair or walker, your friends and relatives may, and they’ll thank you for it.
How to Do the Audit
To conduct your own access audit, take two weeks to observe yourself in the activities of daily living. Take notes, and be specific. List items that are broken, inconvenient, crowded, cluttered, noisy, unsafe, dark, hard to clean and harder to use. Invite friends and family members to offer their opinions; anyone who uses the house or knows you well can add to the list. After all, an accessible home is a “visitable” home too – user-friendly to those who visit as well as live there.
Now convert that list of problems to solutions. You’ll likely need outside help to see the possibilities right in front of you. Lots of professionals are out there, and their expertise, skills, and work styles can vary greatly, even within a single field.
While this list of helpers is long, you don’t need them all, and many will come out to the house at no charge (strange but true, it’s how the construction industry works). As you ponder all this new information, certain projects and priorities will become clear, and you’ll have a plan of action, as well as a team of design and building professionals who can help you implement it.
Now that you have conducted your access audit and identified solutions, your job is to enjoy seeing your dreams come to fruition. Construction is dusty and noisy – can you live offsite for a while? It’s also somewhat unpredictable, as plaster walls can conceal pipes and rotted wood that need to be addressed, so include a contingency in your budget. With realistic expectations, these issues are hiccups along the path to a longer and happier life at home.
With a roadmap for improvements, a supportive team of helpers and the knowledge that home remodeling can provide greater comfort, independence, and safety, it’s a wonder more people don’t take the plunge. The alternative to renovating is not to do nothing. The alternative is actually the cost of at-home care and take-out meals, or of moving to assisted living -- easily $4,000 a month for an indefinite period of time. Access improvements, beautifully conceived and artfully executed, can both expand the market as well as increase the value for future sales – a good investment. Like re-balancing the portfolio or updating a will, having an accessible home gives peace of mind, and it also brings more enjoyment to everyday living.
Deborah Pierce, AIA, is a principal at Pierce Lamb Architects in Newton, Massachusetts. She is the author of The Accessible Home: Designing for All Ages and Abilities (The Taunton Press, 2012).