Making and Paying for Home Modifications to Help the Elderly Age in Place
What are Home Modifications?
Home modifications are physical changes made to one’s home to accommodate for the changing needs of the elderly or disabled. 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.
Home Modifications Terminology
To better understand the options available to pay for home modifications for the aging, it is helpful to understand some of the specific terms which are commonly used.
- 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
There are many different types of modifications that can be made. Although not a comprehensive list, the following is included to give readers an idea of some of things that might be paid for by home modifications grants.
- Grab Bars and Rails – in bathrooms and hallways assist persons in preventing falls and improving mobility
- 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.
- Traction or Non-Skid Strips - installed most commonly in bathrooms but also anywhere a floor is hazardous or slippery including kitchens and staircases.
- Widening Doorways and Hallways – to accommodate for wheelchairs and walkers
- Smoothing Floor Surfaces – removal of molding, carpeting and anything on the floor which limits the mobility of a wheelchair
- Wheelchair Ramps and Stairglides – for persons unable to manage stairways
- Push Button Door Openers – to automate the opening and closing of doors
- Easy Use Fixtures – oversized light switches and levers replacing or installed over faucet knobs
- Lighting – modifications within the home and around the property for increased visibility and security
- Climate Controls – installing larger digital displays and / or remote controls
- 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.
- Accessory Apartments – both for the elderly and live-in caregivers
- Weatherization – such as storm windows, screening and air conditioning
- Security Systems – remote monitoring and personal emergency response systems
- Computer Equipment – large screen monitors and oversized keyboards
- Software Tools – that enabled increased independence
- Walk in Tubs - seated bathtubs, sometimes wheelchair accessible. Learn more about paying for walk in tubs.
Determining the Appropriate Home Modifications
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.
For those inclined to determine what modifications are necessary themselves, Dynamic Living Inc offers a helpful guide for each room of the home. These guides are available as a free download from their home-modification website, AdaptMy.com
. One can also get a get a free quote for bathroom safety modifications
How to Pay for Home Modifications for the Elderly?
Fortunately, there are many different types of assistance and sources of assistance for making modifications to one’s home to accommodate the elderly and/or disabled. Prior to a discussion of the sources of assistance, it is helpful to distinguish between the types of assistance available.
Types of Home Modification Assistance
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.
Home Modification Resources
Most financial assistance for home modifications comes from one of the following 3 major sources. One can browse the programs using the links below or search for relevant programs using our Home Modification Resource Locator Tool.
1. Federal Government Programs for Home Modifications
There are government programs such as HUD Home Improvement Loans
, USDA Rural Repair and Rehabilitation Grants
and multiple grants from the Veteran’s Administration including SAH Grants
, SHA Grants
and HISA Grants
2. State Government Programs for Home ModificationsNon-Medicaid Home Modification Assistance
Some of these state government programs may be specifically designed to help with home modifications but most of them fall under the category of nursing home diversion programs in which assistance in making home modifications is provided with the objective of preventing individuals from having to move into skilled nursing homes. Unfortunately not all states offer programs.Medicaid Waivers for Home Modifications and Assistive Technology
For individuals enrolled in, or qualified for Medicaid, many states have home modification and assistive technology Medicaid waiver programs. These waivers are intended to enable nursing home qualified individuals to remain living at home. In doing so, the waivers often will pay for approved home modifications to increase an individual’s ability to live independently.
3. Non-Profits and Community Organizations
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 / Christmas in April
which offers 3 programs: Safe at Home
, Heroes at Home
and National Rebuilding Day
. Community building projects
provide seniors with volunteer labor to help them make home improvements.
Finally, there are other miscellaneous home modification assistance resources
such as reverse mortgages
and tax deductions for home modifications
that can help to reduce or offset the cost of making a home more accessible to the elderly.
Does Medicare Pay for Home Modifications?
Medicare and 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.
Page Reviewed / Updated - Apr. 2013