PLAN AHEAD
ally thwart their owners’ desire to stay in them.
Solving that problem, individually or collectively, means confronting certain obstacles.
About 3,500 CAPS graduates across the country — builders and remodelers, occupational therapists, interior designers — retrofit homes to help people remain in them safely, said Dan Bawden, a Houston contractor who helped develop the program in 2001.
I asked how many it would take to serve all the older and disabled Americans who want to age in place. “Ten times the number we have now,” he said. Moreover, participants in the program remain unevenly distributed, clustered in cities.
Many of the nation’s more than 200,000 occupational therapists also assess homes and recommend safety modifications, said Scott Trudeau, who manages productive aging programs for the American Occupational Therapy Association.
The process works best, he said, when CAPS-trained remodelers and occupational therapists team up, as a growing number have. Bawden’s Legal Eagle Contractors (he’s also a lawyer) works with a therapist, Kate Akers, for example.
“She’s better at spotting problems than I am,” he said. “Then I come in and make the changes based on what she suggests.”
Other groups are also tackling home accessibility, including nurses, academic researchers, and another certification program called the Certified Living in Place Professional program. Local agencies on aging or senior centers may provide referrals, too.
Yet even as more professionals enter the field, costs present a major barrier.
Though prices vary by location, most CAPS remodelers can install two grab bars for a modest $200 to $300. Figure $60 to $90 to replace a doorknob with an easier-to-maneuver lever, Bawden said, and $175 to $250 for every relocated light switch or outlet.
But replacing a tub with a roll-in shower will run $8,000 to $10,000, he said. A new bathroom incorporating universal design elements could top $25,000.
Homeowners will find scant government help with that expense. Some states reimburse homeowners through tax credits or Medicaid, and the Department of Veterans Affairs offers some grants. (It is paying the bill for Goldberg’s $7,900 renovation, for instance, and buying the new stair lift.)
But home modification remains essentially a privately financed undertaking, even though it could help prevent far more expensive hospitalizations and nursing home admissions. A bill to offer seniors $30,000 in federal tax credits for modifications was introduced in Congress last year with bipartisan support, but it has made little headway.
“How do we structure these programs so they’re available not just to the few, but to the many?” Trudeau asked. “CMS” — the federal Medicare and Medicaid agency — “needs to start thinking about this.”