Home Modifications Definitions and Terminology
Home modifications are physical changes made to one’s home to accommodate for the changing needs of the elderly or disabled, to enable aging in place. As we age, our mobility and physical strength diminish and many aspects of a home that were once functional become difficult. Home modifications can be as simple as changing water faucet handles from knobs to levers or as comprehensive as the construction of an accessory apartment or elder cottage on the property.
- Assistive Technology, Adaptive Technology or AT for short, refers to any tools or devices that enable independence for persons with disabilities.
- Environmental Accessibility Adaptations and Environmental Modifications are commonly used phrases which simply mean the same as home modifications.
- ECHO Units is an acronym for Elder Cottage Housing Opportunities. These are small, livable cottages designed specifically for seniors that can be placed temporarily on the property to allow an elderly or disabled family member to live near but not with their family. They are also referred to as Accessory Units or less formally as Granny Flats.
- Universal Design is a phrase that means a product or building was designed with the needs of both the disabled and people without disabilities in mind.
Common Types of Home Modifications for the Elderly
There are many different types of modifications that can be made to accommodate for aging challenges. Although not a comprehensive list, the following is included to give readers an idea of some of things that might be made:
- Accessory Apartments – both for the elderly and live-in caregivers
- Climate Controls – installing larger digital displays and / or remote controls
- Computer Equipment – large screen monitors and oversized keyboards
- Easy Use Fixtures – oversized light switches and levers replacing or installed over faucet knobs
- Grab Bars and Rails – in bathrooms and hallways assist persons in preventing falls and improving mobility
- Lighting – modifications within the home and around the property for increased visibility and security
- Pull Out Shelves – also referred to as roll-out, glide-out or slide-out shelves, these enable easy access to deeper spaces for clothing, food and other storage.
- Push Button Door Openers – to automate the opening and closing of doors
- Security Systems – remote monitoring and personal emergency response systems
- Smoothing Floor Surfaces – removal of molding, carpeting and anything on the floor which limits the mobility of a wheelchair
- Software Tools – that enabled increased independence
- Stair Lifts – also called Stair Glides or Lift Chairs. Learn more about paying for stair lifts here.
- Traction or Non-Skid Strips – installed most commonly in bathrooms but also anywhere a floor is hazardous or slippery including kitchens and staircases.
- Transfer Benches – also called showering benches or transfer chairs, these enable individuals to get in and out of showers, tubs and wheelchairs with little or no assistance.
- Walk in Tubs – seated bathtubs, sometimes wheelchair accessible. Learn more about paying for walk in tubs.
- Weatherization – such as storm windows, screening and air conditioning
- Wheelchair Ramps and Stairglides – for persons unable to manage stairways
- Widening Doorways and Hallways – to accommodate for wheelchairs and walkers
Determining What Modifications are Needed
While it is possible for the non-professional to assess the modifications required to make a home both accessible and safe for the elderly, the use of a professional occupational therapist can be worth the additional effort and is sometimes paid for by Medicare. There are two major considerations. First, it is important to recognize that aging is a progression, modifications to accommodate needs today might not be sufficient for needs 2 years in the future. Being able to project how one’s needs will change is of critical importance if one hopes to make lifelong modifications in a single project.
Second, knowledge of assistive technologies is critical. There are many devices on the market today and importantly a flood of new options become available each year. For the most cost-effective modifications, one needs to be aware of the full breadth of products on the market today but also the tools that will be available in the near future.
Financial Assistance for Home Modifications
Fortunately, there are many different types and sources of assistance for making modifications to one’s home to accommodate elderly and/or disabled persons. Prior to a discussion of the sources of assistance, it is helpful to distinguish between the types of assistance available.
Some organizations, mainly governmental, offer low interest loans for home modifications or guarantee loans so that banks are less restrictive with their lending requirements. These loans, of course, need to be paid back. Home improvement grants, on the other hand, are typically one-time and available for a specific home modification purpose and do not need to be re-paid. Another form of assistance is free labor to make home improvements. Finally, some organizations make free, long term loans of home modification equipment to the elderly. For example, they may lend a senior a removable wheelchair that does not need to be returned until the senior moves from the home and no longer requires use of the ramp.
Medicare’s Benefits for Home Modifications
Most people immediately think of Medicare as potential source of financial assistance. Unfortunately, Medicare and most other private insurance typically do not pay for the cost of home modifications. However, there are some exceptions to this rule. Medicare may pay for assistive technology devices that are part of the modification process provided they are required for medical reasons and prescribed by a doctor. One might also receive assistance from Medicare in determining what home modifications are medically required. Medicare Part B will pay for an occupational therapist to evaluate a home and determine what changes are required. Finally, in some rare instances, Medicare will pay for bathroom modifications and walk-in tubs. Learn about more paying for walk in tubs or stair lifts specifically.
Medicaid HCBS Waivers and Home Modifications
Medicaid is an federal and state insurance program that offers assistance to low income seniors. The program was originally intended to help the elderly who require nursing home level care to afford nursing home care. Now most states have Home and Community Based Services (HCBS) Waivers. These Medicaid Waivers provide assistance to help qualified individuals avoid nursing homes and remain living at home. As such, many of the waivers pay for home modifications to increase an individual’s ability to live independently. Each state has different waivers with different eligibility requirements and benefits. A complete list of Medicaid Waivers that help with home modifications is available here.
Veterans Programs for Home Modifications
There is home modification assistance available to veterans from both the VA and from unassociated, non-profit organizations. The VA provides multiple grants including SAH Grants, SHA Grants and HISA Grants. Also available are Veterans Directed Home and Community Based Services. This program provides veterans with financial assistance to help them remain living in their homes and provides them with a certain amount of discretion to use those funds as they see fit. Making home modifications to accommodate for a disability would usually be an acceptable use of funds regardless of whether or not their disability was connected to their military service. Learn more here. Finally, the national, non-profit organization, Rebuilding Together, offers home modification assistance both in the form of labor and some materials to US veterans through its Heroes at Home Program.
Non-Medicaid Government Assistance for Home Modifications
Many state governments and several agencies within the federal government have programs which help seniors with home modifications. The Department of Housing and Urban Development offers HUD Home Improvement Loans, and the US Department of Agriculture has Rural Repair and Rehabilitation Grants. Many states have a category of assistance program referred to as nursing home diversion programs. These programs, as their name implies, are intended to prevent or delay nursing home placement and as such they offer financial assistance and support services to help the elderly remain living at home. Some of these programs include home modifications as a benefit. A complete list of those which is available here. Unfortunately not all states offer programs.
Non-Profit and Foundation Assistance for Home Modifications
Many non-profits and other organizations offer assistance in the form of financial aid or volunteer labor to help seniors with home modifications. One of the most noteworthy is the organization Rebuilding Together (originally called Christmas in April) which offers 3 programs: Safe at Home, Heroes at Home and National Rebuilding Day. Another options are community building projects which provide seniors with volunteer labor to help them make home improvements.
Other Financial Options for Home Modifications
Reverse mortgages are an option for home modifications to enable aging in place, however these only make sound financial sense in certain situations. If the homeowners move from their residence for a period of 12 consecutive months, a reverse mortgage becomes due. Therefore, it only make economic sense to use a reverse mortgage in order to make home modifications that will enable a senior (or their spouse) to continue living at home for several years.
Homeowners should be aware that in some circumstances the cost or a portion of the cost of home modifications for the elderly are tax deductible. Read more about this and other miscellaneous home modification assistance resources.