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Problems With Aging In Place In A Multi-Level House

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Senior man standing in front of his multi-level home.

Aging in place in a multi-level house presents unique challenges, as stairs become major obstacles and increase the risk of falls and injuries for seniors.

This article explores the physical, emotional, and logistical difficulties faced by elderly individuals and their families, including mobility issues, accessibility concerns, and the potential for social isolation.

We also discuss the financial implications of necessary home modifications to ensure safety and comfort.

Below are 6 common problems that aging adults face when aging in place in a house with multiple levels.

Problem: The master bedroom and bathroom are upstairs.

Solution: If the homeowner simply cannot use the stairs then the solution is to move the bedroom down to the first floor. Hopefully, there is a bathroom on the main level, if not, then some remodeling may be required.

A wonderful solution for wheelchair users (and even for those with severely poor mobility) is the use of a portable indoor shower. Yes, there is such a thing. It’s a great option for 2 story homes that only have a half bath on the first floor.

Besides the problem of mobility issues, having a first-floor bedroom is smart for several reasons:

  1. Escape routes are easier to access in case of a fire or other problem.
  2. If no one else is using the upstairs – electricity and heating costs can be lower.

Problem: Slippery steps

Solution: If the steps are wood or stone or any other type of smooth material, they can be slippery. Rubber-soled shoes are the best type of footwear for seniors but not everyone will want to wear them or should wear them.

For men, Sketchers makes a slip-resistant slip-on shoe that you could try.

One note of caution: if you or your senior loved one tends to shuffle their feet then this type of shoe may actually increase their chances of falling because if they don’t raise their foot or feet off the ground then the resistance in the bottom of the shoe may cause them to trip.

Another solution is to use non-slip flooring at the bottom and top of the stairs, as well as rubber treads on each step and landing. These days they come in a variety of styles and designs.

The caution you need to take is to make sure that they will not lift up or get caught up if the homeowner is using a cane or other walking device.

If possible – on wooden steps I would recommend gluing or nailing down the rubber treads for added precaution.

Other solutions include:

  • Carpeting the staircase
  • Installing a chair lift

Problem: Poorly constructed handrails or lack of handrails

Solution: It’s always best to have two sets of handrails, one on either side of the stairs if possible. It’s simply safer and usually an easy solution.

If the handrails are poorly constructed or in need of repair, of course, I would recommend to my patients that they get a handyman to fix the problem(s). The cost to fix this problem is much less than the medical cost if they fell.

The homeowner should be able to put all of his or her weight on the handrail and feel secure. They should also be able to wrap their hand fully around the top of the handrails.

Problem: Poor vision

Solution: For those seniors with poor vision – it’s strongly recommended to install adequate lighting to reduce the risk of falls from missing a step.

There are many different varieties of step lights for indoor and outdoor steps. They can be added to each step and landing or can be built in.

Of course, overhead lighting and other lighting options are also good. Just as long as it casts a good amount of light on the area. (I personally prefer can lighting for these areas.)

Problem: Trouble lifting legs

Solution: The standard height of each step may be too difficult for some elders and for them, there are 5 solutions.

  1. Alter the height of steps – Use the guidelines for Low Riser type of stairs. These are most often used outdoors in public places but if your home (and budget) can allow for them, they are an excellent solution.
  2. Modifying Staircases with Stair Aides – These are products such as stair aid blocks that can make it easier to use the stairs. But if there are any cognitive problems such as Dementia or Alzheimer’s – it’s not recommended to use stair aide blocks as it may be more difficult for the homeowner to remember how to use them safely.
  3. Stair Lifts – You probably guessed that stair lifts are the most common solution for those who have physical difficulty getting up and down stairs.
  4. Elevator – It’s great to see newer models of interior elevators coming to market as more and more older adults incorporate them into their homes. Of course, most homes cannot accommodate (or afford) an elevator, but it is an option if you can do it.
  5. Mobile stairlift – this is more like a portable wheelchair, so it can be used in the senior’s home or taken anywhere (inside or outside) that has stairs. The rider cannot operate it alone, however – there must be someone guiding it up and down the stairs.

Problem: High frequency of using the stairs

Solution: Oftentimes someone living in a two-story home finds themselves going up and down the stairs multiple times a day. If the objective is to reduce the possibility of falling on the stairs, you want to reduce the number of times you have to use them.

Here are some tips on how to do that:

  • If the home security system only has a panel on the main level, it’s recommended to add another panel on the second floor (in the master bedroom if possible).
  • Keep several bottles of water upstairs.
  • Stash away some crackers or granola bars, etc. upstairs.
  • Purchase a second set of cleaning supplies (if you do the cleaning) and keep them upstairs. If need be, purchase a second vacuum cleaner for upstairs.
  • If the laundry area is on the ground level – if possible, install a laundry chute upstairs and hopefully you will be able to connect it to the laundry room.
  • Being safe means not taking chances. It’s mandatory to enforce the idea that carrying things up the stairs is NOT safe. If the homeowner MUST carry small items upstairs – a good way to do that is by wearing a backpack or an apron with pockets, etc.

Tips On Converting A Home For Elderly Adults

As an OT, I used to do home assessments often. It was my job to check and ensure that my patient could go home to a safe environment.

And not only did their home need to be safe, but it also needed to accommodate them if they were now using a walker or wheelchair, or another mobility device.

Recommendations often included modifications to the home. Some were minor modifications that were easy to make, although some were structural. I would also provide a list of tools and/or equipment such as stair lifts, raised toilet seats, grab bars, medical alert devices, etc.

Of course, the pros and cons of aging in place always need to be factored into the decision.

Sometimes the home environment really wasn’t suitable for the patient any longer, making it very difficult to convert it to what they now needed.

Often financial restraints would prohibit them from moving, so we did the very best we could with what we had.

Here are some tips on converting a home for elderly adults:

  1. Improve Lighting: As I mentioned earlier, vision can deteriorate with age, it’s important to ensure that all areas of the home are well-lit. This includes staircases, hallways, and outdoor areas.
  2. Install Handrails and Grab Bars: These can be particularly helpful in bathrooms, staircases, and hallways. They provide extra support and can prevent falls.
  3. Remove Tripping Hazards: This includes securing loose rugs, removing clutter from walkways, and ensuring that cords are not in the path of walking areas.
  4. Modify the Bathroom: Install a walk-in shower or tub, use non-slip mats, and consider a raised toilet seat for easier access.
  5. Rethink Flooring: Carpets can reduce the impact of a fall, but they can also be a tripping hazard. Consider low-pile carpeting or slip-resistant flooring.
  6. Adjust the Height of Counters and Shelves: Lowering these can make it easier for someone in a wheelchair to use them.
  7. Install a Stair Lift or Elevator: If the home has multiple levels, consider installing a stair lift or elevator for easier access.
  8. Widen Doorways: If the individual uses a wheelchair or walker, doorways should be wide enough to easily accommodate these devices.
  9. Install Lever-Style Doorknobs: These are easier to use than round doorknobs, especially for those with arthritis or limited hand strength.
  10. Create a Bedroom on the Main Floor: If possible, arrange for the elderly individual to have a bedroom on the main floor of the house to avoid the need for stairs.
  11. Kitchen Modifications: Consider installing pull-out shelves, a wall oven at a comfortable height, and a counter with open space underneath for seated work.
  12. Emergency Plan: Install a reliable security system and ensure that the elderly individual knows how to use it. Consider a medical alert system as well.

Remember, each person’s needs will be different, so it’s important to tailor these modifications to the individual’s specific requirements and abilities.

It’s also a good idea to consult with an occupational therapist or a certified aging-in-place specialist to ensure all needs are met.

For more tips on making a house senior-friendly – click here.

Getting Financial Help

Major renovations such as moving a bedroom downstairs or installing a full bathroom with safety features on the first floor can be costly.

But, the majority of the time only minor changes will have to be made and these can be more affordable.

There are over 400 federal, state, non-profit, and private organizations in the United States that offer programs that provide financial assistance for older adults.

For home modifications and equipment – you can fill out the form at to see if you qualify and what programs are in your area.

Partnerships For Home Modifications

When it comes to making homes more accessible and safe for seniors, partnerships play a pivotal role.

These collaborations, often between non-profit organizations, local businesses, and government agencies, aim to provide resources, expertise, and funding to facilitate necessary home modifications for the elderly.

  1. Non-Profit Organizations: Many non-profits, such as Rebuilding Together or the National Aging in Place Council, focus on assisting seniors with home modifications. These organizations often rely on volunteers and donations to provide services, ranging from simple installations of grab bars to more extensive home renovations. Partnering with or seeking assistance from such organizations can be a cost-effective way for seniors to make necessary home changes.
  2. Local Businesses: Some local businesses, especially those in the construction or home improvement sectors, may offer discounted services or products for seniors. By partnering with senior advocacy groups or community organizations, these businesses can provide specialized expertise in creating age-friendly living spaces.
  3. Government Programs: Various federal, state, and local government programs offer grants or loans for home modifications for the elderly. For instance, the U.S. Department of Housing and Urban Development (HUD) has programs aimed at helping seniors make home improvements. Additionally, Medicaid’s Home and Community-Based Services (HCBS) waivers can sometimes cover the costs of home modifications.
  4. Collaborative Community Initiatives: In some communities, neighborhood groups or local councils initiate programs where younger residents assist seniors with basic home maintenance and modifications. Such grassroots efforts not only help in making homes safer for the elderly but also foster inter-generational connections and community bonding.
  5. Universities and Educational Institutions: Some universities, especially those with occupational therapy or architecture programs, may have initiatives where students assist with home modifications as part of their coursework or community service. This provides a win-win situation: students gain practical experience, and seniors benefit from the latest knowledge and techniques in home design and safety.
  6. Online Platforms and Apps: With the rise of technology, there are now platforms and apps that connect seniors with service providers specializing in home modifications. These platforms often come with reviews, ratings, and the ability to get multiple quotes, ensuring transparency and quality of service.

Online Platforms And Apps

Here’s a list of some of these platforms and apps that I talked about above.

  1. HomeAdvisor: This platform connects homeowners with local service professionals for home improvement, maintenance, and repair projects. They have a category dedicated to “Aging in Place” which can help seniors find professionals experienced in home modifications for the elderly.
  2. Angie’s List: Similar to HomeAdvisor, Angie’s List provides user reviews and ratings of home service professionals. Seniors can search for contractors who specialize in home modifications or accessibility improvements.
  3. Thumbtack: This platform allows users to find professionals for various services, including home modifications. Users can get quotes from multiple professionals and choose the one that fits their needs and budget.
  4. Houzz: While primarily a platform for home design inspiration, Houzz also connects users with professionals. Their extensive database includes professionals who specialize in “Universal Design,” which focuses on designing spaces that are accessible to all, regardless of age or ability.
  5. SilverSpaces: This is an app designed to assess the age-friendliness of a home. It provides a room-by-room assessment and offers recommendations for modifications to improve safety and accessibility.
  6. TaskRabbit: For smaller home modification tasks, platforms like TaskRabbit can be useful. Users can hire local “Taskers” to help with various tasks, including minor home improvements.
  7. AARP HomeFit Guide: While not an app or platform in the traditional sense, AARP offers a guide that provides advice on how to make homes age-friendly. It can be a valuable resource for seniors looking to understand what modifications might be necessary.

For seniors and their caregivers, understanding and leveraging these partnerships can significantly ease the process of home modification.

Not only can they reduce costs, but they also ensure that modifications are done professionally and in line with the best practices for senior safety and comfort.

There’s no doubt in my mind that technology will play a huge part in the future of aging in place, especially for those living in a 2 story house.

With the rise of smart homes and digital assistants like Amazon’s Alexa or Google Home, older adults will be able to control many aspects of their home environment with simple voice commands.

This technology will not only enhance convenience but also improve safety for seniors.

Smart sensor systems can monitor activity levels and detect any potential falls or accidents, alerting emergency services if necessary.

Advancements in virtual reality technology can allow seniors to safely exercise and stay active without leaving their homes.

This is especially important for those living in a 2 story house who may find it challenging to navigate stairs or leave the house due to mobility issues.

Additionally, telemedicine is on the rise, allowing seniors to consult with medical professionals from the comfort of their own homes.

This is especially beneficial for those who may have difficulty getting to and from doctor appointments.

With the help of technology, older adults will be able to maintain their independence and age in place safely for longer periods of time.

It also opens up opportunities for inter-generational communication and connection, as younger family members can easily check on their older loved ones through digital platforms.

As the population continues to age, it’s crucial that technology is user-friendly and accessible for seniors of all abilities.

All in all, the future of aging in place for those living in a 2 story house is bright with the integration of technology.

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