Aging in Place: How seniors are living safely in their homes for longer

More than a quarter of U.S. households are headed by someone 65 or older, a number that keeps growing; 77% of Americans over 50 want to remain in their homes as they age, according to AARP.
What demographers call the Silver Tsunami presents a growing need for modifications that let people live safely in the comfort of their houses for longer. Across New Jersey, a number of companies have come up with ways to help them do just that.
"I think it's absolutely critical to have seniors stay comfortable in their home as long as possible, because the data shows that there are better health outcomes," said Liz Rabban, co-owner of TruBlue Home Service Ally, based in Morristown and Montclair, New Jersey.
"And so for all of the reasons you would imagine why somebody wants to stay in their home, I think that building the support system for them to stay where they are is important," Rabban said.
For these services, she said, it's not just about finding somebody who will perform the necessary renovations; homeowners need someone who will put in the effort to truly understand each person's needs.
The sentiment was echoed by Linda Pollock, owner of North Jersey Maintenance Group, who said it's important to find a company with adequate training to handle these projects.
"There are companies out there that say they do Aging in Place services but don't have the training to really understand what seniors and individuals with disabilities really need," she said. "My goal is not to get rich on any individual client. I don't charge very much for my services because I want people to be safe and it's a true passion of mine."
In general, Pollock said, it's best to prepare your home for aging in place before you get into an accident or urgently need modifications.
Saverio Nestico is the president of Philadelphia-based SPN Cos., which does home modifications including bathrooms, kitchens, ramps and lifts for stairs and wheelchairs. The business helps clients across New Jersey, Pennsylvania and Delaware.
The first step typically involves an assessment by an occupational therapist, Nestico said. Often, it's prompted by a medical event that necessitates accommodations. The therapist will recommend ways to make a home safer and more accessible.
"The occupational therapist will go to the home and identify what's needed for the individuals," Nestico said. "We then take those recommendations and go out there, assess the home, take photos, measurements, speak to the individuals, understand what they're needing to accomplish.'
Both Rabban and Pollock said that before doing anything, they always complete home assessments to get a true feeling for what residents may be struggling with. They watch individuals go up stairs, see how they navigate bathrooms and observe how they get to things that are otherwise out of their reach. From there, they'll move on to making the necessary modifications.
Debbie and Charles Gibbs have begun the process. They moved to Lawrence Township to be closer to their daughter and son-in-law about a year ago. They appreciated the area's proximity to high-quality medical care and the international character of nearby Princeton.
But living comfortably in their Colonial, which has two floors and a basement, required some extra work. The couple recently had an elevator installed. Debbie, 71, said it was a proactive move.
"I have rheumatoid arthritis, and stairs are hard. We knew eventually I'd need it," she said. "I've never lived dependent on others, so the elevator gives me independence."
Now the former educator and current mixed media artist won't have to rely on her husband "to carry laundry or heavy things." That includes the tree branches, sticks, canvases and other assorted materials that she uses in her creations that line the walls of the house.
Finding the right company to install the elevator was crucial, Debbie said. "I didn't want to hire a contractor to do one part and then find someone else to do another," she said. After researching online, Gibbs found Mobility 123, a Garden State company that advertises comprehensive solutions and "turnkey" operations, handling everything from permits to construction.
Leon Fischer founded Lakewood-based Accessible Homes after noticing that many people who left hospitals and care facilities needed modifications to return home safely. His mission is to make homes more accessible and 'senior-friendly,' he said.
Falls are a leading cause of injury for seniors, says the National Institute on Aging. That's why Fischer advises people to secure rugs with nonslip pads and to ensure that paths are clear of clutter as first steps in making homes accessible.
Adding handrails and grab bars in critical areas such as bathrooms, along staircases and in hallways would be next in reducing fall risks, Fischer said. Lighting is another quick and easy enhancement that is often overlooked, he added: Motion-sensor lights for hallways, staircases and entrances can go a long way toward mitigating accidents in the home.
A final note from the experts when it comes to falls: Wearable smart devices can monitor heart rates and sleep patterns and detect falls. They can also alert emergency services if necessary, advises AARP. Devices like Google Home or Amazon Echo allow seniors to control lights with voice commands, They can also lock doors and operate televisions.
Both Pollock and Rabban said their services are broken into two categories: maintenance and modifications.
"When it comes to maintenance, you don't think of that as senior safety," Rabban said. "But when you think of seniors having to get up on a ladder to change their smoke detector batteries and things like that, it is."
Each of their companies offers programs in which they will come to their clients' homes four times a year, or as needed, and perform routine maintenance. That involves things like changing old filters and batteries in smoke detectors, among other tasks.
Common remedies include grab bars and railings, improved lighting and nonslip flooring, as well as switching out bathtubs for walk-in showers and widening doorways to make them more accessible. But there are a variety of other modifications that can be made for those looking to age in place, depending on needs.
"When I say 'senior,' there's a very big spectrum. There's a really big difference between somebody who's 65 and somebody who's 85. so the needs for people are different," Rabban said.
In some instances, Pollock has also added lockboxes to properties so that if the homeowner does fall or have some other accident, and they don't have family nearby, first responders can easily gain access to the home. Similarly, she has installed baby cameras so live-in help or relatives can keep track of seniors as they move around their home for further peace of mind.
"If they have the choice of being able to stay in their home or going to assisted living, there are pros and cons to both. But overall, I think seniors want to stay at home because they're comfortable where they are," Pollock said. "Seniors should be able to stay in their home if that's what they choose, so having services available that help make their spaces safe is important."
Costs and timing vary significantly.
Simpler installations like grab bars range from $100 to $200. In terms of timelines, the most basic jobs like adding aluminum ramps, widening a doorway for a wheelchair or installing bars and a nonslip floor in a shower can be done in a day.
Nestico said transforming a bathroom to be fully accessible might involve "redoing the surroundings to accommodate a roll-in shower or a walk-in tub, which can cost upwards of $10,000 to $12,000." The job typically takes two to three weeks to complete depending on the extent of the modifications and the need for custom solutions.
Home elevators are among the most complex modifications, often requiring extensive planning, structural changes and lengthy time frames.
"Comprehensive projects like installing an elevator start around $35,000, including all necessary construction and permits, and can take several weeks to months, depending on the complexity and the specific requirements of the building codes,' said Ryan Penn, owner of Mobility 123.
Mobility 123 grew out of Penn's father's durable medical equipment company, Diamond Scooters, which sold scooters and wheelchairs in the early 2000s. The business now focuses on more extensive modifications like elevators. The company operates from three locations, in Absecon, Tuckerton and Hillsborough, and serves New Jersey, parts of Connecticut, and Philadelphia.
The cost of Debbie and Charles Gibbs' three-stop elevator exceeded $60,000 due to additional construction and enclosing the elevator shaft, said Charles, 74.
He emphasized the need to plan ahead financially: "We thought it was smart to do this while I'm still earning some money, rather than waiting until later."
Accessibility modifications often can be partly financed through tax incentives, Medicaid programs, private insurance and veterans' benefits, said Tom Beck of Mobility 123, who also highlighted specific state resources.
"In New Jersey, Medicaid typically covers about $5,000 for something like a stair lift and recently increased coverage to about $15,000 for prescribed needs," he said. The Department of Veterans Affairs "also offers grants for veterans, even if disabilities are not service-related."
The Internal Revenue Service allows deductions for modifications deemed medically necessary. Eligible projects include widening doorways and hallways, installing ramps, adding grab bars, lowering countertops and adding stair lifts. To qualify, modifications must address a medical condition. Only expenses exceeding 7.5% of adjusted gross income are deductible, says Lifeway Mobility, a home accessibility company.
Medicaid coverage varies by state. In New Jersey, some home modifications can be covered under the Managed Long Term Services and Supports program, says the state's Department of Human Services.
Private health insurance coverage for such work differs significantly among policies. But some may cover prescribed modifications, so Penn suggests exploring both insurance and state aid programs.
Traditional Medicare typically doesn't cover home modifications, its website says. However, some seniors with prescriptions may get limited coverage for enhancements like wheelchair ramps or walk-in tubs, says The Senior List, an online resource for older adults.
Veterans with disabilities may also be eligible for grants through several programs, including the Specially Adapted Housing Grant for extensive home renovations and the Home Improvements and Structural Alterations Grant, which covers medically necessary projects like ramps and bigger doorways, says Rosarium Health, an accessibility company.
Debbie Gibbs encouraged homeowners to start the process early.
"From looking into an elevator to having it installed took about six months, mostly due to permitting and ordering," she said. "Planning ahead made it manageable."
This article originally appeared on NorthJersey.com: Home renovation tips for seniors looking to stay in family homes

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Medicaid handouts only create dependency. Able-bodied adults should work.

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