After the debacle of outbreaks of COVID-19 in long-term care homes, people increasingly want to age in place. An October, 2020 survey by the National Institute of Ageing and Telus Health found that almost 100 per cent of Canadians 65 and older plan to live independently in their homes for as long as possible.
What are the essential changes you need to make to age in place and how much might you have to spend?
“The number one concern people usually have is just trying to get in and out of the house because their mobility may have changed,” says David Borthwick, a construction engineer technologist and founder of Accessible Solutions in Oakville, Ont., which offers home assessments and accessible design services.
“Modifications might include bilateral stair rails, a porch lift, ramp, or a stair lift within the garage. Once inside, people need a means of changing levels within the house, because the bedrooms and their bathroom are typically upstairs. Then you’re looking at stair glides or a vertical lifting device such as a through-the-floor lift, or a more traditional elevator that requires a full shaft enclosure.”
Mr. Borthwick says what the homeowner chooses to install depends ultimately on the person’s function – and there are a lot of variables. Can they transfer to a stair glide? Are they wheelchair dependent? Do they use a walker or cane? What are their future needs?
A porch lift is generally around $9,000, while the cost of a stair glide depends on the stair configuration, Mr. Borthwick explains. It’s around $4,500 for a straight stairway but L shaped stairs with a 180-degree turn on the landing or U-shaped stairs require a custom stairlift, so the cost can go up to $12,000.
A through-the-floor lift (which travels through a customized opening in the floor) is cheaper (averaging $30,000) but typically only links two floors. Elevators are a major expense at $80,000 to $100,000.
“You can build an exterior shaft and put an elevator in there, depending on the home’s outside space,” says Mr. Borthwick. “What we like to do from a designer’s perspective is put it in the garage because then it becomes a three-stop elevator getting you to the basement, main floor and upper level.”
Once you’ve sorted out stairs, Mr. Borthwick says the most dangerous room is the bathroom.
“Most people need bathroom modifications because that’s where falls typically happen. We often take out the bathtub and put in a zero-threshold shower. Open-access showers are better suited for a variety of disabilities as opposed to walk-in bathtubs. Depending on the disability, the person can utilize a bath bench to do their hygiene so they’re not standing.”
Renovating a bathroom can cost between $20,000 to $30,000, Mr. Borthwick estimates. A kitchen renovation – including slide-out shelves and lower countertops so you can sit to prepare food – runs between $40,000 to $80,000. Other adaptive changes include enlarging doorways in older homes – from 32 to 36 inches to accommodate walkers and wheelchairs. Another consideration is tight spots as the turning radius for a power wheelchair is six feet.
“What’s really critical is that it’s designed properly,” Mr. Borthwick says. “Over 26 years, we’ve seen a lot of things where people spent good money on a bad idea. If you go into an accessible bathroom that’s properly designed, it doesn’t look institutional. It looks like these safety modifications should be in every house.”
Accessible Solutions works with occupational therapists who first assess clients from a functional perspective and get their input when it comes to design. Once the design work and drawings are done, the company can tender the project out to different contractors for the client. Project management is also an option.
“It’s a collaborative team effort between an architect and engineering technologist and a medical professional,” Mr. Borthwick says. “We’re marrying the function with the design to make sure it fits the person’s needs.”
Donna Franz is a registered occupational therapist and accessibility consultant in the Okanagan, B.C., as well as the founder of Design 4 Accessibility, which designs effective and attractive accessible spaces in homes, workplaces and the community. She says every project is unique.
Her idea is to create an adaptable, comfortable and aesthetic space that supports health and wellness, starting with an in-home assessment and health questionnaire of all the people living in that home.
“We’re capturing their current situation, what’s happened in the past and forecasting their future needs,” Ms. Franz says. “The focus is on physical in terms of safety, such as flooring, pull-out drawers and different handles that are easier to use for people with limited grip strength.
“There could also be smart technology so if you’re aging and require more assistance, there’s an ease of connecting with family and home monitoring. An example would be a security system with a front-door camera where the lock might actually be operated by other family members as well.”
In addition to the on-site interview about the past and present health activities of daily living, Ms. Franz does a tour of the home with measurements and photographs that are designed to create a template for change. Her recommendations are prioritized and include specifications that would help people make decisions. For example, she might recommend a non-slip tile versus a large, smooth tile for the bathroom.
“Buying decisions are up to the homeowner and perhaps their interior designer, but the recommendations for the safest installation would come from the occupational therapist,” Ms. Franz says. “We start right at the beginning to educate the client. The report at the end is, ‘this is the information we received about your health, and these are the projected recommendations for your current and future situation.’ "
Ms. Franz also makes sure in her report that the contractor will understand the reasons for specific design details. After modifications are completed, she ensures the homeowner knows how to use each adaptation correctly.
While there are differences with every province, there are tax credits available as well as limited funding through the March of Dimes Canada or through insurance. However, most people pay for renovations out of pocket.
If you’re considering modifications, Ms. Franz says occupational therapists would be familiar with the grants available in their area.
In terms of how these renovations might affect resale, Ms. Franz says if they’re not aesthetically pleasing or they look medicinal, they can have negative effects. For instance, if you add a very visible ramp, it could significantly damage your resale value, while a hidden walkway built into the landscaping could be a benefit to a young mother with a stroller.
Even if your modifications are well designed and constructed from quality materials, they’re still unlikely to equal your investment when it’s time to sell.
“If you dropped $120,000 to put in an elevator, it’s not like your house has gone up $120,000 in value,” Mr. Borthwick says. “You don’t get that back, but it won’t hurt you. Plus, as baby boomers age, there are more people looking for accessible features.”
Sylvia Rak-Baede, a sales representative with Royal LePage Real Estate in Toronto, says resale value all depends on the market and how the alterations are integrated.
“If the market is really, really hot and demand is high, it doesn’t really matter what the house looks like,” she says. “But in a slower market like now, if the renovation is extreme or looks institutional, people just won’t like it.”