Saturday, July 26, 2008


Home Modifications

Home modifications are changes made to adapt living spaces to meet the needs of people with physical limitations so that they can continue to live independently and safely. These modifications may include adding assistive technology (see the fact sheet on Assistive Technology for details) or making structural changes to a home. Modifications can range from something as simple as replacing cabinet doorknobs with pull handles to full-scale construction projects that require installing wheelchair ramps and widening doorways.

Other examples of home modifications include:

Grab bars in the bathroom (including by the bathtub, shower, and toilet)

Handheld, flexible shower heads

Handrails on both sides of staircases and for outside steps

Lever-operated faucets that are easy to turn on and off

Sliding or revolving shelves for cabinets in the kitchen

Walk-in showers
The main benefit of making home modifications is that they promote independence and prevent accidents. According to a recent AARP housing survey, “83% of older Americans want to stay in their current homes for the rest of their lives,” but other studies show that most homes are not designed to accommodate the needs of people over age 65

Most older people live in homes that are more than 20 years old. As these buildings get older along with their residents, they may become harder to live in or maintain. A house that was perfectly suitable for a senior at age 55, for example, may have too many stairs or slippery surfaces for a person who is 70 or 80. Research by the national Centers for Disease Control and Prevention shows that home modifications and repairs may prevent 30% to 50% of all home accidents among seniors, including falls that take place in these older homes.

The best way to begin planning for home modifications is by defining the basic terms used and asking some simple questions. According to the Rehabilitation Engineering and Assistive Technology Society of North America (RESNA), home modifications should improve the following features of a home:

Accessibility. Improving accessibility means making doorways wider, clearing spaces to make sure a wheelchair can pass through, lowering countertop heights for sinks and kitchen cabinets, installing grab bars, and placing light switches and electrical outlets at heights that can be reached easily. This remodeling must comply with the Fair Housing Amendments Act of 1988, the Americans with Disabilities Act accessibility guidelines, and American National Standards Institute regulations for accessibility. The work must also conform to state and local building codes.

Adaptability. Adaptability features are changes that can be made quickly to accommodate the needs of seniors or disabled individuals without having to completely redesign the home or use different materials for essential fixtures. Examples include installing grab bars in bathroom walls and movable cabinets under the sink so that the space can be used by someone in a wheelchair.

Universal Design. Universal design features are usually built into a home when the first blueprints or architectural plans are drawn. These features include appliances, fixtures, and floor plans that are easy for all people to use, flexible enough so that they can be adapted for special needs, sturdy and reliable, and functional with a minimum of effort and understanding of the mechanisms involved.

Visitability. Visitability features include home modifications for seniors who may want to entertain disabled guests or who wish to plan ahead for the day when they may require some extra help in getting around their own homes. For example, installing a ramp to the front door of a house and remodeling the hallways and rooms to allow wheelchair access would make a home easier to visit for disabled family members or friends. Such changes may also give seniors a head start on home modifications they may need later in their lives.
Before you make home modifications, you should evaluate your current and future needs by going through your home room by room and answering a series of questions to highlight where changes might be made. Several checklists are available to help you conduct this review. The National Resource Center on Supportive Housing and Home Modifications is a good place to start. Go to the center’s website at and click on the link to the “Safety Checklist and Assessment Instrument.” Once there, you can choose from the following options:

Checklist for Stairways, Especially for Homes—Includes tips for making trips up and down stairs easier and safer.

Housing Highlights: Home Modification and Repair—Offers an overall assessment tool for your home.

How Well Does Your Home Meet Your Needs?—Provides both general home evaluation questions and advice on how home modifications can make your residence a safer place to live.

Safety for Older Consumers: Home Safety Checklist—Suggests strategies for making home modifications and repairs and includes information on how to assess your home and yard.
In addition, Rebuilding Together, Inc., has an excellent home modification checklist on the Internet.

You can begin your survey by examining each area of your home and asking the following questions:

Appliances, Kitchen, Bathroom

Are cabinet doorknobs easy to use?

Are stove controls easy to use and clearly marked?

Are faucets easy to use?

Are there grab bars where needed?

Are all appliances and utensils conveniently and safely located?

Can the oven and refrigerator be opened easily?

Can you sit down while working?

Can you get into and out of the bathtub or shower easily?

Is the kitchen counter height and depth comfortable for you?

Is the water temperature regulated to prevent scalding or burning?

Would you benefit from having convenience items, such as a handheld shower head, a garbage disposal, or a trash compactor?
Closets, Storage Spaces

Are your closets and storage areas conveniently located?

Are your closet shelves too high?

Can you reach items in the closet easily?

Do you have enough storage space?

Have you gotten the maximum use out of the storage space you have, including saving space with special closet shelf systems and other products?
Doors, Windows

Are your doors and windows easy to open and close?

Are your door locks sturdy and easy to operate?

Are your doors wide enough to accommodate a walker or wheelchair?

Do your doors have peepholes or viewing panels? If so, are they set at the correct height for you to use?

Is there a step up or down at the entrance to your home? If so, is the door threshold too high or low for you to get in or out easily?

Is there enough space for you to move around while opening or closing your doors?
Driveway, Garage

Does your garage door have an automatic opener?

Is your parking space always available?

Is your parking space close to the entrance of your home?
Electrical Outlets, Switches, Safety Devices

Are light or power switches easy to turn on and off?

Are electrical outlets easy to reach?

Are the electrical outlets properly grounded to prevent shocks?

Are your extension cords in good condition?

Can you hear the doorbell in every part of the house?

Do you have smoke detectors throughout your home?

Do you have an alarm system?

Is the telephone readily available for emergencies?

Would you benefit from having an assistive device to make it easier to hear and talk on the telephone?

Are all of the floors in your home on the same level?

Are steps up and down marked in some way?

Are all floor surfaces safe and covered with non-slip or non-skid materials?

Do you have scatter rugs or doormats that could be hazardous?
Hallways, Steps, Stairways

Are hallways and stairs in good condition?

Do all of your hallways and stairs have smooth, safe surfaces?

Do your stairs have steps that are big enough for your whole foot?

Do you have handrails on both sides of the stairway?

Are your stair rails wide enough for you to grasp them securely?

Would you benefit from building a ramp to replace the stairs or steps inside or outside of your home?
Lighting, Ventilation

Do you have night lights where they are needed?

Is the lighting in each room sufficient for the use of the room?

Is the lighting bright enough to ensure safety?

Is each room well-ventilated with good air circulation?
Once you have explored all the areas of your home that could benefit from remodeling, you might make a list of potential problems and possible solutions. For instance, a typical list might look something like this:

I Have Difficulty ... It Would Help If I ...
Climbing the stairs Added sturdy handrails for support
Entering my home Installed an access ramp
Getting in and out of the shower Installed grab bars or a shower bench
Keeping my home at a comfortable temperature Installed air conditioning, fans, insulation, or storm windows
Keeping my balance in the shower or tub Put non-skid strips on the floor
Turning faucet handles or doorknobs Replaced them with lever or pull handles

Of course, all seniors have different needs, depending on the condition and design of their homes and their physical conditions. The following case study shows how home modifications can help seniors continue to live independently:

Case Study
George and Laura are both in their mid 80s and have lived in their ranch-style house in Texas for more than 30 years. Recently, George had a mild stroke that left him weak on his right side and required that he use a cane or walker to get around. Stairs were not a problem for George because the house was built on a single level, but he was finding it hard to get into and out of the shower and up and down from the toilet.
Laura arranged to have non-slip decals and a shower seat placed in the bathtub and grab bars installed in the bathroom walls. After that, George was able to use the bathroom much more easily because he had handholds for leverage when using the toilet, and he was no longer afraid of falling in the shower.

Many minor home modifications and repairs can be done for about $150-$2,000. For bigger projects, some financing options may be available. For instance, many home remodeling contractors offer reduced rates and charge sliding-scale fees based on a senior’s income and ability to pay or the homeowner may be able to obtain a modest loan to cover urgent needs. Other possible sources of public and private financial assistance include the following:

Home modification and repair funds from Title III of the Older Americans Act—These funds are distributed by your local area agency on aging (AAA). To contact your local AAA, call the U.S. Administration on Aging’s Eldercare Locator (1-800-677-1116) or visit the Eldercare Locator website at

Rebuilding Together, Inc., a national volunteer organization, through its local affiliates, is able to assist some low-income seniors with home modification efforts. To obtain more information contact your local area agency on aging or contact Rebuilding Together at 1-800-4-REHAB-9 of visit the website at: Click Here

Investment capital from the U.S. Department of Energy’s Low-Income Home Energy Assistance Program (LIHEAP) and the Weatherization Assistance Program (WAP)—Both of these programs are run by local energy and social services departments.

Medicare and Medicaid funds—Although these programs usually cover only items that are used for medical purposes and ordered by a doctor, some types of home modifications may qualify. To find out if Medicare will help to cover the cost of a home modification ordered by a doctor, call 1-800-MEDICARE (1-800-633-4227 or TTY/TDD 1-877-486-2048). You can also find answers to your questions by visiting the website at on the Internet.

Community development block grants—Many cities and towns make grant funds available through the local department of community development.

Home equity conversion mortgages—Local banks may allow a homeowner to borrow money against the value of his or her home and pay for needed improvements. The homeowner then repays the loan as part or his or her regular mortgage.
In fact, your local AAA can tell you more about whether you are eligible for any of these forms of financial aid or refer you to the agency that can answer your questions.

Seniors may also choose to bypass public assistance programs and hire a contractor to do their home modifications or even do the job by themselves. Keep in mind these points if you want to have a professional contractor come into your home to work on a large project:

Ask for a written agreement that includes only a small down payment and specifies exactly what work will be done and how much it will cost (with the balance of payment to be made when the job is finished).

Check with your local Better Business Bureau and Chamber of Commerce to see if any complaints have been filed against the contractor.

Make sure that the contractor has insurance and is licensed to do the work required.

Talk with your family and friends to get recommendations based on their experiences with the contractors they have hired. This step may actually be the most important one, because contractors with a good reputation can usually be counted on to do a good job.
The National Resource Center on Supportive Housing and Home Modifications has a guide with useful information on home modification resources across the country. Go to the center’s website at and click on the link to “The National Directory of Home Modification and Repair Programs” for a listing of what is available in the state where you live.

Mentioned as a resource throughout this fact sheet, the National Resource Center on Supportive Housing and Home Modifications (NRCSHHM), is one of the best sources for more information about home modifications. The center is a major clearinghouse for news on government-assisted housing, assisted-living policies, home modifications for older people, training and education courses, and technical assistance. It publishes fact sheets, guidebooks, and a newsletter.

USC Andrus Gerontology Center
3715 McClintock Ave.
Los Angeles, CA 90089-0191

The NAHB National Center for Seniors’ Housing Research offers the latest information about design features and products available through the home building industry. They are a repository for “smart-aging” residential design and are now training remodelers who are Certified Aging in Place Specialists in home environments that accommodate the needs of older persons with physical limitations and that assist family caregivers in their care.

NAHB Research Center, Inc.
400 Prince George's Boulevard
Upper Marlboro, MD 20774-8731

Rebuilding Together is the nation’s largest volunteer housing rehabilitation organization and the only national-level organizations that focus on the home repair and home improvement needs of lower-income homeowners. Through their partnership with the Administration on Aging, local affiliate chapters are working with area agencies and aging service providers to address the needs of low-income elderly.

Rebuilding Together
1536 Sixteenth Street, NW
Washington, DC 20036-1042
1-202-483-9083 or 1-800-4-REHAB-9

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