Aging in place home parameters

  • Active since 1995, Hearth.com is THE place on the internet for free information and advice about wood stoves, pellet stoves and other energy saving equipment.

    We strive to provide opinions, articles, discussions and history related to Hearth Products and in a more general sense, energy issues.

    We promote the EFFICIENT, RESPONSIBLE, CLEAN and SAFE use of all fuels, whether renewable or fossil.

Poindexter

Minister of Fire
Jun 28, 2014
2,821
Fairbanks, Alaska
I have spent a fair bit of time on this. The wife and I are both late 50s with the kids gone, looking at what our next/ last home needs to have. I am sure I have overlooked some stuff.

FWIW I am a 25 year RN, I have been working with shut-ins, the homebound, for the last 5 years or so. Home Health Nurse in US parlance, that would be a 'district health nurse' in the UK. The wife and I are both in good enough baseline health to expect most likely both of us will be using walkers before we kick the bucket, and a 50-50 shot for either of us to be wheelchair bound before we get to go home to Jesus.

The main break point I see is 'independent at home.' That is one spouse working, the other able to be at home alone for extended periods. The four things I have seen over and over are for the one at home to be able to get from the bed to the bathroom to the kitchen and to a vehicle. We are looking for a 3 bedroom/ 2 bath ranch, all one level, with enough room in the garage to build a ramp at 1:12 slope and still fit a vehicle.

The fundamental problem with most bathrooms in the USA is the toilet is too close to the bathtub. Once you (I, we, the patient, whatever) ; once 'you' need a walker to get into the bathroom, and a shower bench to sit down on before you slide over the bench into the tub, the darn throne is too close to the tub.

For the bath, if we start with a tub, throne and double vanity we could probably drop to a single vanity, move the throne over away from the tub and move on. If someone has a big stroke and needs a slider transfer bench for both the commode and the tub this won't be enough room.

Certainly this is a moving target. I have plenty of patients so hard to move that it is just easier to bring in a third party to give them a bed bath, compared to using a crane to pick them up and then roll the crane into the bathroom, these folks are usually not safe to leave at home alone for several hours in a row. Folks in powered wheelchairs too, usually, but not always, just more efficient to provide a bed bath rather than transfer in and out of the tub.

So for independent at home we are looking for the following- but I am real curious to know what I might have overlooked.
1. 3/2 ranch, all one level. Master bedroom and two offices while the wife and I are still independent. Could provide a room to a live in caregiver in the future if needed.
2. 1:12 slope ramp, preferably in the garage for all weather usability, for vehicle access by wheelchair or walker.
3. outdoor patio or deck wheelchair accessible from main level
4. one ADA bathroom, aka the tub and shower bench wheelchair accessible
5. large enough kitchen to get in there with a wheelchair, open the fridge, grab prepared food, heat it in a microwave while still in the wheelchair, and then a spot at the dining table to roll up to.

Nice things would be
1. a sink in the bathroom with no vanity under it so a fella could brush his teeth or shave without having to twist a whole lot.
2. Minimum 38" (3-2) doors throughout. I like 3-6 (42") doors better for wheelchair use. I don't know how many thousands of dollars I have been paid in the last 5 years taking care of skin tears on the backs of the hands of folks whose doors are really too narrow for wheelchair use, but it is too many thousands. I got a nice boat, but I don't like profiting from preventable stuff.

This is where you guys come in. In 25 years of practice, the number of patients I have met with a life goal of moving in to Shady Acres Rest Home is zero. Zilch. Nobody wants to go. Our bathrooms are too small, our doorways to narrow, and our homes have too many stairs. I have a reasonable number of folks on my census who can get from bed to bath to kitchen, but they can't get to the garage and instead need the fire department to come carry them out of the house, and then come back to carry them back in after they go see a doctor.

I did look at buying a wheelchair accessible minivan a couple years ago, probably 2019 or so. I can't make the money work. Even staying within the ethical limits of my job and just advertising on facebook and craigslist without my name on it, getting a chairbound individual into the minivan takes time, and time is money. If I was paying a driver $15/ hour with no benefits and keeping the vehicle in a heated garage so it would last, I would have had to charge $200 or so round trip to take one individual round trip to one doctor appointment. And good luck finding a good driver willing to work on call for $15. How long does it take you to get into the cab and shut the door when you are travelling? Do you buckle your own seatbelt? In a more moderate climate I could dispense with the heated garage, but the problem remains that each fare needs a roundtrip, not a one way.

Appreciate your thoughts here, many of you have aging parents and may very well have seen something I haven't.
 

clancey

Minister of Fire
Feb 26, 2021
2,392
Colorado
This is the problem that I am having right now and over a 25 year period have built up this tiny tiny house to make it comfortable for me when I get "old"--glad I have done this and that's one of the reasons that the thought of moving is giving me difficulty here. If you have support and help from your family you are very very fortunate for we all need a support system. But if you are completely independent you have problems because people now a days only have time for themselves and their family--there are no "charity" moments here no more.. You could work for a person as a cleaning lady for 15 years and a all around gal--store shopping and trips to the different places and different restaurants to eat food so that they can get out and "feel the air" so to speak--a change of scenery in their daily lives and its when you try to talk them into having a surgery that would take the pain away from their mouth and jaw with nerve damage (neuragia--(sp here) and after the long spill about how good it would be for them---they argue with you and ask " "Who are you?"---meaning not family but just a "clean up lady"...That hurt...Yea all of this is depressing thought but its the reality that we all will face "someday" and its comes quick too....Time moves quicker now a days it seems. Thank you for that "heart felt posting" that really said "something to me and all those things that you pointed out are "wonderful" with full impact thinking that was involved and all I can say is: "You are not alone" for "worldwide" --people are facing the very same fact of being older and less able to do the things that we once did with ease and they have to depend on people with different sorts of help like lifting heavy boxes and stuff like that when they are around and willing and able to do these things just to satisfy a "senior" person and make their day a little bit more happier especially when they are low on cash and cannot afford to pay a helper all the time. You raised some very important points thank you..clancey
 

EatenByLimestone

Super Moderator
Staff member
What about home on slab? You may not need stairs to get inside, and therefore no ramp needed. Then you don’t need a special deck/patio either.
 

FramerJ

Member
Mar 18, 2021
64
Missouri
Are you going to build or buy? I cant imagine too many current homes out there with the space to retrofit 38" doors everywhere and not to mention very expensive. Like Limestone mentioned above, you could build on a slab or have a zero-entrance home built. I have framed a few of these the last couple of years. Basically the main floor is set flush with the top of the foundation instead of on top of the foundation-so no steps anywhere. If you move somewhere with tornadoes, you might look into having a safe room built.

Dont forget a laundry on the main level.
Raise all outlets higher off the floor. Standard height is approx 14" so maybe 20" for less bending over
Upper kitchen cabinets should have low handles and they make shelving inserts that actually fold/lower down to be easily accessible
Speaking of handles, you may want door levers instead of round door knobs. These are more likely to catch on things but much easier to open
 

begreen

Mooderator
Staff member
Nov 18, 2005
96,422
South Puget Sound, WA
We're a couple of decades ahead of you and definitely thinking more about this. Gardens are important to us so our primary garden is set up to be wheelchair friendly.
I don't think a ranch design is the best for heating. My preference is for a more open and squarish floor plan. Design for low maintenance and consider the effects of climate change on the region in the next 30+ yrs.
As much as you plan, life may throw a monkey wrench in the plans. There are all sorts of things that will happen along the way that may require rethinking options. Our house is 2 stories, our property is sloped, and I have a bad knee, but we persist. My office is on the first floor and may eventually become a bedroom. FWIW, having a great neighborhood and neighbors is as important as all the planning in the world.
 
Last edited:

Poindexter

Minister of Fire
Jun 28, 2014
2,821
Fairbanks, Alaska
Haven't decided where we are going yet. I kinda like climate zone 5, my wife kinda likes interstate 5. Build or buy will depend on what housing is available at whatever place we agree on.

@EatenByLimestone , the flat slab is a good idea. One problem I already see in some homes is those powered wheelchairs are very heavy, I know of one over 400#. Most of them aren't quite that heavy, but they aren't light when no one is sitting in them either. They are hard on regular lumber framed floors.

@FramerJ , laundry on the main level is a good idea. I look at three levels of function routinely. ADLs, the activities of daily living are being able to dress your self, use the bathroom without assistance, and feed yourself once the plate is on the table. The IADLs, the independent activities of daily living are stuff like cooking, grocery shopping, doing laundry, cleaning the bathroom.

Outlets higher off the floor, I like that one a lot. I will have to check local codes and NEC when we get where we are going. My wife already likes door levers instead of door knobs, but yes, those are easier to use when someone has say really bad arthritis in their hands.

Kitchen cabinets is a bugaboo for sure. All of kitchen really. If we build I will just go full plaid on whatever ADA (Americans with Disabilities Act) says when I go for a permit, with some kind of near the kitchen pantry to makeup for lost cabinet space under the wheelchair accessible counters.

I do agree with @begreen that having (and cultivating) great neighbors is one crucial key to success. I am planning to deliver pies and participate in neighborhood barbecues as long as I am able. Then when I am not able, I hope to have some karma built up.

One feature I would like to have is some kind of a root cellar. It could be above ground, earth covered and big enough to hold two wheelchairs if we end up in tornado country. Just roll out there, close the door, boom, months and months of food on the shelves, maybe stash a composting toilet in there. Mostly I want a cool dry place to store canned food items.
 

bigealta

Minister of Fire
May 22, 2010
863
Utah & NJ
Haven't decided where we are going yet. I kinda like climate zone 5, my wife kinda likes interstate 5. Build or buy will depend on what housing is available at whatever place we agree on.

@EatenByLimestone , the flat slab is a good idea. One problem I already see in some homes is those powered wheelchairs are very heavy, I know of one over 400#. Most of them aren't quite that heavy, but they aren't light when no one is sitting in them either. They are hard on regular lumber framed floors.

@FramerJ , laundry on the main level is a good idea. I look at three levels of function routinely. ADLs, the activities of daily living are being able to dress your self, use the bathroom without assistance, and feed yourself once the plate is on the table. The IADLs, the independent activities of daily living are stuff like cooking, grocery shopping, doing laundry, cleaning the bathroom.

Outlets higher off the floor, I like that one a lot. I will have to check local codes and NEC when we get where we are going. My wife already likes door levers instead of door knobs, but yes, those are easier to use when someone has say really bad arthritis in their hands.

Kitchen cabinets is a bugaboo for sure. All of kitchen really. If we build I will just go full plaid on whatever ADA (Americans with Disabilities Act) says when I go for a permit, with some kind of near the kitchen pantry to makeup for lost cabinet space under the wheelchair accessible counters.

I do agree with @begreen that having (and cultivating) great neighbors is one crucial key to success. I am planning to deliver pies and participate in neighborhood barbecues as long as I am able. Then when I am not able, I hope to have some karma built up.

One feature I would like to have is some kind of a root cellar. It could be above ground, earth covered and big enough to hold two wheelchairs if we end up in tornado country. Just roll out there, close the door, boom, months and months of food on the shelves, maybe stash a composting toilet in there. Mostly I want a cool dry place to store canned food items.
I put 1 outlet centrally located in the house at about 25" off the floor. I love it! use it to plug in vacuum. No awkward bending over to plug in and out. I will have at least 1 or 2 of these high access outlets in any future house i'll be in.
 

SpaceBus

Minister of Fire
Nov 18, 2018
7,089
Downeast Maine
Some day we have to figure out our stair situation. It's very steep, like a Victorian or Colonial staircase, we call it "the ladder." That's the main thing that worries me about staying in our house into our golden years. The bathroom is going to be remodeled and we will make sure it's useable for us in old age.
 

EbS-P

Minister of Fire
Jan 19, 2019
3,554
SE North Carolina
Just some observations.
Some old habits never die. Change gets harder as you age and is appears to me that so does spending money even if you have it to spend. I have been trying for a long time to get the in-laws to replace a 2x10 step that goes from mud room (which connects to the garage) to the house. I decided that replacing now is more dangerous as they have muscle memory of the step and how to navigate it.

They have the funds to redo a bathroom but won’t. Same with a mini split heatpump. They have breathing problems and heat makes it worse. Having an air conditioned house to go into when you have overdone it in the heat I appreciate not sure if it has medical benefits but I think it does.

zero entry shower. It can have glass doors now and when needed they can be removed and replaced with a a curtain.

My wife has cerebral palsy. Mostly effects her lower legs and feet. Managing it requires 90 minutes stretching PT and exercise a day. First project at our new house was to put in a ramp, we were 30 at the time. It was only two 5” steps but the top brick overhung just enough to catch and capture a foot. Accessible, useable spaces that reduce risks is something I think about more than the average person. My wife is also a disability scholar. I have more exposure to what it really takes to live with limited mobility and be disabled through her circles and what I can say is that it takes an amount of money that many don’t realize.

Staying healthy and fit is very important. I should really cut out all alcohol. I haven’t. My dad was helping me mill some timber. He just turned 70. I realezed that if I want to help my youngest with a project when she’s 40 I’ll be 80!! Finding activities to keep you active is important. Yard work kept my grandfather young. Lived at home untill he was 91. Had rude awakening one day when he decided to take a nap in the yard after mowing. Neighbors saw him laying there and called 911.

The house we have now could be fairly accessible. Changing out a vanity is easy. We redid a master bath with a zero entry shower. Doors can be widened and would need to be. It’s a job but can be done. Biggest issues is the new bathrooms floors are an 1”or more above the original hardwoods. New thresholds would be needed to easily roll into those spaces.

Kitchens is where it would take a complete redo. And at considerable expense.

I would like the opportunity to design my own space. Either new construction or complete renovation. And being able to do it long before it is truly needed would be my goal.
 
  • Like
Reactions: Prof

begreen

Mooderator
Staff member
Nov 18, 2005
96,422
South Puget Sound, WA
One feature I would like to have is some kind of a root cellar. It could be above ground, earth covered and big enough to hold two wheelchairs if we end up in tornado country. Just roll out there, close the door, boom, months and months of food on the shelves, maybe stash a composting toilet in there. Mostly I want a cool dry place to store canned food items.
My brother-in-law designed his house with a bump-out room in the basement foundation. The basement is all insulated, except for this room. This is the root cellar room and it works great.

PS: Our community has an average age of 55. Lots of geezers here and very few are wheelchair-bound, even in their eighties.