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Options abound to give seniors ability to age in place

Reducing fall risks a major concern

Sandy Gellis remodeled his State College condominium to be pleasing, purposeful and practical with the goal of living independently for another 20 years.

At 76, he jokes that the only thing he would do differently is add a second bathroom vanity sink for his new girlfriend. Gellis is among a growing trend of seniors who wish to “age in place” — retain independent living in a private home — by adding user-friendly features and retaining aesthetics.

According to AARP, older home owners overwhelmingly prefer to age in place, which means living in your home safely, independently and comfortably, regardless of age or ability level.

According to a 2017 HomeAdvisor report, 37 percent of homeowners reported having difficulties walking up stairs or reaching for cabinets as they age, and 41 percent said they’ve experienced a trip or a fall. Thirty-six percent said they count on help to do everyday tasks at home. Nearly half of owners 75 and older responded that they had prepared for aging with home renovations, but 15 percent did so only after their physical needs made their dwellings unlivable.

Too often an inability to lift a foot over a traditional tub/shower combination “forces a person into an assisted living,” said Lou Mihalko, president of Mihalko’s General Contracting. Each January for the past several years, he has noticed an uptick in inquiries from those who wish to add a first-floor bath or bedroom with common features, such as levered door handles, zero-entry showers and higher toilets.

Remodeling is a spectrum from user-friendly changes for an older resident to extensive renovations for wheelchair accessibility. Gellis’ renovations were more on the user-friendly side of the scale rather than full-accessibility modifications, according to Peter “Toby” Hood with Cisney & O’Donnell.

For Gellis, the firm:

– Created additional space in the toilet area and added a comfort-height seat.

– Created more counter space, and a taller height vanity with more storage.

– Eliminated a soaking tub and replaced an existing module shower unit with custom tile and a true zero-entry shower with a seat and a handheld shower.

– Improved lighting.

Hood said Gellis’ space could be modified for full accessibility compliance in the future if necessary.

The glass shower doors could be replaced with a curtain and grab bars could be installed as the walls were “fortified” during the remodeling.

Hood went through specialized training with an emphasis on helping seniors plan ahead for changes that come with aging and is certified for aging in place services through the National Association of Home Builders/Remodelers. For people with low-vision or balance deficiencies, Hood said installation of contrasting floor and wall colors help people differentiate their position in a steam shower environment.

Tim Ellis, NAHBR chairman, said those contemplating a remodel need to “design for future needs,” he said. It goes beyond easier bathroom access and extends to kitchens, hallways and home entrances with the goal to make the home design “the most versatile and easier to ‘age-in-place’ while considering the customer’s desires. Are they looking to remodel an existing space, are they thinking of moving mom or dad into their home? What are mom’s future needs down the road? Do they want to plan for using a walker or wheelchair?”

Remodeling to accommodate health and less mobility due to aging run the gamut in features and price points, local contractors said. A modest bathroom remodeling project costs an average of $15,000 to $25,000 and more homeowners are willing to make the investment in an effort to stay in their home within the neighborhood and community they enjoy.

“We try to give people all their options,” said Jason Leaper of J&J Remodeling/Multi-Service of Altoona.

Leaper and other contractors like Lou Kabello of Altoona confirmed a local, multi-year industry trend. Initially, a remodel project may spring from an aesthetic desire to refresh existing structures. Such was the case with Joi Cooney of Loretto who said she’s wanted to update her A-frame home for years. At 62, Cooney said she wasn’t prepared to fully address the accessibility issues Mihalko’s suggested.

“I had my heart set on a soaking tub — the kind with jets,” she explained. But she did concede to the placement of grab bars to ease her entry and exit from the tub. Her remodeled bedroom and ensuite bathroom is in the upstairs of her home.

However, when her mother, 86, scheduled knee surgery, accessibility at her mother’s home became a priority.

Lou Mihalko, president of Mihalko’s General Contractors, said most people think of stainless steel grab bars, but other changes can also reduce fall risks.

“Most people don’t prepare but wait until a health situation forces them into it,” he said. “People should pre-plan, but they don’t.”

Most older people run into accessibility problems in the bathroom, he said. The key to accessibility is planning ahead for the time when a leg can’t be lifted over and into a bathtub.

Immediately after the holidays, Mihalko and other remodelers said they see a spike in requests for bathroom remodels.

“Often kids from out of town visit over the holidays and become concerned about mom or dad or their aunt or uncle’s safety so they are the ones who start the discussion,” he said.

Often it takes a fall or another medical issue to prompt a discussion about making accommodations. While a complete bathroom remodel tops the list, other more gradual changes can be helpful.

For instance, levers instead of round door handles make a big difference for people who struggle with arthritis in their hands or who lose the ability to grasp a door knob or a faucet due to a stroke.

Other helpful and modest changes include brighter lighting in hallways and sturdy handrails, Mihalko said. Both can be made to blend and enhance existing decor.

Accessibility concerns aren’t limited to home interiors, said Shawn Warner of Altoona, who owns a general contracting and landscaping business.

“More and more, people want to eliminate exterior barriers,” Shawn said, such as multiple entryway steps, and they want to increase accessibility to enjoy the outdoors.

In his 16-plus years in remodeling, Leaper said he has seen an increased desire among homeowners to remain in their home. Looking ahead during the design process can be less expensive in the long run both in actual construction and in avoiding assisted-living or nursing home costs.

“It’s so much cheaper to address issues during the design phase than after construction when you have to go back and re-do it,” he said. Review doorway widths, transitions between thresholds and flooring materials.

Intergenerational living sees a resurgence

“The hardest thing to admit is we’re getting old and we need help,” Ellis said. “You’re trying to balance that reality and see that mom needs help. … We’re seeing more families combine households. It’s a lot cheaper than having someone come in and assist mom in her own house.”

The trend toward intergenerational living is seen in the 65- to 75-year-old demographic, he said.

Sometimes parents move from their two-story colonial-style home into an added on one-level suite with their children and grandchildren.

“It is becoming more common to see several generations living together in the same home. Some families do this for the benefit of sharing the cost of living expenses, and some families find this helpful when someone in the family needs care. Having the family members all in one household makes this situation easier,” said Lisa Moyer, a supervisor with Blair Senior Services Long Term Living program. “We are also seeing a great increase in the number of grandparents who are the primary caregivers for their grandchildren.”

Like many other communities, Altoona has many older homes that are two-stories with a single bathroom on the second floor. Older homes with narrower doorways make accessibility for a person who uses a walker or wheelchair difficult.

If a permanent first floor bathroom can’t be added, a portable commode may be a solution provided someone can take it up stairs for emptying. Another option could be a stair glide system to provide second-floor access.

“Often, they can’t make it upstairs easily to get to bed or out to the garage. Plus, the house is just too big to maintain, clean and keep up,” Ellis said.

Ellis has seen a significant uptick in requests for “mother-in-law suites” where he lives in Harford County, Maryland.

“We let (the homeowner) know that we’re not just designing to meet their mother’s needs today, but also to address their own needs in the future. They are creating a future where the son and daughter can then age in place,” he said.

This trend is fueled as families move less often and the cost of elder care rises.

He’s witnessed a son and daughter-in-law move back into the childhood home and live upstairs with an aging parent living on the first level.

While more expensive up front, the cost of building an addition is recouped within a few years — especially compared to an average nursing home cost of $10,000 per month.

“Municipalities are more willing to grant variances and assist in getting through the building permit process. They are getting on board.”

Programs offered

Blair Senior Services Inc. offers a variety of services to assist people in remaining in their homes, according to Supervisor Lisa Moyer.

– The OPTIONS program offers home delivered meals, personal care assistance (bathing, dressing and grooming), assistance with purchasing incontinence supplies and nutritional supplements, personal emergency response systems, and adult daily living program services, which assist with day-to-day tasks people may have trouble completing on their own.

– The Caregiver Support Program can provide caregivers with reimbursement for out-of-pocket expenses related to the care of their loved one, such as assistance with respite care and other costs that are not covered by some other programs, Moyer said. Limited reimbursement may be available for qualified home modifications and adaptive equipment not covered by insurance.

For grandparents raising their grandchildren, the Caregiver Support Program can offer reimbursement for some caregiving costs for the children, such as seasonal clothing, school supplies and extracurricular activities.

– For individuals who do not qualify for other programs, or need assistance in addition to what those programs can provide, the CHOICES program may be able to assist.

CHOICES is a private-pay program which can provide respite care, personal care, financial management assistance, housekeeping, shopping, medication management and nursing services, as well as more comprehensive care management services to individuals who need it.

“The CHOICES, Caregiver Support and OPTIONS programs can be used together to create a complete plan of care that can help the person remain in their home,” Moyer said.

– For individuals who require additional assistance, the Community Health Choices program may help medically and financially qualified people with multiple services which may help them remain in their homes. There are no costs to the consumer to participate in this program.

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