June is a widow living in Colorado. Her home is a traditional two-story colonial with a lovely porch and a spacious backyard. June raised two children in her home with her husband Bill. He passed away three years ago. June is retired and lives an active life filled with volunteering, social occasions, and travel. Recently, she’s had a health scare that got her thinking about the future. She would like to stay at home as she enjoys her retirement, but she knows it might not be safe to live in her beloved house. She is hoping to find a way to stay at home that will not be too costly. She wonders if the cost of aging in place is doable on her small retirement income.
What is Aging in Place?
According to an AARP study, 90 percent of people age 65 and over would prefer to stay in their own homes as they age. Aging in place is defined by the U.S. Centers for Disease Control and Prevention (CDC) as “the ability to live in one’s own home and community safely, independently, and comfortably, regardless of age, income or ability level.” The important words are safe, independent, and comfortable. Many residential buildings were not constructed to accommodate the unique needs of older adults. To age in place successfully, older adults like June and their families should discuss what can be done to make the home and community safe and comfortable not only for the present but also for the future. For more information, read our blog post on the ins and outs of aging in place.
The Cost of Aging in Place
There are costs to aging in place that June must consider in this important decision. The largest expenses come in two parts: the ongoing costs of utilities and property taxes and maintenance and the likely need for some one-time home modifications. Other costs to consider may include those for personal caregivers, in home health care, and security and related devices. The more planning June and her family can do now, the more successful she will be at aging in place.
Universal design is a concept for building, designing, or remodeling a home so it’s more comfortable, convenient, safer, and easier for people of all generations, including older adults.
It is about creating an attractive, stylish home that everyone, regardless of age, size, or ability, can live in or visit, now and in the future. Very few existing homes have encompassed universal design. Hence, the possible need for modifications to the majority of homes that will include some of the concepts of this design.
The most likely modifications to accommodate an older adult aging in place include items like : :
- Removal of tripping hazards on floors
- Bathroom changes
- Door widths and pull down handles
- Stair lifts
- Kitchen modifications
- Security systems and related in-home technology
June’s two-story home may need some modifications. Although she is very mobile right now, she may have difficulty in the future. The stairs may become dangerous for her to climb; installing a chair lift should be considered. . Also, installing grab bars and non-slip skids in the bathrooms is critically important, as is a walk-in shower. Is there a bathroom on the ground floor? Handrails should be installed on all steps. Often, wheelchair ramps over outdoor steps is a great option. Widening doors and lowering counters may be important if June needs a wheelchair in the future.
The cost of aging-in-place home modifications can be expensive, but these modifications are usually not any more costly than a typical home renovation project. Retirement Living has provided some average estimates on the most popular modifications.
- Walk-in Tub or Shower — $5,000
- Ramp Installation at Entrance — $1,113
- Widen an Entry Door — $800
- Stair lift Installation — $8,000
- Install Entry Handrails — $800
- Remodel Bathroom — $14,000
- Kitchen Countertop Height Adjustment (to accommodate wheelchair) — $18,000
For more information on aging in place home modifications, read our post, Home Modifications for Seniors Aging in Place.
Aging in place also means keeping seniors healthy and happy at home. That’s where home care and home health care services can help. Home care services provide seniors assistance with the instrumental activities of daily living (IADL), such as housekeeping, laundry, cooking, and design. These services can also provide transportation to appointments and help with medications. If a senior needs more personal care, home care services can help with bathing, dressing, eating, and mobility. These more hands-on services are called activities of daily living (ADL).
In addition, home health care professionals can be hired to help seniors at home with certain medical treatments and services. These caregivers are medical professionals and can provide:
- Physical and occupational therapy
- Administration of prescription medications or shots
- Medical tests
- Monitoring of health status
- Wound care
June may want to keep her independence, but everyone needs help once in a while.
She should think about her future personal and medical needs. Right now, June is completely capable of taking care of herself, but she has witnessed how her neighbors have slowed down and are having trouble doing the daily tasks that were so simple before. Her volunteer group delivers meals to elderly neighbors who are too frail to cook for themselves. What would she do if she was unable to cook for herself? Also, her daughter worries about June going to doctor appointments alone and taking her medications correctly. What if there comes a time when she needs more medical care?
According to the 2019 Genworth Cost of Care Survey, the average hourly rate for home care in Colorado is $26.00. The statewide average cost for home health care is about the same. Your total cost will depend on the amount of time the caregiver spends with your loved one and the services they provide.
For peace of mind, June and her family may want to update the security of the home. This could include smart doorbells, security cameras, emergency response pendants, and alarm systems. Much of the technology available today is relatively inexpensive and non-intrusive and well worth the cost.
June feels safe in her neighborhood, but her daughter insists on installing a smart doorbell and security cameras just in case. The decision about wearing an emergency response pendant is not necessary at the moment, but June is not opposed to wearing one in the future.
The cost for aging in place security could be as much as:
- Kitchen Home Automation — $6,000+
- Living Room Home Automation — $3,500+
- Bathroom Home Automation — $2,500+
- Bedroom Home Automation — $1,000+
- Sensor Light Installation — $350 – $500
- Home Security System — $15 – $70 (per month)
Certified Aging-in-Place Specialist
There are professionals who can help with these decisions. A Certified Aging-in-Place Specialist (CAPS) can help seniors like June navigate the decisions needed in planning to age in place. These professionals understand the unique needs of seniors as they age and are knowledgeable about the strategies to keep them safe at home. The certification program was developed by AARP, in partnership with the National Association of Home Builders. CAPS are often remodelers, designers, and architects familiar with making homes accessible and safe for seniors.
June met with a local CAPS who recommended a home renovation plan tailored to her house and needs. They also helped the family prioritize the list to save some costs until later. The consultant also helped them find an affordable licensed contractor familiar with universal design practices and recommended the best fixtures and elements for the renovation.
It’s important to know that CAPS are not medical or health care professionals. They are construction and design experts. CAPS can charge by the hour or by the project. These professionals may be worth the expense if the home needs a lot of work to make it safe.
Saving Money While Aging in Place
The median household income in Colorado for those 65 and older is just a bit more than $50,000, putting the state just outside the top 10 states’ older adults’ income levels. However, the state’s health care costs and cost of living are often higher than in many other states.
June and her family will save money by planning ahead so that they have the time to find the best vendors and the best deals. She will also designate the Health Savings Account she amassed while working to pay upfront for the cost of aging in place. But many seniors do not have the income or savings to cover the costs of aging in place. How can they save their limited resources and still stay home?
There are agencies that can help. Many are listed as providers on AgeWiseColorado.org
Every state has Area Agencies on Aging designed to provide services for older adults, in particular those at lower income levels, in any given geographical area.
Medicare and private insurance plans may cover some home health care costs when the services are prescribed by a doctor. Medicare will not pay for most in-home care. Medicaid covers both types of care for income-qualified seniors as long as certain conditions are met. The state of Colorado mandates that home health care services can be paid by Medicaid for a maximum of 60 days unless the older adult is approved by the Options for Long Term Care agency for long-term care. Medicaid will also cover the cost of some home modifications. Personal home care services will only be paid if the senior is receiving home health care services. If the older adult is a veteran, the Veterans Administration offers plans that will help pay the costs of aging in place.
Long-term care insurance is designed to cover the costs of nursing home care, assisted living, and home health care. These plans may not cover personal home care unless there is an allowance for non-medical services. Benefits vary depending on the plan and when your loved one purchases the policy. Premiums are lowest when the plan is purchased while a person is healthy and relatively young (50-60 years old). Older adults with health issues may not qualify for long-term care insurance.
With some planning, older adults like June can enjoy the many benefits of aging in place for many years and her family will have peace of mind knowing that she is safe and living where she wants to live.