• Aging in place – Homeowners work with builders to rethink design as they grow older

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    Irina MacPhee
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    Aging in place

    Homeowners work with builders to rethink design as they grow older

    The older economy

    In 2010, disposable income for Americans age 50 and over was $3 trillion. This huge demographic group accounted for almost one half of all expenditures, including $250 billion on apparel, personal-care products, education and entertainment.

    Adapting their homes so they can age in place also is a priority for this group, especially on Cape Cod with its large retiree and second home population.


    The older Cape Cod demographic

    • 1 in 4 Cape Cod residents is over 65
    • Orleans’ residents have the oldest average age in Massachusetts.
    • Among the top 25 municipalities with the oldest-aged residents are Brewster, Chatham, Dennis, Eastham,  Falmouth, Harwich, Orleans, Provincetown, Truro, Wellfleet and Yarmouth


    People facts                        Barnstable County            Massachusetts

    Population, 2012 estimate          215,423                             6,646,144

    Persons, 65 years and over            26.3%                                14.4%


    Source U.S. Census Bureau: State and County Quick Facts


    Town             Median age      Rank in Massachusetts


    BARNSTABLE             47.0                 54

    BOURNE                     42.9              155

    BREWSTER                 53.6                11

    CHATHAM                  56.9                  5

    DENNIS                        52.5                15

    EASTHAM                   56.6                  7

    FALMOUTH               50.8               22 tie

    HARWICH                   50.8               22 tie

    MASHPEE                   46.7               62

    ORLEANS                    62.4                 1

    P’TOWN                      51.8               17

    SANDWICH                43.5              129

    TRURO                         50.3                 13

    WELLFLEET                 60.1                 3

    YARMOUTH               51.4               19

    SOURCE: US Census, 2007-2011 American Community Survey


    The ideal home for aging in place

    How to live safely, independently and comfortably in a state-of-the-art home, room by room

    By Joe Santangelo

    The baby boom generation, born between 1946 and 1964, makes up 25 percent of the entire U.S. population.  Already one in four Cape Cod residents is over 65, and that number is growing. Nationwide, 10,000 people turn 65 each day.

    To improve comfort and safety, many baby boom retirees and pre-retirees are making substantive home improvements so they can continue to live in their own house for years to come. The ideal design blends aging-in-place improvements into the home in a seamless way.

    Issues to be addressed in many existing homes range from small bathrooms and tubs that are hard to navigate to poorly-designed kitchens, hazardous rugs and carpets, inadequate lighting and too many stairs.

    Based on research by the National Association of Home Builders and a course given by the Home Builders & Remodelers Association of Cape Cod, here are some design solutions for the perfect aging-in-place home.


    First, homeowners need easy access at the entryway, so they can get out and enjoy all the Cape has to offer.  Doorway clearances at the entry and throughout the home should be at least 32 inches wide for future wheelchair accessibility. Electric wheelchairs and motorized scooters need a turn radius of up to 60 inches once inside the entry door.

    A zero-threshold at both the front and back door is ideal, permitting quick access in a wheelchair or walker for everyday use, or in an emergency. If possible, front steps might be eliminated altogether.  If not, then ramps can be integrated into the front porch design and rear deck.

    Non-slip surfaces are recommended, along with proper lighting and continuous handrails. Lever-type door handles are more user-friendly than traditional door knobs.


    As the gathering place, the kitchen is a home’s focal point but also a potential challenge when it comes to maneuverability.  Aisles between cabinets and kitchen islands or peninsulas need to be wider for wheelchair clearances.

    Wall cabinets may have to be lowered for people with mobility issues, or pull down shelving can be added.  Base cabinets may need to have roll-out shelving. Access to sink, cooktops and small appliances may have to be lowered. Counters can be added on both sides of the refrigerator for help storing various items.


    Perhaps no other room receives as much notoriety for in-home accidents as the bathroom.  As one ages, the concern for bathroom safety increases. A safe, accessible, ground-floor bathroom is a must.

    Bathing facilities may need to be enlarged, by expanding into adjacent space in the home. Increasing the bathroom size will provide more room for the older user, potentially in a wheelchair, and also for a second person as caregiver. Handheld showers are an essential improvement.

    Handicapped accessible toilets, sinks, faucets, walk-in or roll-in showers and tubs, grab bars and handrails as well as reachable light switches and electrical outlets are some of the vital improvement of an aging in place bathroom.

     Living area/family room

    Most user-friendly rooms for older residents will have tight weave carpet so people are less likely to trip and fall. Other soft surfaces throughout the house can cushion a fall and minimize injury. Ample space for moving around furniture is a must, and a 36-inch-wide route throughout the house is considered essential.

    Electrical improvements include dimmers for lighting and three-way switches to turn on lights from both ends of a room. Switches, outlets and thermostats should be positioned at an accessible height.

    Use of contrasting paint colors provides a clear demarcation for someone leaving one room and entering another.

     Heating, ventilation, air conditioning

    Often overlooked is the need for improved air quality and more comfortable temperatures throughout the living area in summer and winter, especially as people age and develop health issues.

    Many local contractors now have earned a CAPS certification, or Certified Aging in Place specialist, developed by the National Association of Home Builders, in association with AARP.

    For more information, click on www.nahb.org/caps.

    Going to school on aging and accessibility

    The Homebuilders and Remodelers Association of Cape Cod offers an in-depth course developed by the National Association of Home Builders on Strategies for Aging and Accessibility.  Successfully completing the three-day course results in an aging-in-place specialist certification.

    Many local contractors now have earned a CAPS certification, or Certified Aging in Place specialist, developed by the National Association of Home Builders, in association with AARP.

    For builders, remodelers, designers and professionals in the real estate and health industries, this course examines this demographic group and how it is experiencing the normal aging process:

    • Aging without urgent mobility needs
    • Aging with progressive needs, requiring some home modifications now and more later
    • Aging with traumatic needs, requiring immediate changes to age in place


    For example, most households with people over 65 have someone experiencing a medical issue such as arthritis, heart disease, respiratory challenge, diabetes or other conditions. As people get older and want to stay in their homes, many will need modifications to doors, entryways, floors, kitchens, baths and more.

    The course teaches how to identify, recommend and provide design solutions to improve lifestyle and safety so people can stay in their own homes, rather than move to assisted living or nursing homes. The design changes may include zero-step entrances, a ground-floor bath with hand-held shower, switches and outlets at accessible height, tight-weave carpet or wood floors for easier access, more lighting and the latest smart appliances.

    One builder who took the course worked with a client and looked outdoors as well as indoors. They designed a ramp to the back yard, an accessible outdoor shower, a garden that could be reached by wheelchair and a ramp to the driveway. That way, the owners could enjoy outdoor visits with family members and daytrips to the beach, even while their mobility became limited.

    The course includes specific design/build solutions for aging in place that can be included in a new or remodeled home, including driveways, entryways, kitchens, bathrooms, closets, laundry rooms and other key issues.

    The course discusses how to collaborate with homeowners and their healthcare providers to develop the appropriate solutions for each property owner.

    Also covered are marketing and communications strategies to reach the aging-in-place market as well as business management issues for builders and remodelers.


    For information about this or other Cape Cod homebuilders’ courses, click on capecodbuilders.org or e-mail chris@cpecodbuilders.org.


    A model aging-in-place home.

    Two home owners, builder John Falacci and designer Ken Sadler have created a model home for over-65 Cape Codders based on needs of their clients.


    Starting with a 24- by 30-foot Cape Cod cottage that had been in the family since 1968, the owners decided on a 700-square-feet addition and completely reconfigured the existing space – all on one floor, with a deck, outdoor shower on the deck and no-threshold entries.

    The goal was to create more room for visiting children and grandchildren, plus wider 36-inch interior doors, more space in the living area and kitchen for a person with a wheelchair or walker and a state-of-the art handicapped-accessible bathroom with entries from the hall and the master bedroom.

    Builder John Falacci of Home Improvement Specialists and designer Ken Sadler of KSA Designs, both in Hyannis, handled the project.

    “The bathroom now has a walk-in shower, so I can take a wheelchair right into the shower. That’s really my favorite,” the owner says.  “A walk-in shower is important, whether you use a wheelchair or not.”

    Other favorites in the bathroom are grab bars with a towel rack built in just below and a similar grab bar/toilet paper holder combination.

    The toilet is wall-mounted, so it can be any height off the floor. Falacci recommended a SensoWash toilet that comes with water jets for easy personal hygiene.

    Electrical outlets and switches were placed at heights that could be reached from a wheelchair.

    Outside, there are ramps off the new deck for access to the car and garden.

    All the selections and designs were based on one of the owner’s specific desire to maintain her independence. She wanted to be able to clean her own home even though she has a physical disability (another reason for wall-hung toilets). And she wanted to be able to stay by herself while her husband left the Cape for work. She had never been able to stay alone before the remodel.

    Overall, this is the type of home for people of all ages and abilities to move about inside, go out to the yard or to the beach, and back and use the outdoor shower before entering the house.


    November 20, 2013