Aging in Place

According to AARP, almost 90 percent of people over age 65 say they want to stay in their homes as long as possible. The vast majority—63 percent to 80 percent depending on the study—believe their current home is where they will always live.

Most of those homes, though, are not built with older people in mind. However, stylish and cost-effective renovations are available that make it easier on people with arthritic hands and reduced mobility.

People just are aren’t asking for them yet. New Hampshire is an aging state. By 2020, NH residents age 65 and up will make up 20 percent of the state’s population, up from 13.5 percent in 2010. If those people choose to age in place, their homes will need to adapt to meet their needs.

When that time comes, builders and architects are ready. This fall also saw the creation of the first NH chapter of the National Aging in Place Council, which provides advice and conducts background checks on suppliers of goods and services to the growing market of older adults.

Kendall Buck of the NH Home Builders Association says many builders have taken the training to become Certified Aging in Place Specialists, or CAPS, but aren’t necessarily using those skills yet in NH. Architects are also increasingly likely to have attended classes that help them design or build housing that is suitable to people who expect to age in place.

Aging in Style
Forget about ramps and hallway rails. Universal design, is an architectural approach that seeks to create housing that works for people with a wide spectrum of needs without making a home look like an institution.

“Just because someone’s old, they don’t lose their sense of design,” notes Robert Kaplan, a partner in OK 2 Age At Home LLC, a Massachusetts-based contracting company that serves the needs of adults looking to age in place, including those in southern NH and the Seacoast.

He and his partner help assess and modify homes to allow for aging in place. In some cases this means installing ramps or grab bars, or constructing accessible bathrooms, but not always.

The first thing Kaplan looks for is to reduce the risk of falling, and that can be as simple as getting rid of a throw rug or trimming down a threshold someone could trip over. Among their projects was a simple but stylish railing that was added to the steps of a townhouse entrance.

Architect John Catlin, of Catlin and Petrovik Architects in Keene, has made a specialty of designing spaces for those with varying needs, namely senior centers. But he says the term “senior center” is now out of fashion. He builds adult community centers.

The fact remains, however, that the design has to consider older adults at various stages of ability—the go-goers, the slow-goers and the no-goers—as he puts it. The design features that meet these needs must be “inclusive yet unobtrusive,” he says.

“I’m really anti-ramp,” he says as an example. “Ramps single out people who are handicapped.”

Instead he looks to re-landscape to create entrances that are level with the ground.

Other tricks of the trade? Sinks can be built with a cabinet door underneath that moves out of the way so a wheelchair user can easily access the basin and taps. Lever door handles instead of knobs can be installed to make it easier for arthritic hands.

Instead of a railing in the hallway, he can add wainscoting with molding that has enough of a lip to provide an easy stabilizing support for someone whose balance is impaired.

Doors can also be made wider, hallways easier to negotiate and bathrooms can be built without a tub that requires someone to step over a large lip, and none of it has to look ugly.

Catlin also likes to incorporate what he calls “stealth exercise” features to help older adults remain fit and healthy. He pushes back against designs that eliminate stairs, saying the act of walking up and down stairs is valuable in maintaining balance, cardiovascular fitness and flexing hips, knees and ankles.

For active adults looking to build a space where they can age at home, he’d keep the stairs but build a full bathroom downstairs and create a “library” or other space that could serve as a first-floor bedroom if that becomes necessary.

If built from scratch, he says none of these design features are any more expensive than a conventionally-designed home. Renovations, while generally more expensive than new construction, can similarly be built according to the principles of universal design without being more expensive, but more depends on the existing structural features of the space.

Playing the Youth Card (For Now)
Gordon Cormack, owner of Cormack Construction in Madison, is one of those who got certified roughly seven years ago. “There’s very little demand for it,” he says.

“A lot of [my customers] are doing retirement homes, but they’re mobile and not thinking about it,” he says. He does see more interest in first-floor living. He says lever handles have become more popular than door knobs but largely for stylistic reasons rather than practical ones.

Yet when he’s made suggestions like avoiding steps at the front entrance, “that typically doesn’t fly,” he says. Accessible bathrooms also tend to get rejected unless there’s an immediate need.

Part of what’s at work is human nature, several people noted. No one wants to think about using a walker or needing a wheelchair. The first wave of the baby boom generation, (born 1946-1964) only started reaching age 65 in 2011, so many are still physically fit.

Catlin and others say, thus far, very little of their business is in NH. Though Catlin’s architectural partnership is based here, his work is overwhelmingly in Massachusetts, he says. Kaplan of OK 2 Age in Place, says he had two NH projects, one in Hampton and one in Windham, but his customers are predominantly in Massachusetts. More education may be required of the benefits and simplicity of these designs options before Granite Staters think to seek out these options, they said.

Jim Miller, a real estate agent with Coldwell Banker in Amherst, says he has built a clientele interested in 55-and-up age-restricted housing that now makes up 70 percent of his sales.

Miller, who sells homes to older adults, says he rarely gets requests for properties with accessibility features unless a member of the couple is disabled.

According to the Demand Institute, a nonprofit think tank run by the Conference Board and Nielsen, two-thirds of baby boomers who move remain in-state and more than half relocate within 30 miles of their current homes.

In NH, this trend is evident in the growing proportion of older residents. Whether retirees remain in the family home, move to an active adult community or relocate to an urban hub, they are looking to age in place.

“It’s going to be a wave that’s going to be affected. This generation and even those of us who have to care for seniors,” said Darlene Pearl, of Merrimack Mortgage, who along with a friend Gayle Davis of Senior Helpers of the Greater Seacoast, launched the NH chapter of the National Aging in Place Council. “We’re excited. It’s just something we know is needed.”

But those whose job it is to plan ahead—like state and local officials—are worried, in part because housing is only one of many issues that has to be addressed if people are going to age in place.

The National Conference of State Legislatures along with the AARP Public Policy Institute did a 55-page report looking at the need for state livability policies and practices.

Before even considering aging at home, people need to look at their options for transportation, access to doctors and health care services, personal finance, as well as their ability to stay engaged in community and social activities.

For people like the founders of the NH Aging in Place chapter, architect John Catlin or OK 2 Age at Home’s Robert Kaplan, the opportunity to create the environments that allow people to age with dignity at home is a calling as much as a job.

For Catlin, his interest began when he was a young man accompanying his mother on volunteer visits to the elderly and disabled.

After a successful career as a conventional architect, he wanted to use his skills to contribute to the greater good and began taking on projects serving the elderly.

Kaplan, similarly, moved into this field after a previous career in marketing. “I thought this was a great opportunity to give back,” he says. “I look at this as the best part of my life to use all my skills to help other people.”

It may take a while, and some educational outreach, before older consumers start demanding the designs and services that are part of a successful plan for aging in place, but as every single person interviewed noted, the demographics in NH are clearly on their side.

SEVEN PRINCIPLES OF UNIVERSAL DESIGN:

1. Equitable Use
The design does not disadvantage or stigmatize any group of users and is marketable to people with diverse abilities. For example, using levers as door handles.

2. Flexibility in Use
The design accommodates a range of preferences and abilities such as left or right-handed use and provides a choice in methods of use.

3. Simple and Intuitive Use
The design is easy to understand, regardless of user’s language skills, visual acuity, muscle strength or concentration level. Such as toggle light switches.

4. Perceptible Information
The design communicates necessary information using pictures, audible or tactile methods such as pictorial signage or beeping crosswalks.

5. Tolerance for Error
The design minimizes hazards or adverse consequences from accidents or unintended fatigue such as even flooring without thresholds.

6. Low Physical Effort
The design can be used efficiently and comfortably and with a minimum of fatigue.

7. Appropriate Size and Space
The appropriate size and space is provided for approach, reach, manipulation and use, regardless of the user’s body size, posture or mobility level such as a 36-inch wide doorway.