Stay at Home Solutions
Maintain Your Independence

Blog, News, & Resources

Stay at Home Solutions blogs on topics such as aging in place, universal design, adaptive equipment, home modifications, accessibility, durable medical equipment, legislation, and caregiving.

Posts in finances
What Do You Need? A Zero Step Entry!
Front entry with zero step entry. Photo by the Journal of Light Construction

Front entry with zero step entry. Photo by the Journal of Light Construction

A zero step entry is a doorway to get in and out of your house with ZERO steps.

You know what’s a shame though? Less than 3.5% of homes in the U.S. have one zero step entry according to Joint Center for Housing Studies (2011).

Now, of course, I hope that figure has gone up since 2011. But I highly doubt it!

When I drive around and see new construction for houses and apartments, you better believe I’m rubbernecking to see if they’re putting in one entryway with zero steps!

But here’s the unfortunate truth: I see steps to go inside the front door, back door, and garage door.

Why do builders do this?

Because they do what they know. Builders don’t obsess about accessibility the way occupational therapists like me do!

I understand people think that a couple, two, three stairs won’t hurt anybody from going in and out of their house. But it actually does in the long run.

Let’s try an experiment:

I want you to carry something that requires two hands, like a laundry basket, across level flooring for ten feet.

I’ll wait here. . .

Okay! You’re finished! Great! How much effort did you put into that? How hard are you breathing? Can you still hold a conversation? Are your muscles tired?

Now, I want you to carry that same object up and down at least two stairs. If you have more stairs, try carrying your object up and down all of your stairs.

After all of your stair climbing, how much effort did your body put in to carrying an object up and down the stairs compared to no stairs at all?

As we age, this “simple” task of carrying objects up and down stairs becomes more difficult. Even though I’m in my 30’s, I notice I exert more energy to carry things up and down stairs compared to carrying things across the floor.

I hate to burst your bubble, but there will be a day when it’s harder for you to carry things up and down the stairs. It may be due to a back injury, arthritis, heart condition, etc., etc. You just never know!

So if you DON’T have a zero step entry, what can you do NOW to make sure you’re set for the future?

Start planning your zero step entry for your home!

Front zero step entry with portico and rampscape. Photo by Sutton Group Preferred Realty

Front zero step entry with portico and rampscape. Photo by Sutton Group Preferred Realty

It can be any entry you desire! The front door, the side door, the back door, the garage door, etc. You pick what works best for you and your house.

You can convert an existing window into a zero step entry door! If you’re creating a door out of a non-existing door, make sure to have the doorway width measure 36 inches for plenty of room to maneuver in and out of the house.

An issue that may come up is the fact that the main level of your house is not the same as the ground outside.

I have that EXACT same issue! So let’s dive into the problem solving process for my humble abode.

This is my back stoop with uneven pavers and rubber mats! This is a work in process, my darlings!

This is my back stoop with uneven pavers and rubber mats! This is a work in process, my darlings!

The problem for my house is the front and back entryway both have stairs to go inside. I would choose to make my back door zero entry because it’s closest to our driveway. There are several options I can think of off the top of my dome:

Wooden ramp from driveway to front door. Photo by Wheelchair Special Needs Project.

Wooden ramp from driveway to front door. Photo by Wheelchair Special Needs Project.

1) Install a ramp at the back door and create a minimum 6’x6’ landing for space to open the door and walk inside and outside. The ramp incline would need to gradually rise one foot per inch from the ground level to the height of the door threshold.

In my case, I would need 14 feet of ramp to accommodate the 14 inches from the ground to the top of my threshold. I would also make the ramp width at least 60 inches to allow plenty of room for a wheelchair user.

2) Install a rampscape at the back door. Rampscapes are ramps made by grading dirt to make that gradual incline to the door threshold. They look very pretty when landscaped with whatever materials you choose. I would lay a 6’x6’ concrete patio by the door, a 60 inch wide concrete sidewalk on the rampscape, and add lots of plants around it!

Rampscape from the driveway to the front door using pavers with a gradual incline. Photo by Schafer Construction

Rampscape from the driveway to the front door using pavers with a gradual incline. Photo by Schafer Construction

3) Install a vertical lift. A vertical lift is a platform that takes you from ground level and elevates you to the main threshold, like an outdoor elevator! I would still create a 6’x6’ landing to allow enough room to open and close the back door. This option would definitely require an overhead above the vertical lift to protect it from rain and snow.

Vertical platform lift next to small porch with four steps to enter door. Photo by Mobility Express

Vertical platform lift next to small porch with four steps to enter door. Photo by Mobility Express

All of the options above would cost thousands of dollars. The most inexpensive option would be installing a ramp. Personally, I would install an overhang or portico to cover the landing above the back doorway to avoid all forms of precipitation, especially after witnessing Missouri imitating Siberia this year!

Although I don’t have the funds at the moment, I can discuss this with my family, look for ways to fund a zero step entry, and ask for bids to help me select the best option and plan. Creating a zero step entry is a three year goal for me.

If you’re looking into building a new home, then you will spend the least amount of money to create a zero step entry!

Let’s say you wanted your zero step entry to be your garage door. Tell your builder! They can grade the site to ensure you drive into your garage and effortlessly step in and out of your home.

Sometimes, people are concerned that the only style of house they can build to include a zero step entry is a patio home.

NOT TRUE.

If your builder is not willing to make at least one zero step entry and keep whatever style of house you choose, then they do not have the creativity or desire to move outside of their comfort zone.

You can build ANY style of house and have at least one zero step entry.

Whichever doorway you choose, remember: it’s best to have the doorway covered above and to make sure water will drain away from the door. Water is bad inside of the house.

Contact me to help you create a zero step entry! You better do it before you need it!

Do you have a zero step entry? Show us pics. If not, what are your plans? Share in the comments below!

Preparing for the Costs of Long-Term Care: Tips for Seniors
Pexels

Pexels

Foreword:

The goal of Stay at Home Solutions is to do everything in our power to help you make changes in your home in order for you to live safely and independently for as long as you would like. However, the reality is sometimes “the best-laid plans of mice and men often go awry”, meaning that you can make as many changes as you would like to your home, but you may need 24 hour personal care that your family cannot help you with.

None of us like to think that we could end up in that situation. Since we are practical people, we like to share additional information on what else you can do to prepare yourself. Luckily, we found someone who enjoys helping people do the same.

Hazel Bridges is the creator of AgingWellness.org, a website that aims to provide health and wellness resources for aging seniors. She’s a breast cancer survivor and challenges herself and others to live life to the fullest. Hazel contributed the information below for you to make the best decisions for you!


Preparing for the Costs

of Long-Term Care: Tips for Seniors

stay_at_home_solutions_long_term_care_medicare

It’s important to plan for your long-term care needs even if you don't end up needing it. You can never be sure if an unexpected illness or accident will suddenly change your ability to care for yourself. Though Medicare is valuable to seniors, it provides little coverage for the extensive costs of long-term care. The best thing you can do is prepare for the possibility of long-term care while you’re still able to make important decisions and look into your funding options.

Know What Types of Costs to Expect:

There are three main options for long-term senior care: nursing homes, assisted living facilities, and in-home care. According to A Place for Mom, a private room in an assisted living center costs about $90 per day while a private room in a nursing home costs $205 per day for the more intensive levels of care. In-home care costs anywhere from $112 to $192 per day, depending on the amount of time that care is required. If you have family members that can step in and help out, you can cut out some of the costs of in-home care. If you’re looking for the most affordable facility options, consider a care center in a non-urban area rather than one in the city.

Understand What Medicare and Medicaid Cover:

Long-term care services include assistance with daily living tasks such as dressing, cleaning and eating. Although Medicare can help seniors out with their required medical services, it does not cover any other aspects of long-term care. For example, Medicare covers doctor's visits, prescription drugs and hospital stays. It may also pay for a portion of the costs for short-term care in a certified nursing facility following a hospital admission, which can be helpful if you just need to recover from an accidental injury. Other than this, the program does not help with personal or long-term care services.

Unlike Medicare, Medicaid can help you cover some of the costs of long-term care, but only if you are low-income with few assets. Medicaid does pay for long-term care services in nursing homes and at home. However, states have different eligibility requirements and differ according to which services they cover.

Consider Funding Long-Term Care Yourself:

Of course, you are welcome to self-fund your long-term care if you have the means. This is a great way to avoid paying expensive premiums for insurance and have the flexibility to put your money exactly where you need it. However, this is difficult to do unless you have substantial savings built up or assets that can be liquidated. Selling your home can be a viable option if both you and your partner are moving out of the house. Before you sell, make sure you're up to date on the current home sale trends in your area. For example, homes in Smithville, Missouri have sold for an average of $215,000 in the last month.

Know About Your Insurance Options:

stay_at_home_solutions_money

According to Mariner Wealth Advisors, there are two main types of long-term care insurance. These are the stand-alone policy and life insurance with an accelerated death benefit rider. Stand-alone long-term care insurance covers the expenses that aren’t taken care of by either Medicare or Medicaid. This includes assisted living, nursing homes, and at-home care. However, if you don’t end up needing care, you don’t get any benefits from the insurance. On the other hand, a death benefit rider on a life insurance policy allows you to receive benefits if you end up needing care while any unused benefits will be paid to your beneficiaries. This type of policy is more flexible but tends to have higher premiums.

Many Americans' greatest fear about aging is requiring long-term care and not being able to pay for it. This is no surprise since costs can get as high as $100,000 to $250,000. Although government programs can be valuable to seniors requiring medical services, it's important that you make alternate plans to pay for possible long-term care needs in your future.


Afterword:

Although planning long-term care has its benefits, this can be a difficult topic to discuss between family members. No one enjoys thinking about the possibility of needing long-term care in the future. It’s easy to put this topic on the back burner.

Some tips to make long-term care planning easier include:

  1. Reflecting on what you want if you needed long-term care

  2. Identifying family and social supports

  3. Organizing information you gather to help you make sense of everything

In my experience, families who do talk about long-term care planning do not appear as stressed or frantic when their loved one needs it. They know what to do, where to go, and how it’s being funded. Peace of mind comes with planning your long-term care needs. It’s a lot of work, but consider the process as a gift to you and your family!

What Happened?

On December 20th, Congress passed the Tax Cuts and Jobs Act of 2017 which will create a deficit of $1.5 trillion in the next ten years. Unfortunately, legislators will cut spending from social welfare programs, such as Medicare and Medicaid, which will hurt older adults and people with disabilities. These cuts will drastically affect these populations in reducing affordability and accessibility of health care services.

Organizations, such as AARP, wrote a letter to congress to share their concerns and disapproval. AARP mentioned although the medical expense deduction is still intact the new tax legislation lowered it from 10% to 7.5%. Almost three-quarters of tax filers who claim the medical expense deduction are over the age of 50 and have at least one chronic condition.

On a personal note when I work in rehabilitation facilities, patients balk at the $157.50 co-payment they need to pay on day 21 of their stay. The co-payment amount will increase to $167.50 daily co-payment in 2018. Patients end up discharging home too soon resulting in medical complications or injury. With the great possibility Medicare will undergo spending cuts, this co-payment could possibly rise even higher. I am not convinced members of congress considered the potential harm this legislation will cause to older adults and their families.

Are You on a Fixed Income?

If you live in the Kansas City metropolitan area and are concerned about falling in your home, I have the answer for you. Rebuilding Together of Kansas City has a Safe at Home Program which offers a sliding payment system for home modifications, like installing grab bars or making accessible entryways. This program partnered with AARP and the American Occupational Therapy Association to help older adults live in their homes. For more information, click on this link: Rebuilding Together Kansas City.

Slippery Floors

It is inevitable for tile or other floor surfaces to become slippery when wet. A great solution to preventing falls on bathroom or kitchen flooring is Slip Doctors anti slip coating.  This is an inexpensive solution to prevent falls from happening in the first place. The anti slip coating improves traction on a myriad of surfaces to include: stone, porcelain, fiberglass, concrete, boat decks, ladders, and ceramic. Slip Doctors provides choices in types of anti slip coating and colors. Hotels such as the Hilton and La Quinta use Slip Doctors anti slip coating in their tub showers! 

The Rub: Remodel or Move?

As people face empty nests and near retirement age, they start to consider if they should live in their current home or move. Read about what this couple decided to do in this New York Times article. Consider your own options for the future to maintain a healthy, independent life.

Payment Options for Home Modifications

The cost of a home modification can be expensive to many individuals. Keep in mind that you are investing in yourself through a home modification to remain in your home compared to living in a nursing facility. In Missouri, the average cost per day in a nursing home is $153 with a yearly total of $56,000.

Paying for Senior Care has valuable information on financial resources at your disposal when considering a home modification. The state of Missouri has limited waivers and loans for low-income residents. Other financial options to consider are veteran's benefits and long term care insurance benefits.