With the wonder of modern medicine and our greater awareness of healthy lifestyle choices, people are living longer than ever. The consequence of increased longevity—coupled with the aging baby boomer generation—is the growing need for help with daily tasks as we grow older. To remain in the comfort of your own home and avoid entering an assisted facility for as long as possible, experts in the field note two major considerations that allow people to remain independent longer: living space alterations (including the use of medical devices) and caregiver support services. Home Design for Aging in Place The place we call home becomes a different space as we grow older and the home's layout no longer functions effectively as our mobility decreases. "There's a movement of universal [home] design, which Europe adopted earlier than we have," said Peter Gulick of Gulick & Company Renovation Contractors in Madison. Using universal design principals, "when you build a [new] house, you do it for everybody, right away, so that you have high and low areas in kitchens that can be reached without stretching, and you have wide doorways to accommodate wheelchairs." Gulick, who has an aging in place certification, brings his knowledge to bear when called upon to assess the layout of an existing home to make it friendly to seniors. Items like replacing bathtubs with walk-in showers (called zero-entry showers so there is no threshold to step over) and installing wide shower doors and grab bars are highly recommended by eldercare professionals. "The challenge is getting people to realize they need help," Gulick said. "One of the biggest problems we have is getting people to get rid of their throw rugs, which are a major trip hazard. It's difficult to tell people they have to eliminate things they have always lived with." Occupational therapists and visiting nurses will survey a home and give recommendations that contractors can install. Those recommendations run the gamut from simple alterations like replacing hard-to-turn doorknobs with ADA compatible levers, changing drawer knobs over to pull handles, and installing ramps and stair lifts to eliminate stairs both inside and outside the home. "More complex alterations include the widening of doorways if a wheelchair is involved, or turning an unused room on the first floor into a bedroom," Gulick said. The latter often includes turning a first floor half-bath into a full bath by moving a wall and installing a zero-entry shower. "There are several things a designer can do to make the home more functional and safe, but talking people into making those dramatic changes can be a challenge," Gulick admitted. "We really need to get people to starting thinking about this and avoid nursing homes. But some people will fight even having grab bars installed." In Gulick's study of universal design, which is also called barrier-free design, he's learned that upper cabinets are best when eliminated from a kitchen. "You build a pantry instead, which is accessible to everyone," Gulick said. "People are also putting tables back into their kitchens, which is great for people in wheelchairs and for kids, instead of tall islands," Gulick noted. "And universal design will have the area under a kitchen sink open so a wheel chair can be pulled up to it, or a sink cabinet in a bathroom replaced with a pedestal sink for the same reason. "Ideally you want people to be pro-active and say, 'Hey, I'm getting older now and I need to think about changes to my home before I get too much older and a problem develops,'" Gulick said. Personal Assistance for Seniors Freda Arel of Comfort Keepers in Guilford notes the importance of homecare aides for seniors who develop age-related mobility restrictions. "When you can no long bend or stretch and do the things you used to be able to do, homecare aides will come in and help with the laundry and cleaning, meal preparation, and reminders to take medications," Arel said. Comfort Keepers will also handle essential tasks like grocery shopping, running errands, and taking clients to doctor's appointments. "We enable seniors to stay in their homes by providing assistance for household tasks. Seniors want to be able to do these things for themselves, but they often cannot, so the homecare aid takes the burden off," Arel said.