Independent Living: How to Plan and Budget for Aging in Place

When customers contact Owen Barclay, it’s usually too late. “They end up calling us, urgently needing a bathroom renovation because they’ve had a mobility event,” says Barclay, owner of a Surrey, B.C.-based home-adaptation company, Accessable Home & Property. “Despite people’s intentions to get ready for aging, people procrastinate … we end up doing expensive renovations for people who should have started the process anywhere from five to maybe even more than 10 years earlier.” 

Aging in place is taking on new urgency for older Canadians who watched COVID-19 run rampant in nursing and retirement homes and cause 80 per cent of deaths in the first wave, according to Ryerson University’s National Institute on Ageing (NIA). In July that year, the NIA, along with Telus Health, surveyed more than 1,500 Canadians about their perspectives on aging, and almost 100 per cent of those 65 and older said they intended to stay in their own homes as long as possible. The report noted a “disconnect” between the desire to live at home and the reality, after just 30 per cent said they don’t feel prepared to handle a medical emergency. 

The report also pointed out that more than half of all injuries to seniors happen at home, 80 per cent happen during the day, and almost a third of those 65 and older will fall at least once a year. These accidents can start a cascade of medical issues that often end in admission to a seniors’ home. 

Joanie Sims-Gould, an associate professor in the Department of Family Practice at the University of British Columbia and part of the university’s Active Aging Research Team, encourages seniors to think proactively. “I think that it’s always more challenging when you are in a place of reactivity,” Sims-Gould explains. “The more that you can prevent and anticipate, the more it enables people to grow old with choice.”

Age-proofing a home can cost as little as $50 to install a grab bar to $35,000 for a home elevator, to as much as $250,000 for an outdoor lift to bypass steep, rough terrain. Barclay says it’s not uncommon for customers to do the work piecemeal, starting with things like handrail and grab-bar installation, before tackling larger projects such as a shower conversion or elevator installation. 

Seniors may be eligible to recoup some money through federal and provincial tax credits and grants. In Ontario, people 65 and older can claim a tax credit — 25 per cent of up to $10,000 — to make their homes safer and more accessible. Eligible expenses include grab bars, wheel-in showers, non-slip flooring and motion-activated lighting. Home accessibility expenses of up to $10,000 can also be claimed on federal income tax returns. “We get a lot of requests early in the new year for people that have lost invoices or lost receipts because they want to claim things,” he explains.

Low-income seniors may qualify for grants like B.C.’s Rebate for Accessible Home Adaptations, which offers up to $17,500, but Barclay says qualification guidelines can be tricky to navigate. For example, large-scale projects, like a $5,000 wheelchair ramp, require contractors to complete an assessment and an estimate, although he warns that the approved grant may not cover the full cost. Smaller renovations, like upgrading a regular toilet to a “comfort height” model for less than $1,000, wouldn’t require an assessment.

Here are a few home modifications to consider for aging in place.

 

Handrails

 

Most stairwell handrails in homes are insufficient for aging seniors, according to Rob Geller, VP of corporate relations for Promenaid, a Montreal-based, accessible handrail company. “The optimal shape is round,” Geller explains. “You can get your hand around it [with] a firm grip.” The more common “bread-loaf” style, with a rounded top and wide base, often has posts or brackets that require the user to take their hand off to get around them. “You [should] have a continuous grip, meaning the railing is unobstructed as you move your hand along it,” says Geller.

Upgrading handrails begins at the stairwell, where most falls occur. But Geller has also seen customers use them in garages, hallways and basements. Adding an accessible handrail to one side of a hallway or stairwell is a good start, but Geller advises installing them on both sides where possible. “As we age, maybe one side [becomes] weaker than the other,” he explains. A handrail or a grab bar near exterior or side entrances — any threshold with a step or two — can help. Promenaid has grab bars that look like a decorative handle. “We can attach it to the door frame and it looks like a little esthetic handle,” Geller explains.

To improve visibility, handrails can be upgraded with LED lights. Promenaid’s handrails accommodate lights that snap into the base — Geller recommends having one every two or three feet (0.6 to 0.9 metres) — and the system can be used outdoors. “They can also be hooked up to [smart speakers, such as] Alexa and Google Home,” says Geller, allowing users to use voice commands to turn on handrail lights. Standard straight handrails cost about $20 a linear foot (0.3 metres) while a wood-wrapped design costs about $35 a foot. Handrails for stairways that have curves and bends are custom-made and priced accordingly. LED lights cost $90 each.

 

Decorative Grab Bars

 

One way to combat the stigma around supportive accessories like grab bars is to disguise them as something else. The Invisia line from HealthCraft, an Ottawa-based home safety and fall prevention product company, aims to do just that. “You’re not putting in a grab bar; you’re putting in a towel bar that just so happens to support 500 pounds,” explains national sales director Jason St-Amant. Invisia’s support accessory line includes grab bars that act as shampoo shelves for the tub, and toilet roll holders. These functional items further camouflage their secondary use as a support accessory compliant with the Americans with Disabilities Act Standards for Accessible Design.

Another way that the Invisia line eschews the look of traditional grab bars is by using a stem-mounted design as opposed to flanges, a protruding lip or rim at contact points to the wall. “Those circular flanges are the thing that screams to people, ‘I’m a grab bar,’” St-Amant says. “If you were to show people our shampoo shelf [and they] didn’t have any prior knowledge of what it is they’re looking at, most would not think, ‘Oh, that’s a grab bar.’” Invisia’s curved designs are ergonomic, according to St-Amant. “If you’re grabbing one of our rails from the side, it’s meant to engage your top two fingers and your bottom two fingers, so you’re getting the most amount of grip.” 

Pleasing design does come at a premium. Invisia’s shampoo shelf starts at $270 while its towel bar costs $189, compared to a standard grab bar that costs $50 to $75. But St-Amant encourages customers to see the value in the products’ dual purpose as a support accessory and a shelf (or a toilet roll holder, or a towel bar).

 

Accessible Showers 

 

These days, accessible showers are preferable to walk-in tubs, says Joselle Stringer, a sales and customer service representative from the Vancouver-based, safe-bathing solutions company ORCA HealthCare. “With a shower, a person can feel safe by holding onto the grab bars while stepping in,” Stringer explains. “It is so much easier to transfer from wheelchair to the shower seat than getting into a walk-in tub.” Tubs are less environmentally friendly since they use more water – they also take longer to fill — although some seniors prefer the therapeutic benefits of a bath, especially if it has air jets, to alleviate pain.

Walk-in baths cost up to $22,000, while a walk-in shower costs around $10,000 to $12,000, including installation. “A walk-in tub still has a four-inch to six-inch (10-cm to 15-cm) step to consider,” Stringer explains. “The door will also be more narrow.” Roll-in showers, in contrast, have a half- to one-inch (1.2- to 2.5-cm) curb and cost $11,000 to $13,000. ORCA also offers a “Lifetime Shower” design with a $300 mini-curb that can be removed to convert a walk-in shower to a roll-in. “Some very mobile seniors don’t like the idea of needing an accessible shower at the beginning,” says Stringer. Safe bathing accessories, like grab bars and handles, are included in the cost estimate. Tubs can be upgraded with premium finishes on fixtures, like oil-rubbed bronze or satin nickel, and rain-shower or handheld showerheads, increasing the price by another $1,000 to $2,000. Adding a teak shower seat would cost another $1,500. ORCA can create custom coloured-tile patterns to suit the user’s tastes. For those on a budget, and with more mobility, the company offers a tub-cut service to convert an existing bathtub into a walk-in shower. It costs about $1,000 and takes a few hours to install.

 

Elevators

 

Traditional elevators — similar to what you’d see in an office tower or condo building — are not as popular as are home lifts, according to Steve Reid, the owner of Kingston, Ont.-based Home Elevators, because the cabs run along support rails through cut-outs in the floor. Most traditional elevators require a machine room, as well as overhead and underground clearance for machinery, which can require excavation below the basement. “[Lifts are] designed for retrofits, so they’re ideal for people who are retiring and wanting to stay in their home,” Reid explains. “[There’s] very little construction involved,” and installation takes about three days. A two-floor, two-person lift costs about $30,000, while a three-person lift, which can accommodate a wheelchair and move between as many as three floors, costs about $35,000. 

Another style growing in popularity is the vacuum elevator — a round glass tube reminiscent of the pneumatic mail tubes of old. “[They’re] sharp-looking elevators,” Reid says. “People love them, [but the] price point is obviously a lot higher.” They start at $45,000 for a small, two-floor model and can go up to $100,000 for a larger design with multiple stops. The vacuum elevator’s operation is just as nifty as its design. “[It] has a turbine unit on top of the elevator that draws the air out from above the cab,” Reid explains. “The cab has a seal around the top and it creates a vacuum above the cab and draws it up. When it gets to the floor, it locks itself onto the rails. Although there are no cables, it can’t fall. [It’s] very safe, very efficient.” Vacuum elevators are suited to retrofitting and are quick to install over two to three days. 

 

Outdoor Lifts 

 

Renewed interest in rural living during the pandemic has spiked interest in John Weinstein’s lift business, based two hours north of Toronto in Bracebridge, Ont. Seniors make up the majority of Inclined Elevation’s clientele because they face challenges traversing steep, rocky cliff faces to their homes and cottages. “Sometimes, people buy them because they have really extreme situations, like it’s half an hour to get to the water and they have to go some circuitous route,” Weinstein explains.

Inclined Elevation’s outdoor tracks run from 40 feet to nearly 346 feet (12 metres to 105 metres), lifting passengers up to 20 storeys, about 216 feet (65 metres) or more. Carriages look similar to the cabin of an amusement park ride and can seat up to four people, or accommodate a wheelchair user and an attendant. While Weinstein used to build two or three a year, the pandemic has brought unprecedented interest. By the end of 2021, Inclined Elevation booked contracts to construct nine lifts in 2022.

Each lift is custom designed and installed over two to three weeks. But they don’t come cheap, with a typical price of $100,000, while lifts that require longer tracks, higher elevations, multiple stops or changes in pitch, cost more — his priciest lift to date came in at about $250,000, and he’s built about 100 since he started the business in 2006. “I’m fond of saying that people don’t buy inclined elevators, they buy their property for the rest of their lives,” says Weinstein. “They’re buying access to the water, or maybe to the property itself, because sometimes the lift goes from the parking area to the cottage.” 

A version of this article appeared in the February/March 2022 issue with the headline “The Cost of Aging in Place,” p. 42. 

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