Where the heart is: how to pay for home modifications

By Michelle Seitzer

Aging in place (AIP) costs considerably less than assisted living care, but it’s not free.

Though funds are dwindling for many senior-related programs (Medicare, Medicaid and Social Security have all spent ample time on the chopping block lately), there are still a number of federal, state, local and private organizations that offer financial support to seniors who want to stay where the heart is.

To begin – because first you might need to sell the idea to skeptical family members, or just figure out what modifications are needed before getting the capital to do it – get to know what services and resources are offered in your home state via these helpful sites:

• Search for home repair and modification resources in your region at Eldercare.gov.
• HomeMods.org is a national information clearinghouse on all things related to home modifications. Professionals and consumers alike can peruse an extensive resource directory on the site.
• Not sure if your own home or a senior loved one’s residence is adaptable for AIP? Most are, but the WellCome Home site helps you clearly see the potential and know where to direct your energies and efforts when it’s time to transform the home.
• Download this Home Safety Checklist from Rebuilding Together, Inc. to remove fall hazards and resolve accessibility issues, many of which may be implemented without spending a dime.

Should the need arise for assistive equipment (such as power chairs or stair lifts) or home modifications (like wheelchair ramps or door-opening systems), here are a few ways to ease the burden of purchasing or installing these costly components.

Claim a deduction. Russell Glickman, a DC-based home design and remodeling expert, recommends conferring with a Certified Public Accountant (CPA) to find out whether you or a loved one is eligible to deduct the cost of home modifications on your federal income tax. You need a written recommendation from your doctor as proof that the modifications are medically necessary. Glickman also states that you can claim a deduction for the costs of operating and maintaining the modifications, whether or not the stair lift, ramp, or other equipment qualified as a medical expense. Home improvements (or capital expenses) that may be deducted per the IRS.gov are as follows:

• Constructing entrance or exit ramps for your home.
• Widening doorways at entrances or exits to your home.
• Widening or otherwise modifying hallways and interior doorways.
• Installing railings, support bars, or other modifications to bathrooms.
• Lowering or modifying kitchen cabinets and equipment.
• Moving or modifying electrical outlets and fixtures.
• Installing porch lifts and other forms of lifts (but elevators generally add value to the house).
• Modifying fire alarms, smoke detectors, and other warning systems.
• Modifying stairways.
• Adding handrails or grab bars anywhere (whether or not in bathrooms).
• Modifying hardware on doors.
• Modifying areas in front of entrance and exit doorways.
• Grading the ground to provide access to the residence.

Note: You can only itemize these deductions if the main purpose of installation is medical care for you, a spouse or dependent (modifications made for aesthetic, architectural or other personal reasons do not qualify). Permanent improvements that boost your property’s value may be partially included as a deduction; in this case, the cost of the home modification is reduced by the amount of the property value increase (whatever the difference is what your qualified medical expense to deduct will be). If the home modification does not increase your property value, you can deduct the whole cost as a medical expense.

Visit the Area Agency on Aging. Every state offers different incentives, programs, and benefits to their senior residents. The best way to learn about them all, in addition to any tax credits or federal monies available through Medicare, Medicaid (in some states, you may be able to qualify for funding via the Medicaid HCBS – home and community-based services – waiver), HUD, the VA, or the USDA that would be disbursed through the state, is at your local Area Agency on Aging. The AAA is a one-stop-shop neighborhood branch of your state’s department that handles senior care (i.e. Department of Aging, Department of Public Welfare, etc.). Go to Eldercare.gov or N4A.org to find your AAA by zip code, city or county.

Apply for grants or take advantage of state assistive technology projects to make your home wheelchair accessible. According to HomeMods.org, funding is available for this specific modification through the Department of Veteran Affairs (call 800-827-1000 or your local VA for more details) and via the United Cerebral Palsy Association (call 800-872-5827). The IRS also permits those with disabilities to claim some of these expenses as a tax deduction. Check in with the National Council on Independent Living Center (call 703-525-3406) to get local funding information and referral services.

Get a loan to add a room. If Mom is moving in and she has health needs or disabilities, you may be eligible for government funding. FannieMae offers the HomeChoice program, Home Keeper program, and the Home Equity Conversion Mortgage (get more details at eFanniemae, or visit the local office). In Texas, New Mexico, California and Illinois, residents can apply for a Home Modifications Loan for Homeowners (with fixed interest rates and low minimum loan amounts) via Bank of America, under the “Access Loans” category. For more information, call 800-843-2632 (in CA, IL) or 800-900-9000 (in TX, NM).

Contact local foundations and non-profit organizations. Some may offer financial assistance or services referrals for those providing care for someone with disabilities or diseases like Alzheimer’s, multiple sclerosis, or rheumatoid arthritis. Easter Seals and Rebuilding Together both offer low- or no-cost community-based home modification and repair programs.

Take out a second/reverse mortgage. If you have the equity, this is a good way to secure a loan for a home modification, which, if done well, should add value to the home as more people will be seeking homes where aging in place is possible. You must be over 62 to secure funding via a reverse mortgage. (Learn more about reverse mortgages here.)

Check your insurance policies. The National Association of Home Builders says that some programs (auto insurance, worker’s compensation, long term care policies, state catastrophic accident insurance plans, and medical trust funds) might cover the costs of a home modification.

Move your parents in. If you have decided it’s best for Mom and Dad to just move in with you so you can provide care more readily, Glickman says you may be able to use proceeds from the sale of their home to make an accessible suite at your residence. He adds that adult children can avail themselves of the space in the future too, as their own care needs change.

Ready to consider a home modification for a family member’s residence, or your own? 101 Mobility has a full line of products (stairlifts, auto lifts, ramps, and more) and a team of highly-trained professional installers standing by to get AIP construction underway. Learn more about our services and find the local office serving you at http://101mobility.com/locator/.

Additional Sources:

• HomeMods.org
• National Association of Home Builders 

Tips for Preventing Falls in Your Home

Because falls are one of the leading causes for injuries among aging adults, we thought we would pass along these Tips for Preventing Injuries from the American Association of Neurological Surgeons (AANS). We hope they will help you to stay safe.

 AANS Injury Prevention Tips for Inside the Home

• Buy bath mats and rugs with slip-resistant backing and secure them.
• Do not walk on slippery, freshly washed floors and avoid floor waxes.
• Install grab bars and handrails if you are frail or elderly.
• Improve the lighting in your home; dim lighting can increase the risk of falls.
• Install night lights in halls and bathrooms, and keep a flashlight near your bed.
• Store products in easy-to-reach places; use stepstools/ladders only when absolutely necessary.
• Wear proper shoes with slip-resistant soles.
• Secure loose electrical cords and put away any items that are lying around.
• Do not use recalled products – discard or take back to the store.
• Keep chairs and other furniture away from windows.
• Use safety gates and install window guards.

AANS Injury Prevention Tips for Outside the Home

• Install outdoor handrails if elderly or frail.
• Inspect and remove debris and ice from walkways, driveways, porches, and yards.
• Inspect and remove debris from lawns before mowing or gardening.
• Store outdoor equipment and tools properly.
• Make sure that ladders are stable and secure before using them.
• Do not use broken equipment or tools.
• Do not let children engage in activities inappropriate for their age.
• Supervise younger children at all times.
• Never drive while under the influence of drugs or alcohol or ride as a passenger with anybody else who is under the influence.

As a side note to these outside tips, if you are unstable on your feet please consider asking for help or hiring out your lawn care and outdoor home maintenance projects for your safety.

Bathroom Safety Should be a Top Priority

When a loved one is disabled or aging, and wishes to maintain their independence by staying in their home, bathroom safety needs to become a top priority.  At 101 Mobility, we understand the importance of bathroom safety and have worked with hundreds of homeowners to make their bathrooms a safe place.

We offer a complete line of bath safety products to meet all of your needs.  Because most falls in the bathroom happen as people enter or exit the bathtub, we offer the Safety-Step Bath Door. This product lowers the threshold of entry into the bathtub to 9” making it easier to get into and out of the tub.  It includes a water-tight seal.  The Safety-Step Bath Door can even be installed on your existing tub for your convenience, eliminating the need for a lengthy and expensive bathroom remodel.

Grab bars are another important bath safety modification item.  Grab bars around the tub can help ease the transition in and out of the tub. It is important to note that no one should ever use towel bars to ease the transition in and out of the tub. Towel bars simply cannot support you if you slip or fall.  101 Mobility can position and install grab bars to help you get around your bathroom with ease.

Many of our clients also require transfer benches or toilet safety frames to ensure their safety in the bathroom. 101 Mobility has a wide range of products in this area to help you feel comfortable and safe in the bathroom. There is no need to worry about your safety when the team from 101 Mobility is around. We have the experience to answer your questions and provide the top quality products that will ensure your safety in the bathroom.

For more information about 101 Mobility’s complete line of bathroom safety products, please contact your local 101 Mobility location.

Home Improvements and Structural Alterations (HISA) and 101 Mobility

101 Mobility is proud to help America’s Veterans. Under the Home Improvements and Structural Alterations (HISA), Veterans may receive “home improvements necessary for the continuation of treatment or for disability access to the home and essential lavatory and sanitary facilities.” We work with Veterans each and every day to help them improve mobility in their homes.

With 101 Mobility and the HISA, Veterans can:

• Replace all bathroom tubs with shower stalls complete with molded or pull-down seats
• Install non-skid strips or slip-resistant tiles in the shower
• Install grab bars in the shower stalls and toilet area
• Install hand-held showerhead
• Install raised toilet seats
• Install handrails on both sides of the stairs for better support
• Replace carpeting and tile flooring with non-slip/skid type flooring
• Install non-skid rubber strips on the edge of stairs to help prevent falls
• Convert kitchen cabinets into drawers to hold pots and pans for easier access
• Replace door knobs with lever handles
• Install lever-handle faucets in kitchen and bathrooms
• Consider increasing door opening sizes to as much as 36 to 42 inches
• Install a permanent or portable wheelchair ramp
• Install a stairlift or chairlift

Your local 101 Mobility location is ready to help you with need HISA improvements and alterations. All of our 101 Mobility locations are GSA Contract Holders, and have the experience and knowledge to help you achieve a completely functional and accessible home, customized for your needs.

For more information on how we can help you, please contact your local 101 Mobility location.

Aging in Place can be a Viable Option

When faced with the choice of moving to a senior care facility, moving in with a loved one, or choosing to age in place, most of us would chose to stay in the home we love, among the things we know, and the memories that sustain us. Aging in place allows us to retain our independence and prevents us from feeling we are a burden to others. But with so many of us living in two-story, single family homes and relying on cars to get around, staying in our homes as we age is a significant challenge.

One of the greatest challenges facing those who wish to stay at home is adapting to the change in mobility.  Adapting our homes to help us get around requires an investment, but that investment is far less expensive than a move to a senior care facility. There are many things we can do to make our homes safer, more accessible, and that will help us to keep our independence.

• Investigate assistive living technologies that monitor your home. A 24 hour monitoring device can be activated if you fall giving you the assurance you need that help is on the way. Many companies that offer these services have enhanced options that will monitor other areas of the home such as the stove. For example, if your stove is left on for an extended period of time it can be turned off remotely.
• Evaluate access in and out of your home. For some, the height of the stairs leading into and out of the home can become too steep. Simply installing a ramp can make your home more accessible.
• Worried about climbing the stairs inside your home? Installing a chairlift can make it easy to access the second floor or basement once more. This is especially important for those homes where the washer and dryer are in the basement. A chairlift can be a much easier fix than relocating water lines and exhaust vents.
• The bathroom can be a particularly dangerous area as we age. Installing toilets that are just a few inches taller, handrails, a tub door, or adjustable shower head can make it much safer for you to stay in your home.
• Those suffering from arthritis find that a simple change from doorknobs to lever handles makes a world of difference.

Simple changes like these can make a real difference in the ability to stay in our homes as we age.  With changes like these, the loving support of family and friends, and the determination to age in place, many more aging Americans will be able to stay in the homes they love.

If you would like more information on aging in place, please contact the National Aging in Place Council.

Helping Your Parents Keep Their Independence

It can be one of the most challenging phases of the parent/child relationship, and we aren’t talking about the teenage years.  As parents age and adult children are faced with the prospect of having “the talk” about moving to an assisted living facility, it is quite possibly the most stressful time in the parent/child relationship. Neither party is happy and both are feeling a great deal of anxiety.

According to 2008 federal data, approximately 70% of adults over the age of 65 are expected to need some type of long term care services during their lifetime. That leaves very few of us exempt from having to have “the talk”.  Additionally, 42% of adults between the ages of 45 and 65 feel that discussing if elderly parents are no longer able to live on their own is the most difficult topic they face*.

With so many of us facing this difficult issue, and with so few of us really having a handle on how to address it, how can parents and adult children minimize the stress?

First, we recommend starting the discussion early. Don’t wait until there is a crisis on hand or your parent’s health has begun to deteriorate. If you are active in your parent’s estate planning, now is a good time to begin the process. Discuss with them what their long term care goals are. Get them down on paper, begin researching and visiting facilities, and have a plan in place that you can put into action when the time comes.

As your parents age, consider taking steps that can help them to stay in their homes longer.  The longer your parents can maintain their independence, the easier the transition is likely to be. For example, consider hiring a cleaning service to help with heavy duty cleaning tasks, hire a hospice service to ensure that medications are taken on schedule, install safety devices in the home including chairlifts and shower barsto minimize falls. All of these items help to maintain parent’s independence while giving adult children peace of mind.

When it comes time to make the move to an assisted living facility, take the time to have a heart to heart discussion. This means turning off the cell phone and disengaging from other distractions so you can focus on your parents and really hear what they are saying. Speak clearly about what you are feeling without making your parents feel like they are being attacked.  Offer options to your parents instead of telling them what they are going to do. Ask for their ideas and input. They have many years experience and valuable opinions.

Finally, imagine how all this feels from their perspective. It can be hard to leave their home, routine, all their memories and face the prospect of starting over.  Be gentle, kind and respectful.  Give them the time to grieve and transition as they need to.  Don’t push too hard.  Remember someday you might be having this same discussion with your own children; think about how you would want to be treated by them.

In the end, the most important thing is to maintain the health and safety of your parents. Make the decisions that will ensure that you are all together for as long as possible.

* According to a 2006 study from Home Instead Inc.

Veterans! Do You Qualify for a HISA Grant?

Are you a U.S. military veteran? Do you suffer from a disability due to your service? There is a lot of help out there for funding improvements to your home to assist you with your comfort and recovery.

The Home Improvements and Structural Alterations (HISA) grant can be used for any home improvement necessary for the continuation of treatment or for disability access to the home and essential lavatory and sanitary facilities. Among the improvements a HISA Grant will cover are:

• Allowing entrance or exit from veteran’s home;
• Improving access for use of essential lavatory and   sanitary facilities;
• Improving access to kitchen and bathroom counters;
• Handrails and grab rails;
• Lowered Electrical outlets and switches;
• Improving paths or driveways;
• Improving plumbing and electrical work for dialysis patients

A HISA grant is available to veterans who have received a medical determination indicating that improvements and structural alterations are necessary or appropriate for the effective and economical treatment of a disability. A veteran may receive both a HISA grant and either a Special Home Adaptation (SHA) grant (below) or a Specially Adapted Housing (SAH) grant (below).Home improvement benefits up to $4,100 are available to veterans with a service-connected disability, and up to $1,200 is available to veterans with non-service-related disabilities.To apply, the veteran must first have a prescription from a VA or a fee-basis physician. This must include:

• Specific items required;
• The diagnosis with medical justification;
• The veteran’s name, address, SSN, and phone number(s);

In addition, a list of other items regarding the exact work to be completed, costs, and site drawings must be compiled and submitted as well.101 Mobility is glad to help in this process from start to finish. We are here to make sure that you get the modifications and the equipment that you need in order to live a more comfortable and accessible life.Call us today at 1.888.236.6917 or visit us at: www.101Mobility.com and let us help get you the assistance you need without any hassle or inconvenience to you. Source: http://www.prosthetics.va.gov/docs/HISA_english.pdf