Slowed by arthritis and worsening foot and ankle problems, Gary Blankenburg, 73, is becoming less mobile as he ages.
As stairs grew more difficult, he and his wife Jo, 55, considered selling their two-story Sparks house built in 1922. But years of hunting failed to yield a housing option they loved as much as the three-bedroom home where they had lived for 24 years.
While many older homeowners often downsize to a place more suited to seniors, more and more retirees are staying in their lifelong homes, thanks to smart planning and key upgrades.
A few months ago, the Blankenburgs contacted Brian Brock and Jerry Maenner of Federal Home Solutions, with offices in Timonium and Westminster. The company is one of many in Maryland that specialize in modifying homes so people can stay as long as possible as they age.
For the Blankenburgs, the main change was creating a small bedroom and full bathroom on the first floor so Gary doesn't have to navigate the stairs. The bathroom has a shower stall with no edge, so a wheelchair can be rolled in. Gary doesn't use a wheelchair yet, but they're planning for the future.
"One of the goals for me was not to make it very institutional-looking," Jo says. "As much as possible, I wanted to fit with the flavor of the house."
As "aging in place" gains popularity, more homeowners are working toward the same goal.
The couple are also planning to build a deck in the back so Gary can get outside easily for fresh air and "to smoke his nasty cigars," says Jo, without worrying about the two steps in the front of the house.
"It's really not about the grab bars and stair rails," says Stephen Hage, owner of Strategies for Independent Living, a Takoma Park-based home contractor that specializes in aging. "What the family needs is some way of continuing on the best they can with their life."
Though every house is different, and each occupant ages in his or her own way, here are a eight ideas to consider.
Do your research
Start by finding a contractor with Certified Aging-in-Place Specialist (or CAPS) training from the National Association of Home Builders. Talk to several. Invite those you like for an in-home consultation.
"I strongly believe that having the client, primary caregiver and health care professional meet in the home with the contractor is beneficial, especially for people with progressive illnesses or those that may occur after an injury," says Brian Brock, owner of Federal Home Solutions, a CAPS contractor with locations in Timonium and Westminster.
Be wary of products that do not meet Americans with Disabilities Act standards, such as grab bars affixed with suction cups, says Bruce Cornwell, who owns Safe at Home Repair in Rockville with his wife, Michele.
Look for 'universal design'
One phrase you might hear a lot as you begin this process is "universal design," which refers to a house that is safe, attractive and comfortable for people of varying ages and abilities. Features could include single-floor living, wide doorways, multilevel kitchen counters and easy-to-reach switches and outlets. Incorporating all universal design elements in an older home is probably not practical, but it doesn't hurt to keep the standard in mind.
Bigger, less slippery bathrooms
As people get older, bathrooms are considered a major trouble spot, with high risk of slips and falls.
Space in a bathroom is important, particularly if there needs to be room for a wheelchair or caregiver, says Louis Tenenbaum, founder and president of the Aging in Place Institute in Potomac.
A higher toilet (16-18 inches off the ground, instead of the standard 14-15 inches) is easier to use, and grab bars can reduce the risk of falls. Consider using grab bars that can fold out of the way when not in use, Tenenbaum says.
Another way to add space to an existing bathroom is to replace the bathtub with a shower, he says. One option is a no-lip shower stall that can accommodate a wheelchair or walker.
Cornwell sells GatorGrip "peel and stick" traction mats, which he says are more secure (and less slime-prone) than removable mats.
4. Move downstairs
To make a home as easy as possible to navigate, consider moving the master bedroom downstairs. When possible, opt for open spaces over small rooms and narrow hallways.
Eliminate hazards such as throw rugs or excess clutter. Install railings on both sides of any stairs. Make sure there's plenty of lighting in the hallways. Tenenbaum recommends soft lighting between the bedroom and bathroom, eliminating the shock and glare of going from darkness to bright light.
Think about how you live inside the home, he suggests. Ask yourself: Are clean clothes within easy reach? Is laundry manageable? Is cooking? Is there a comfortable chair with bright lighting for reading? A desk with bright lighting for paying bills?
CAPS-trained contractors look closely at transitions between rooms. Thresholds, which can be trip hazards, can be eliminated or covered with gentle ramps, Hage says. Monochromatic rooms may be attractive, but they can be confusing to older eyes. Use contrasting colors to indicate transition from one room to another, or to show the edge of a countertop or the top of a staircase, he advises.
5. Furniture with function
Getting in and out of beds and chairs can be challenging for aging joints and muscles, so Tenenbaum recommends electric beds that can be raised or lowered, and chairs with spring or electrical tilt mechanisms.
To provide support for getting out of a bed or chair, a SuperPole, which extends from floor to ceiling, can be installed and moved easily, he says. For people who need more help, he suggests a motorized ceiling lift since it takes up virtually no space.
6. Kitchen solutions don't have be costly
In the kitchen, making the countertop lower in some spots creates space for a wheelchair or for a person to sit while preparing foods. A simpler solution is to purchase a cutting board that can be used at the kitchen table, Tenenbaum says. Hage suggests putting the dishes that are used most frequently in cabinets that are easy to reach, ideally 18 to 48 inches off the floor. Consider investing in cabinets with pull-out drawers and trays, Tenenbaum says. As in other rooms, adequate light is important, he adds.
7. Think outside as well as inside
Front walkways pose special hazards, particularly if they have steps. Ramps can be built in some circumstances, but they can detract from resale value and are not always practical, says Hage. "If the door is three to four feet off the ground, you'd need a 60-foot ramp."
In some cases, a motorized lift makes more sense. Or a window at the back of the house can be converted to a door with a ramp leading up to it, Brock said.
Other ideas: Install motion-sensor lighting that illuminates the walk, remove loose bricks and smooth out uneven surfaces, and create a "package shelf" for the homeowner to put down a handbag or groceries without having to stoop to pick them up. Cornwell also recommends a railing on both sides of the stairs, and a grab bar between the storm door and the main door.
And don't forget: Lawns need mowing, driveways need shoveling, gutters need cleaning and so on. Brock recommends finding people who can do these tasks when the homeowner is no longer able to. On the other hand, if you like gardening, you might be able to stick with it longer if you switch to raised beds, Tenenbaum said.
8. Find ways to stay in touch
We're all familiar with the old television commercials for Life Alert, with the famous despairing cry, "I've fallen and I can't get up." Monitoring systems have gotten more sophisticated, no longer requiring any action on the part of the person who needs help, Tenenbaum says.
A company called BeClose in Vienna, Va., for example, combines the alert button with wireless sensors throughout the home, so caregivers and loved ones can track the routines of people inside the home, such as whether they are using the bathroom more or opening the refrigerator less.
Also, consider forming relationships with neighbors who can check on you regularly, and seek out transportation alternatives if you can no longer drive.
"People want to stay in their homes," Cornwell says. "Sometimes, one little thing will make a big difference. People will say to me, 'I don't know how I got along without stair rails.' "