Almost 50 years ago, Nettie Thill's mother-in-law died at home, in her kitchen, felled by a heart attack. Soon after, Thill and her husband bought the small stucco house from the estate, and now Thill says she wants to go the same way.
"They can take me out feet first like they did her," said Thill, a retired cook. "I love it here."
The desire to age in place is both powerful and nearly universal. A 2018 survey by AARP found that three-quarters of those over age 50 say they want to remain in their current residence as they get older. Now in the COVID-19 pandemic era, it's anticipated that more seniors will opt to age in place at home rather than move into a senior living facility.
An army of architects, contractors and designers have been busy retrofitting the living spaces of Americans entering their retirement years. Remodeling company ads and media stories about the phenomenon often showcase high-end projects, featuring roll-in showers in luxurious bathrooms, first-floor master suite additions, even voice-activated lighting and security systems.
But low- and moderate-income homeowners without the budget to fund major construction projects are equally keen to stay in their familiar homes.
Now a pilot program in the Twin Cities is making the goal achievable. Habitat for Humanity's Age Well at Home initiative serves those living on fixed incomes, adapting their living spaces to leave their homes safer and better suited to their needs.
"This model could be a game changer for this growing demographic," said Pat Lund, the Age Well at Home program manager.
In its first 18 months, the initiative has made upgrades to 65 homes in the metro area. Funded through public and private grants, crews have built front-door ramps, added hand-held showers, grab bars and railings, improved lighting, installed nonskid flooring and added smart doorbells and stair lifts.
The average cost of the upgrades is $8,500, an amount that is out of reach for many living on lean budgets.
"A lot of older homeowners still have mortgages. They're dealing with expensive medical bills and prescriptions, they're challenged to pay utilities and put food on the table," Lund said. "It's not just paying to get the work done; it's also tough for some of them to find a contractor who is trustworthy and will do the smaller jobs."
The Age Well at Home program, now being tried in five other American cities, relies on health care providers for referrals. In the Twin Cities, Allina and Hennepin Healthcare identify older patients who would benefit from housing modifications.
"The cool thing about a housing-health care partnership is that homeowners already know and trust their doctors; they have built up a bond with them," said Lund. "We're hoping to embed with other health care systems as we expand."
During the COVID-19 pandemic, Age Well at Home modification work has been limited to exterior ramp building, with most individual and group volunteer activities suspended until further notice, according to Lund. Age Well at Home is not taking additional clients until July 30 at the earliest. The program is looking into the possibility of using a limited number of volunteers starting June 15, following strict safety protocols. Interested homeowners can apply at tchabitat.org.
Financial considerations
Two years ago, Nettie Thill took a nasty fall in her living room, cracking her head on the china closet on the way down. Shaken, she went to the hospital and got the all-clear, lucky that she didn't suffer a break or concussion.
The tumble alerted her health care team and brought a nurse to evaluate her home. Soon a crew arrived to put a banister by the steps leading to her basement laundry room, install easy-open storm doors and add grab bars by her bathtub.
"I like taking a bath but it was hard to get in and out," Thill said. "My arms are still strong and I can pull myself up and down."
Keeping people living independently is more affordable than the alternative. According to Genworth's 2019 Cost of Care Survey, the median monthly cost in an assisted-living facility in Minnesota is $3,800; a semi-private room in a nursing home is just over $10,000.
The Centers for Disease Control and Prevention calculates that 3 million Americans 65 and older are injured in falls every year, with an average hospitalization bill of $33,000. Modifications to make homes more fall-proof can result in significant savings to the health care system underwritten with public dollars.
"It's common sense that if you can reduce injuries, it will reduce hospital stays. It's more cost-effective to keep them at home than in a more supportive environment," said Michelle Radovich. She leads Allina's team of occupational therapists and nurses who visit homeowners and make recommendations on what they need to safely age in place.
After assessing a number of older homeowners, Radovich has seen how updates and repairs in their living spaces often boost their psychological and emotional well-being.
"When they don't have to work so hard just to take a shower, they have more energy," she said. "One gentleman picked his bassoon back up and started playing it again. He'd been exhausted from caring for himself but when the changes were made he could resume an activity he'd always liked. That's huge."
A national model
Thill has no plans to leave her home, situated on a large lot in Spring Lake Park. In warmer weather, she waters her flowers and climbs on her riding mower to tend her lawn; she keeps her bird feeders filled year-round, watching for blue jays and finches and enjoying the antics of squirrels attracted to the birdseed.
"I can still take care of myself but nothing works as well as it used to. I have arthritis, but that's better than rigor mortis," she joked. "I like what they did for me. My kids don't worry about me so much now."
In the Twin Cities, the Age Well at Home pilot will double the number of older homeowners it assists in the coming year. Habitat for Humanity is tracking the completed projects to see if the initiative can be replicated nationwide.
"We think that all of our 1,000 Habitat affiliates could adopt this model," said Lund. "The desire to stay put crosses all class and income lines. It's not that expensive to stabilize homeowners so they can stay in a community where they're comfortable and know their neighbors."
Kevyn Burger is a Minneapolis-based freelance writer and broadcaster. Staff writer Kim Palmer contributed to this report.
