A recent poll conducted by the U.S. Department of Health and Human Services indicates that 86 percent of Americans prefer to “age in place.” This preference has resulted in a nation-wide interest in home improvement and a $40 billion remodeling market. For the advanced planner, gone is the standard 5- by 7-foot bathroom, replaced by spacious rooms built for comfort and convenience. Also gone are inefficient systems that expel energy at a rate far too high for a senior’s retirement income. In their place are energy efficient systems that not only pay for themselves in dollar savings, but also provide a stable and healthy thermal environment.

Accessible and Safe: It’s no myth that the bathroom is the most dangerous room in the house. With an average of 441 people a day admitted to emergency rooms because of falls in the bathtub, safety is of primary concern for the elderly. Case in point is Judith R. Bracht’s, CKD, CBD, (Richard M. Tunis, Inc., Chevy Chase, MD) residential design, which took third place in the National Kitchen and Bath Association’s 1997 Design Competition. According to Bracht, the owner of this bathroom wanted safety, comfort and convenience for today and for his future years. “I’m not leaving this house until they carry me out,” is what the owner in his mid-fifties told Bracht.

To accommodate the owner’s needs, Bracht included a high-seat water closet with a telephone and extra storage within reach; flat entry threshold to avoid tripping; scored granite slab floors to prevent slipping in the shower; 36-inch high lavatories to reduce the need for bending; a hand-held shower and pressure-balanced valves with blade handles.

“A lot of people are realizing they need these features after taking care of elderly parents,” says Bracht. “They are beginning to understand that what they have now just isn’t enough.” After experience with manipulating parents into showers, adjusting temperatures, and getting drenched by wall-mounted shower heads, these children/care-givers are redesigning for the future. “Now, 90 percent of the bathrooms I design include handshowers, the 36-inch vanity and grab bars.”

According to Bracht, three items that should be in every home, no matter the age are grab bars, shower seats and hand–held showers. These items make the home universal, meaning that they are designed to be available and accessible to the least able user, but generally benefit every single user. “You never know when you’ll have a temporary injury and need these features,” says Bracht, whose college-age son recently broke his arm in three places and could have been aided greatly by these items.

Forever Young: When asked about the design of the “safe” bathroom, Bracht’s client made no mention of safety or his plans to accommodate his later years. Instead of repeating what he told Bracht, he said what he wanted was the luxury he found throughout his lifetime of travel in top hotels, avoiding any discussion about aging. His reluctance to discuss aging is common.

One of the largest problems in designing for the future is that age creeps up slowly for both the designer and the customer. “I’m not old so I don’t have to design for it,” is what George McAllister, president of Aqua Bath Co., Inc., often hears. In his talk, “ADA Versus the Elderly” presented at the American Society of Plumbing Engineers Convention in Phoenix last fall, McAllister highlighted the challenges of addressing the needs of the elderly, those 65 and over, not covered in the Americans with Disabilities Act.

“Aging is a much different disability than what ADA describes,” says McAllister. While ADA does provide many of the safety features necessary for older people, maturing needs to be regarded as a natural stage of life, not as an era of dependence. “It takes a different tack to open up the elderly market.”

“What keeps people from jumping on the band wagon is that we as a nation perceive ourselves as a young, can-do kind of country,” says aging in place specialist Irma Dobkin, Irma Dobkin Interiors, LTD., Bethesda, MD. “There is this inherent obligation for Americans to be able to do things like live in homes that were built without any consideration to the changing human capacity through a lifetime. And to say that you need to make changes in your home in order to live — that’s an admission of guilt.”

Of key importance in selling for future convenience is understanding these psychological aspects of aging. We’d all like to think we’ll be as we were in our twenties — strong, independent, tireless — and most people do imagine themselves this way. It’s hard to conceive that we all loose that independence and modesty, especially when a facility does not match our capabilities and we must change life-long habits.

These habits drastically change if a user suffers an immediate life-altering illness, a stroke for instance, and suddenly is forced to rely on others to assist in previously independent and private functions. Not only must designers consider the needs of the elderly on their own, but now also the needs of the care-giver.

Common complaints of elderly users and of their care–givers include:

• lever-type faucets
• poor illumination
• projected edges
• obstructed entrance and exit from the tub and shower
• cold surfaces
• reaching controls from outside the tub and shower
• inaccessible storage maintaining balance

With the variety of products now available, these future problems can be solved today without limiting customer’s design options. Adjustable sinks, raised toilet seats and radiant panel heating are obvious solutions. But many in need of these products are unaware of their existence.

Dobkin’s book, Gracious Spaces, due out later next year, will address these concerns by presenting several design options to the aging and disabled reader. “These products once had the appearance of the medical technology from which they derived,” says Dobkin, “and I had clients who said, ‘it doesn’t matter what it looks like since no one is going to make anything attractive for us.’” Dobkin asserts that they must care because those makeshift products denigrate the quality of life. With well-made, well-designed products to aid their retirement years, Dobkin estimates that 70 percent of the people who choose to move to receive assisted care would continue to live in their homes for another decade and more.

Energy Efficient Designs: Few home builders take their client’s retirement into consideration, making America’s housing stock obsolete since it will not meet future consumer needs. Along with poorly designed spaces that force seniors out of their homes are inefficient energy designs that make upkeep costs unbearable for the elderly on a fixed income.

Most recent statistics from the U.S. Bureau of the Census, which date to 1989, put the median income of families with heads age 65 and older at $22,806, about 63 percent of the median income of families with heads in the peak earning years, age 25 to 64. The median income of elderly people not living in families was $9,422, about 46 percent that of comparable nonelderly.

In recent years, there has been a growing perception that the economic status of the elderly has improved, and that they now have resources relatively equal to that of the younger working population. But other factors weigh in. Along with the reality that they have limited potential to improve their income through work, they become economically vulnerable to circumstances over which they have no control; such as the loss of a spouse, deterioration of health, various legislation of Social Security and Medicare, inflation, and soaring energy costs.

A couple planning their retirement home in Lake Geneva, WI, has taken all these factors into consideration. Energy efficiency and accessibility shaped each construction decision. Expecting completion this month, the owners worked with O’Leary Plumbing in East Troy, WI, and Quehn Heating of Antioch, IL, to develop a barrier-free and energy-efficient home complete with R55 insulation in the ceiling; R19 insulation in the walls; triple-glazed, argon-gas filled windows to ASTMC-106-85; self-adjusting boilers; indoor/outdoor reset controls; an ERV unit and all gas appliances.

“We wanted a house that would be easy to maintain, would provide us with comfort and would be completely efficient,” said the owners, who requested anonymity. “That’s why we chose radiant.” Providing comfortable, clean and quiet heat — the 2-inch acoustic foamboard under the slab supplies sound insulation — radiant also allowed them the zoning control they needed to keep costs down.

With tools to reduce installation time, it took one day for two workers to install the HeatLink radiant system in the 4,500 square foot home, providing obvious savings on installation time. The radiant system also allowed the owners to make the structure completely barrier free and include design features such as a 14-foot entrance and 9-foot ceilings without giving up comfort. Also installed were snowmelt loops for the front steps and the patio to prevent winter falls. With these energy-efficient features, the owners believe the system will pay for itself within the first few years, and provide the savings and safety for years to come.

Public Changes: Our nation’s denial and denigration of age has prevented us from viewing it as a natural cycle of life. As a society, our goal should be to maximize human function and promote good life. At their hearings earlier this year, the International Plumbing Code Committee elected to support this goal by approving unisex toilet and bathing rooms.

Unisex toilet rooms provide both the disabled and the elderly the space and fixtures concurrent to their capabilities. The unisex concept is based on husbands or wives helping each other use the plumbing fixtures. It allows the elderly user the dignity not afforded by most public facilities. Section 404.4 reads, “an accessible unisex toilet room shall be provided where an aggregate of six or more male or female water closets are required.”

This public acceptance of the needs of the elderly and disabled is a definite step toward promoting life. With the help of a vocal aging population and smart contractors, this acceptance will grow into a substantial residential niche.