At first glance, the house at 16218 Pennsbury Drive in Bowie, Md., seems unremarkable. In fact, the neighbors are surprised at just how well it fits into this bedroom community about 20 miles due east from the Nation's Capital.
But a closer look reveals some surprising and unusual details. Handrails disguised as chair molding, for example. Contrasting boarders in flooring and around countertops. A microwave that's reachable from a seated position. A flush doorway with no step-up. Stair rails you can actually latch on to.
Welcome to the house for all ages. But more important, a 1,900-square-foot home for folks who are moving through the later stages of life and would rather stay put than move to another place better designed and equipped to handle the infirmities that are part and parcel to old age.
It's called the "LifeWise House," and it's been built by the NAHB Research Center to show home builders they don't have to go to great lengths - or great expense - to erect houses their owners can remain in for their entire lives.
"Not everything in the house is 100 percent accessible," says Charlotte Wade, a senior research analyst at the Research Center. "But it's pretty much totally adjustable so someone can live with it as their conditions change." Which is, of course, what most people say they want.
Despite the rush of seniors leaving the harsh winters behind for the warmer climes of Florida, Arizona, Southern California and places in between, survey after study finds that the vast majority of people 90 percent of persons age 65 or older, according to the latest AARP figures would prefer to remain in their current residences for as long as possible.
Unfortunately, those who develop a disability that limits their daily activities will find it difficult, if not impossible, to do that because most houses being built today are not designed or equipped to handle the inevitable changes in people's physical abilities.
According to the Census Bureau, more than half of all seniors - 17.5 million people - suffer a substantial limitation in a major life activity. And 12 million of them say their problems are severe.survey after study finds that the vast majority of people 90 percent of persons age 65 or older, according to the latest AARP figures would prefer to remain in their current residences for as long as possible.
Here's an idea of what they are going through, and what the rest of us can expect as we age:
10 million seniors (31.4 percent of the total) report difficulty using stairs, yet you have to step up to enter most houses, and there often are no bedrooms or rooms that can be converted to bedrooms on the main entry floor.
1.2 million (3.8 percent) use a wheelchair, but standard doorways and hallways are not wide enough to accommodate them.
3 million (9.4 percent) have a tough time grasping objects, yet hand rails are more decorative than utilitarian, and grab bars or reinforced walls to hold them are practically non-existent.
7 million (22 percent) have vision problems, 2..8 million (8.8 percent) have trouble bathing, 1.4 million (4.3 percent) find it difficult to use the toilet, and 2.7 million (8.4 percent) have difficulty preparing meals.
The LifeWise house is not a senior's house, at least not per se. In fact, it's 1«-story layout is not a traditional senior's design. But it is senior-friendly, and it is just what the doctor ordered, says Terre Belt, acting president of the Research Center a place that facilitates the ability of older adults "to live comfortably, safely and independently in their homes as they age."
William Stothers, deputy director for the Center for an Accessible Society in San Diego, is enouraged, too. "Hopefully," he says, "builders will begin to see this as a market whose time has come."
They'd have to have vision problems of their own not too. After all, over the next two decades, the number of persons 65 or older will increase by more than 50 percent, rising from 35 million in 2000 to 54 million by 2020.
Historically, builders haven't perceived a need for even the basic tenants of accessibility an entrance without a step, at least one accessible bathroom on the first floor and doorways that are 32 inches clear width on the main living level. In fact, Stothers claims, builders have been pretty much opposed to universal design, or "visitability," as the movement is becoming known, arguing that the market doesn't want it.
But Concrete Change, a Decatur, Ga.-based group dedicated to making all homes barrier-free, points out in its literature that the people who need these features "often have their need emerge suddenly after an illness or injury and are in no position to advocate for their needs on the market."
Even when buyers request accessibility features, the group maintains, they often are told no or charged substantial sums.
Concrete Change believes legislation is necessary to successfully affect the status quo. Not just measures like the one passed in Georgia in 1978, which encouraged builders to voluntarily make the necessary changes, but laws that force builders to do so.
"Once (basic accessibility features) are required, they will become routine," the group says.
Actually, some jurisdictions have already enacted such ordinances.
Normally, local accessibility requirements apply only to single-family houses subsidized with local funds. But Florida passed a law in 1989 requiring that main floor bathroom doors be wide enough to accommodate standard wheelchairs.
And last year, Pima County, Az., became the first place in the country to require a zero-step entry and certain other features in all new houses. The new rules apply only to the unincorporated area of the county and not to the city of Tucson. Even at that, though, an estimated 3,000 houses a year will be covered.
Similar laws are under consideration in Santa Monica, Calif., and Pittsburgh. And at the national level, Rep. Jan Schakowsky, D-Ill., introduced a bill last year that would require all newly-built homes receiving federal funds to meet the three basic standards of accessibility.
"It defies logic to build new homes that block people out," said the Illinois lawmaker, noting that three out of 10 people will face a disability before they are 67. But legislation may not be necessary, suggests Andrew Kochera, a senior policy advisor at AARP in Washington, who says builders are beginning to pay attention to the demographics.
"Overall," Kochera says, "builders are very cognizant of the large generation of baby boomers" that is approaching senior status. "And many are now trying to maneuver themselves to have a product that is attractive to this group."
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JANUARY 17, 2002
SCHAKOWSKY PARTICIPATES IN PANEL ON LONG TERM CARE NEEDS OF AGING PARENTS
EVANSTON, IL - Residents of the 9th Congressional District tonight joined U.S. Representative Jan Schakowsky (D-IL) for a discussion on the long-term care needs of aging parents. Schakowsky said, "Our challenge is to create housing, health care, retirement and support services that don´t just address a theoretical "senior" population - but address the individual needs of individual seniors and their families."
Below is the full text of Schakowsky´s statement:
For decades, we have been committed to expanding the life-span of Americans, and we have been successful. Greater access to health care through Medicare, new treatments, exercise and activities, has allowed our parents and grandparents to live longer and live better.
Policy makers are looking at these demographics carefully. According to the U.S. Census Bureau, the number of persons age 65 and older will grow to over 53 million by 2020, a 50 percent increase from today. As important, the number of persons age 85 and older will grow by even more. In 20 years, that number will grow by 62% -- to 6.5 million.
Each one of those numbers represents real people - our parents, grandparents, friends and neighbors. As we know, each one of those people has different needs and different concerns. According to the 1999 American Housing Survey, there are 25 million households headed by a person age 62 or older. 1 in 5 - 20% -- are renters. And half of those renters pay more than 30 percent of their income on housing.Our challenge is to create housing, health care, retirement and support services that don´t just address a theoretical "senior" population - but address the individual needs of individual seniors and their families.
In housing, that means that we must have a vibrant continuum of care and services that starts by ensuring that seniors can stay in their own homes and be active members of their communities. We need to protect seniors from scam artists, so that they don´t lose their homes. I have introduced H.R. 2531, the Save Our Homes Act, to ban predatory lending practices. Predatory lenders often prey on seniors, hooking them into high-interest loans that all too often result in massive debt and foreclosures.
Many of our parents and grandparents, however, also need housing assistance. This heavy rent burden is on top of the very heavy health care burdens many of them face. One-third of all households receiving federal housing assistance (not including mortgage deductions) are headed by seniors. Many senior citizens benefit from Section 8, a voucher program that provides rental subsidies. However, as the housing market becomes more expensive and Section 8 contracts expire, the pressures on this program are growing.
The major federal housing program for the elderly is Section 202, administered by HUD. Section 202 is the only federally-funded, new construction housing program that focuses on meeting the needs of senior citizens. Section 202 funds can be used for construction or rehabilitation of housing projects. They can also be used to improve housing by providing supportive services such as meals, transportation, housekeeping, personal care and health services. Finally, they can be used to convert existing projects into assisted living facilities. This is a critical program, yet it is seriously underfunded. According to an AARP survey, there are 9 senior citizens waiting for every Section 202 vacancy. And that number is growing.
--U.S. Representative Jan Schakowsky (D-IL)
While new facilities are being built to meet the needs of new tenants, the AARP survey also found that managers of existing Section 202 housing don´t have the funds to retrofit the oldest projects, where many of the oldest residents are concentrated.
The need for senior housing is growing but federal funding is not. Last year, Congress passed a VA/HUD appropriations bill that includes $783 million for senior citizen housing building and retrofitting programs. We provided $50 million to provide support service coordinators in Section 202 projects and $50 million to convert housing to assisted-living programs.
We had to fight hard for what is only a one percent increase in the budget for senior housing programs - not even enough to keep pace with inflation. And, as we know, those 9 senior citizens are still in line waiting for a vacancy. We need to find the resources so that housing is both available and affordable. But that is not enough. Housing must also be appropriate.
Once again, the demographics are important. Many senior citizens are healthy and active. But many are not. A study by the Lewin Group for the AARP estimates that the number of senior citizens who need help with 2 or more activities of daily living (walking, bathing, eating, dressing, transferring from a bed or chair or using the toilet) will grow by 65% over the next twenty years. By 2020, there will be nearly 3 million parents and grandparents who need help with major life activities.
There are many new ideas about how to provide that help and allow senior citizens to stay in their communities. The assisted living movement is growing here and around the country. There is no uniform definition of assisted living but it is generally defined as a combination of housing, supportive services, personalized assistance, and health care designed to respond to individual needs and allow persons to live with the maximum amount of dignity and independence. While we generally think of assisted living as facility-based, there are some home-based or apartment-based models. Assisted living receives a small amount of federal funding -- $50 million - through HUD Section 202, and services are also partially funded through the Medicaid Home and Community-Based Services program. Still, 85 percent of assisted living is privately funded.
One challenge before Congress is to provide more support for those services. But, in doing so, we also need to look at standards for those services. Right now, assisted living providers argue that the federal government should not impose quality and consumer protection requirements, since the federal government doesn´t pay the bill. However, many others argue that quality problems require federal oversight. A 1999 U.S. General Accounting Office report found that 25 percent of assisted living facilities had five or more quality of care or consumer protection violations. 1 in 10 were cited for 10 or more problems. Today, only the states regulate those problems.
I am a cosponsor of H.J.Res. 13 which calls on President Bush to convene a White House Conference to develop national recommendations to promote assisted living facilities while ensuring quality of care. For all of us who believe that this is an important way to allow our parents and grandparents to "age in place," the need for greater federal support is evident.
Some seniors, however, will need greater access to medical or custodial care and will need nursing home care. In March 2000, my colleagues Representatives Blagojevich and Rush and I released a study of Chicago metropolitan area nursing homes. We found that 79% of Chicago area nursing homes violated federal health and safety standards. One in seven had been cited for at least one violation that caused actual harm to residents or placed them at risk of death or serious injury. A year later, we released another study that found that those nursing homes that met minimum staffing ratios had 60 percent fewer violations. However, only 16% of nursing homes met the preferred staffing ratios.
Of course, many nursing homes provide quality care, but we believe that every person who enters a nursing home deserves to know that she or he will receive the best possible care. That is why I introduced H.R. 3331, the Quality Care for Nursing Home Patients Act of 2001 in November. That bill would mandate that nursing homes meet the minimum staffing ratios developed by groups like the National Consumers Coalition for Nursing Home Reform, the National Committee to Preserve Social Security and Medicare, and nursing/gerontological experts from universities like Harvard and the University of California. At the same time, we would review payments to nursing homes to make sure that they are adequate to provide new staffing and make recommendations on how to attract more qualified health care workers to the field.
