Home modifications for seniors to live safely with health challenges

Table of Contents

Introduction

As seniors age, declines in health can make it more challenging to continue living at home safely and securely.  For those who do want to remain at home, or to age in place, here is a comprehensive list of home modifications for seniors that can help address each specific health challenge. While some home modifications require that you own the home, plenty of other improvements can be accomplished while you’re renting.

Falling

Avoiding falls

As seniors age, the consequences of falling become more serious: brittle, broken bones, head injuries, hip fractures, and more.  Ensure your home is free of trip hazards by following the checklist below.

Clear your floors:

1. Crowded floor plan: Rearrange furniture to free up space and create ample walkways.
2. Cluttered floors:  Clean up all clutter and debris from floors, hallways, stairs, and external walkways.  Pay special attention to opening up the path between the bed and the bathroom for nighttime walks in lower lighting. Outdoors, be especially careful to remove mold, moss, and wet leaves from outside walkways.
3. Electrical and phone cords:  Make sure all cords are out of the way, against a wall, and either taped down or held in place with cord covers.

Secure your flooring coverings:

1. Rugs:  Avoid area rugs, throw rugs, and scatter rugs, which can slip easily.  Otherwise, at least use non-slip grips, double-sided rug tape, or rubber backings, especially in the bathroom and other wet areas.
2. Loose carpeting:  Replace old, shaggy carpeting.  Use low-pile, woven carpet or short nap carpet that is in good condition.  Ensure the carpeting is securely attached to the floor, especially on steps.

Avoid having slippery floors:

1. Slippery floors:  Always clean up spills immediately.  Avoid marble flooring and wax polish.  More secure flooring materials to use are cork, non-slip vinyl, wood, bamboo, linoleum, laminate, rubber, low-pile carpet, and non-slip tile – though the last one may be hard to stand on for a long time.  For stairs, use either low-pile carpet or non-slip floor treads.
2. Wet bathroom floors: Use a non-skid, rubber suction mat or non-slip floor strips, treads, or decals in the shower or bathtub. Also use a non-slip, rubber-backed bathroom mat or floor rug.

Avoid having uneven flooring:

1. Damaged floors:  Repair or replace uneven surfaces, tiles, cracks, holes, loose bricks or pavers, broken steps, worn-out floor treads, and other types of damaged flooring. Pay special attention to stairs; repair damaged or uneven surfaces, including any raised nail heads.
2. Door thresholds:  Avoid having speed bumps or raised, hard door thresholds in between internal rooms and at each entrance to the home.  At a minimum, ensure they are easy to see by using contrasting colors, or by covering them up with a compressible rubber threshold or an external threshold ramp.

Managing falls

Implementing the safety measures listed in this article will help you significantly reduce the chance of falling.  Even so, it’s prudent to set up devices and accessories that will protect or assist you in case of a fall.

• Flooring:  If you don’t require hard floors for wheelchair usage, then carpeting is more forgiving when it comes to falls.
• Padding:  Put fall safety mats on the floor beside your bed to cushion your fall in case you roll out of bed.  There is now even smart protective clothing being developed that can help to actively cushion you from falls.
• Communication:  Set up a smart home voice assistant so that if you fall or have another medical emergency, you can call out for help from any location in your home.  Alternatively, you can wear a device such as a cell phone, smartwatch, or medical alert device (also called a medical monitor, emergency button, emergency pendant, panic button, or smart emergency-contact system).
• Fall detection devices:  In case you fall and are not able to call out for help, it can be helpful to wear a fall detection device that will automatically sense your fall and make the call for you.

Balance

Install supportive equipment

One health challenge that elderly adults commonly face is deteriorating balance. To help with balance at home, install supportive equipment that you can hold on to for extra stability:

1. Handrails:  Set up handrails on both sides of every set of stairs, inside and outside.  Also make sure that any step ladders that you use have handles that you can hold on to.
2. Grab bars and handles:  Install these securely to the bathroom walls in the bathtub, shower, and toilet areas.  Some may attach over the side of the bathtub itself.  Avoid using suction grab bars, which can fall off, and towel bars, which are not designed to support an adult’s weight.  Also install these along the edges of your countertops in both the bathroom and kitchen.
3. Toilet frames and safety rails:  These flank the toilet on both sides, so you’ll have even more support than a grab bar attached to a wall.
4. Transfer poles:  An alternative to grab bars are floor-to-ceiling transfer or security poles, which you can install in the bathroom, by your bed, or by your recliner.  These provide a longer bar to hold onto, and some have a curve grab bar attached for even more support. 
5. Bed rails:  These can provide stability as you get in and out of bed, as well as prevent you from rolling or falling out of bed.
6. Shower and bathtub seats:  If you have space, consider sitting on a shower or tub seat,  chair, or bench while you bathe.  This gives you greater stability because you avoid standing and maneuvering about on a wet floor.  You also will want to install an adjustable, removable shower head so that it can easily reach you while you sit.
7. Benches:  Place a bench or chair by the main entrance/exit door so you can sit down while putting shoes on and taking them off.

Accommodate mobility aids

You may be using mobility aids such as canes, walkers, rollators, and wheelchairs to help you get around your home.  If so, the following home modifications for seniors will enable you to use them more comfortably:

• For the larger aids, make sure that your bathroom, kitchen, hallways, and other areas of your home are spacious and open enough to fit them.
• To accommodate wheelchairs, install ramps, smooth flooring, doorways at least 36” wide, tilting mirrors, and a roll-in, curbless shower with a compressible threshold that keeps water in, yet allows wheels to pass over it.  Make sure that countertops and sinks are accessible by lowering their height and removing cabinets underneath, or by making them adjustable height or motorized.
• You may want to install automated, motion-triggered or voice-triggered light switches as well so that you don’t need to let go of your walker and reach out to turn the lights on and off.

Flexibility

Another health issue that seniors may experience is decreased flexibility, as muscles and joints stiffen and fluid and cartilage wears away.  Below are suggestions for home modifications for seniors that will reduce the need to bend over or stretch up to reach things.

Sinks

• Depth:  Avoid deep sinks, as often found in kitchens.  Install shallow sinks instead, so you don’t have to bend over to reach the bottom.
• Faucet:  Make sure the faucet is easily accessible, either positioned on the side or activated by motion.

Bathroom

• Shower head:  Install an adjustable, removable handheld shower head so you can easily direct the water where you want.
• Toilet:  Automatic flushing toilets let you avoid leaning over to reach for the lever or button.  Automatic cleaning toilets, such as bidets, also are helpful if you have flexibility issues.  Make sure the toilet paper holder is installed in a location that is easily accessible while you’re sitting on the toilet; avoid stands that are easily knocked over.

Kitchen

• Refrigerator:  A side-by-side fridge/freezer combination with long handles will be the most accessible.  Look for one that has clear shelves inside so that you can easily see what’s on different shelves without bending.
• Dishwasher:  Installing an elevated dishwasher will reduce the amount of bending needed when loading and unloading dishes. 
• Microwave:  Avoid overhead microwaves.  Place it on the kitchen counter.
• Stovetop or cooktop:  Make sure the controls are at the front, not in the back, for easy and safe access.  
• Oven:  Consider an elevated wall oven so you don’t need to bend down to reach it.  To avoid having to bend over the door when accessing the food, get an oven with a side-opening door or French doors, rather than one that opens out to the front.  A few ovens offer a slide-and-hide door, where the door still opens out to the front, but can then be pushed inwards and hidden below the oven while you access the food.  Make sure to get a self-cleaning oven as well.

Storage

• Placement:  Ideally, all cabinets and shelves will be installed at a height where they are within easy reach.  Put the most frequently used items in the most accessible locations, preferably in open shelves.
• Steps:  Use a stepstool to safely reach higher shelves without having to stretch and possibly drop items.  To reduce the risk of tripping over the stepstool, consider installing steps that are built into the wall or cabinet and can be pulled out when needed and easily stashed away.
• Cabinet and pantries:  To avoid having to reach deep into your cabinets, install rotating trays, also known as Lazy Susans, in corner cabinets.  Also install pull-out organizers,  drawers, and shelves in your cabinets.  To access upper cabinets, install pull-down shelves.
• Closets:  Similarly, place shelves and closet rods within reach where possible.  Install pull-down closet rods to gain more accessible storage space.

Laundry

• Washing machine:  Choose a front-loading, rather than top-loading, washer so that you don’t have to lean deep into the washing basin to retrieve clothes.
• Accessible height:  If possible, choose side-by-side and not stacked washer-dryers.  Also install them on a raised platform, so that neither one requires bending down or reaching up to be used.

Lighting

• Light switches and sockets:  When possible, install these to be at a convenient height where you don’t need to bend or reach to access them.
• Light bulbs:  Use longer-lasting light bulbs to reduce the frequency with which you need to replace them.  Some light fixtures will likely be out of reach, in which case you may need to get a bulb-changing kit or have a caregiver change the bulb for you.  Even so, make sure at least a few of your light fixtures are within easy reach.  That way, you can be assured that you will always have some light at home, since you will be able to replace those bulbs yourself if necessary.
• Window coverings:  Increasing the amount of natural lighting is always helpful.  Make sure window blind strings are easy to reach.  You could consider installing automated window shades, blinds, and curtains for even easier access.

Strength

As your muscle mass, strength, and endurance diminish, you may find it difficult to stand for an extended period of time or to lift and carry heavy items.  Consider making the home modifications for seniors below.

Lower body strength

• Kitchen:  Modify your kitchen so it has one surface or countertop that you can use while sitting, not standing.  If needed, remove the shelves and drawers underneath one of the countertops so you have a place to sit.
• Bathroom:  Lower the sink counter and remove the cabinets underneath so that you can sit while at the sink.  Make sure the faucets at the back of the sink are reachable from that sitting position.  Also lower the mirror or install one that tilts or has a telescoping arm.

Upper body strength

• Faucet:  At the kitchen sink, install a flexible pull-down faucet so that you can fill pots, vases, and other containers directly on the countertop without having to lift them up from the bottom of the sink.  If possible, install a pot filler faucet above your stovetop or cooktop so you don’t need to carry heavy pots of water over from the counter.
• Bench:  Put a bench, table, or chair by the entrance/exit door so you can put down heavy packages while opening the door.
• Storage:  Put heavier, bulkier items on lower shelves.
• Carts:  Use rolling carts or even a rolling office chair to transport heavy items from one room to another.
• Windows:  Fix or replace any hard-to-open windows.
• Safety:  Select a lightweight fire extinguisher so that you can use it effectively. If this is too heavy, get a fire blanket that you can throw on top of small fires in their early stages.
• Maintenance:  Choose materials that are easier to maintain, e.g. avoid granite.  Do the same for your plants and external landscaping.  Consider downsizing to a smaller home.

This article, Home Modifications For Seniors With Health Challenges, has been written and published by Senior Wing.

Transfers

Some seniors have difficulty in transferring from one position to another, such as when using the toilet, bathtub, shower, or bed.  This can result from declining balance, muscle strength, and/or flexibility.

Toilet transfers

To help with sitting down and standing up from the toilet, you can make the following home modifications:

1. Toilet frame or safety rail:  This provides support on both sides of the toilet, so you can hold the frame as you lower and raise yourself.
2. Toilet seat lift:  For more assistance, install a toilet seat lift, which lowers you down to the toilet and lifts you back up when done.  Some are mechanical, while others run on electricity or batteries.

Another approach is to modify the toilet so that the seat is higher, which reduces the distance and effort needed to sit down and stand up.  A few different types of products can achieve this:

1. Raised toilet seat:  Also called an elevated toilet seat, this is a higher seat that sits on top of the toilet bowl, and is used instead of the existing seat.
2. Toilet seat riser:  This is an add-on that is inserted and installed between the toilet bowl and the existing seat in order to raise the existing seat.
3. Toilet riser:  This is an add-on that is installed underneath the toilet itself to lift the entire fixture.
4. Tall toilet:  The most significant change would be to replace the entire toilet with a tall or comfort height toilet.

If the toilet will be shared with other family members who do not want a higher toilet, you may want to get a portable raised toilet seat that is designed for travelers and can be easily set up and removed without tools or assembly.

Bathtub transfers

Lifting your legs to step in and out of a wet bathtub can be a difficult, risky transfer.  To manage this more safely, consider implementing the following home modifications:

1. Tub transfer bench:  This straddles the side of the bathtub so that half of the bench is inside the tub and half of it is outside.  As a result, you can enter the tub safely by sitting down from outside the tub and sliding over, rather than standing up and stepping into the tub one leg at a time.
2. Swiveling, sliding bathtub transfer chair or bench:  This is similar to a tub transfer bench except it has a chair that swivels and slides back and forth where the bench would be.  This may make it easier for you to rotate and slide over the tub, without added friction.  Additionally, the chair often has a seat belt to provide more security during the transfer process.
3. Bathtub chair:  While the main purpose of a bathtub seat, chair, or bench is to let you sit while bathing, you may be able to use it as transfer aid as well.  If the chair is wide enough to reach the edge of the tub, then sit down on it from outside the tub, and rotate your body until both legs are inside the tub.  
4. Bathtub board:  This is a simple board that sits across and on top of the sides of the bathtub.  To use it as a transfer device, sit down on it from outside the tub, rotate, and then slide in.
5. Walk-in tub:  The most significant change would be to install a walk-in tub, which has a door built into the side of the tub.  As a result, you can enter and exit just by walking, rather than by lifting your legs high over the bathtub wall.

The devices above help you enter and exit the bathtub safely.  The next set of devices help to lower you into the tub and lift you back up into a regular sitting position:

1. Inflatable bath cushion:  Put the inflated battery-powered cushion in your tub.  Then sit on it and wait for it to deflate to lower you into the tub.  When you’re done bathing, reposition yourself to sit on the cushion and re-inflate it so it can raise you back up.
2. Bathtub lift chair:  This chair lowers you into the tub, and then reclines the high back.  You can remain on the chair as you bathe.  After you’re done, it will return to the regular upright position and lift you back up.  Some are powered through manual cranking, while others are battery-powered.  Also, some chairs are portable, while others are mounted to the wall, floor, or ceiling.

Bed transfers

Climbing in and out of bed can be particularly challenging for seniors, as it involves transferring across many different positions.

Some seniors have difficulty shifting from lying down to sitting up.  One approach is to set up assistive equipment that you can pull on; another approach is to prop up your back, which shortens the distance between the two positions. Consider using the following tools and devices:

• Bed loops:  These are short strap loops that attach to the side of your bed.  You can pull on them to bring yourself up.  
• Bed trapeze bar:  This device provides a handle that dangles above your bed, which you can grasp to pull yourself up.  It may be mounted to the ceiling or to a standalone frame.
• Bed ladder assist or strap:  Resembling a rope ladder, this device attaches to the foot or side of your bed frame so that you can grasp each successive rung of the ladder as you pull yourself up. 
• Mattress wedge:  Some of these are inserted between the mattress and the box spring, while others are mattress toppers.  Either way, they add a slight incline and lift to your upper body and may make it easier to get out of bed.
• Foam bed wedge pillow or adjustable bed backrest:  Typically meant for other purposes, such as to provide upper body support or relief, these lift up your upper body substantially and can make it easier to get into a sitting position.
• Electric hospital bed or adjustable bed:  These let you adjust adjust the bed height and raise the upper body with the push of a button
• Automated pillow lifter:  This is an accessory that you place on top of a regular bed, and will raise your upper body with the push of a button, similar to an adjustable bed.

Another challenge lies in rotating your body from sitting up in bed to sitting on the edge of the bed, and vice versa.  Here are some tools that can help:

• Leg lifter:  This is a rigid strap with a loop at one end to hold your foot, and a loop at the other end for your hand.  Then you can pull on the strap to lift your leg into the desired position.  Some leg lifters have two straps so that you can use both hands to maneuver your leg, which provides more leverage.  Alternatively, use a belt or luggage strap that you already may have around your home.
• Swivel seat cushion:  This accessory removes the friction to help you rotate and swing your legs around.
• Transfer boards and slide sheets:  These remove friction and make it easier for a caregiver to shift you from one position to another without lifting. 

If you are looking for help getting out of bed and have the upper body strength, consider installing these devices, which give you something to hold on to:

• Bed assist handle or rail:  This also may be called a bed grab bar, bed lever, or bed handle.  Similar to a chair assist, it is a frame that slips in between the mattress and the box spring and provides something stable you can grasp as you get in and out of bed.
• Transfer poles:  Floor-to-ceiling transfer, security, safety, or lifting poles give you a long bar to hold onto as you gradually change positions.  Some of these poles have a curve grab bar attached to provide even more support.  These can be useful not only by your bed, but also in the bathroom or by your recliner.

One issue may be the distance between the floor and the top of the mattress.  Having a bed that is too high or too low can be problematic.  Some devices that can help:

• Bed risers:  Also called furniture risers, these raise the entire bed by a few inches.  If you can shift from lying down on the bed to sitting up on the edge of your bed, but you are having difficulty standing up, then having a higher bed can make that easier.
• Mattress topper:  This also can be used to raise the top of your bed.
• Bed step stools:  If you are having difficulty getting into a bed because it’s too high, or getting out of bed and navigating the distance to the ground, then using step stools can help break down that distance into manageable chunks.

The final device type is a bed lift or bed hoist, which includes sling lifts, ceiling lifts, and Hoyer lifts.  These provide full support by handling the entire process of getting into and out of bed, and many require caregiver operation.

Navigating stairs

Staircases and steps are among the most dangerous parts of the home for a senior.  Ideally, your home will minimize the need to navigate stairs by having:

• At least one step-free entrance/exit
• A bedroom and full bath on the same floor as the kitchen
• A small ramp into your home if the entrance has just one or two steps 
• A laundry chute for multi-level homes

If the stairs in your home cannot be avoided, then be sure to:

• Remove trip hazards, as outlined earlier
• Install supportive equipment for stairs, as outlined above 
• Consider installing a stair walker, stair lift, platform or porch lift, or home elevator, if needed

Dexterity

Manual dexterity may decline with older age, as a result of declining hand grip strength, coordination, and flexibility.  Use the devices and accessories below to make your home easier to navigate.

• Doors:  Round door knobs can be slippery and difficult to turn.  Replace these with door levers.  Alternatively, cover your door knobs with door grips, which effectively add levers to the knob without needing installation.
• Cabinets and drawers:  Replace round knobs with D-shaped pulls that provide ample space for grasping.  Another solution is to install push-to-open cabinet doors and drawers.
• Exterior door locks:  Using a key to unlock a door can be tricky.  Consider replacing it with a smart lock where you simply need to hold up a key fob.
• Light switches:  Standard toggle switches are small and harder to grasp; install large     rocker switches, which are easier to push.  Use touch-control lamps instead of standard lamps with small knobs and buttons.  Better yet, install automatic, motion-activated or voice-activated lights.
• Faucets:  As with door knobs, avoid round faucet knobs.  Update all kitchen sink, bathroom sink, bathtub, and shower faucets to have levers or touch- or motion-based sensors.
• Eating and drinking:  Stock your kitchen with adaptive dishes, cups, and utensils, which are designed to be easier to grip, unbreakable, and spill- and slip-resistant.  Use a jar opener that is designed to work with minimal effort.  Protect your hands by avoiding using dull knives, which are more likely to slip unintentionally, and by wearing cut-resistant kitchen gloves.

Eyesight

In our later years, it can become more difficult to see clearly.  Driving becomes risky, so be sure to check out your local senior transportation options.  Also make sure you’re prepared for power outages and have a way to navigate if the electricity goes out.  Finally, implement the home updates below so you can see things in your home clearly and safely on a daily basis.

Lighting

Seniors are more likely to struggle to see objects at night or in dim light, which increases the risk of falls.  First, remove trip hazards.  Then follow the home modifications checklist below to improve the lighting throughout your home.

Light placement:

• Outside:  Ensure you have sufficient lighting for exterior pathways, front porches, back decks, doorways, and address signs.  Install automatic floodlights that remain on while the sun is down and that are triggered by motion.
• Inside:
  • Set up abundant lighting, including nightlights, for all key areas of the home, such as stairs, hallways, entrances, bathrooms, and bedrooms.
  • Place task or track lighting wherever you may be doing work, including the kitchen, sink, and stove.
  • Install lighting in small closed-in areas, such as the bathroom shower, bathtub, closets, and underneath kitchen cabinets.
  • Put flashlights on every floor and in key rooms in case of power outage.

Light switches:  

• Place light switches at both the entrances and exits of key rooms, stairs, and hallways so you won’t need to walk through parts of your home in the dark.
• For even easier access, set up motion-activated or voice-activated lights.
• Install illuminated light switches and outlet wall plates so you can find them easily in the dark.
• Or use a light dimmer and just keep a light on low all the time.

Light bulbs:  For optimal clarity, use full spectrum bulbs that simulate daylight and have the highest allowed wattage for the light fixture.  LED lights will provide a lot of brightness and power for minimal energy use.

Surface visibility

Ensure surfaces are clearly visible to avoid bumping and tripping: 

• Clearly mark the edge of stairs, countertops, corners, and floor transitions by using paint or tape in a contrasting color, or even glow-in-the-dark tape
• Paint walls a different color from the floors
• Avoid using materials where the surface is so shiny and glossy that it causes glare, such as in the kitchen or on the floor
• Avoid using heavily patterned carpeting on stairs, which can make it hard to see the stair edge

Readability

Ensure you can read all controls so that you avoid mistakes that may cause accidents:

• Ensure that stovetop controls are easy to see, preferably with a large numerical display and colored or lighted indicators when it’s on.  Alternatively, put red nail polish or non-flammable tape on the stove knob so you can easily see if it’s in the proper OFF position from a distance.
• Choose appliances with large, clear displays, including microwaves, toasters, washing machines, dryers, and more
• Make sure the thermostat is easy to read
• Place magnifying glasses or reading glasses around the home wherever you may need to read small print so you don’t overlook important information, e.g. kitchen, bathroom, bedroom, living room

Hearing

If your hearing has declined, make sure to choose devices that will alert you in a way you will notice easily:

• Devices:  It’s important that you can hear smoke and carbon monoxide detectors, doorbells, phones, and alarm clocks from every room of your home, especially the bedroom and kitchen.  It’s also helpful to be able to hear the microwave.
• Alert style:  For these devices, choose models that are loud, or better yet, will flash the lights on and off, send an alert to your smartwatch, and/or shake your bed.

Temperature

It’s important to keep the home at the right temperature, so that seniors can avoid heatstroke, hyperthermia, and other health issues.

• Ensure the thermostat is easily accessible and that there is air conditioning available.
• Install heat lamps in the bathroom for colder locales. If you’re on a budget, see these additional practical tips for staying warm at home.

Seniors also are at risk of scalding because of thinner skin and slower reaction time.

• Reduce the default water temperature to 120F.
• Install anti-scald devices or temperature controls on your kitchen and bathroom sink and in the shower and bathtub.  Insulate any hot pipes that may be exposed under the sink.

Cognitive decline

For seniors who are experiencing some cognitive decline, it can be helpful to install home devices that help ensure that heating devices have been safely turned off, including:

• Auto-shutoff kitchen appliances, toasters, stoves, space heaters, coffee makers, curling irons, etc.
• Smart plugs with timers to turn off the above automatically or from a remote location
• Stove knob locks to prevent accidentally turning on the stove when bumping into the controls
• Home security video cameras to check on your appliances wherever you are

Also use smart devices to make sure that doors and windows are locked when you want them to be – and not locked when you don’t want them to be.

• Avoid using doors that automatically lock when you close them.  Smart locks with numeric codes can provide you with a backup solution to enter when you’ve been locked out without your key.
• Smart locks also let you confirm that your door is locked even when you’re away from home. Smart contact sensors can proactively alert you if a door or window was inadvertently left open – or if a door is being unlocked while you’re away.
• Another benefit of smart locks is that they let you provide caregivers with a temporary code to enter, rather than a physical key that can be lost or copied.