Ten years ago, Esther Greenhouse and her husband designed and built a 3,500-square-foot three-level home in upstate New York near Cornell University, where she teaches. They were only in their 40s, but they created a flexible space where they could age in place if they choose to. The home’s design also means family members — like her mother who uses a walker or her young nephews — can visit comfortably.

Greenhouse is a certified aging-in-place designer, but her work focuses on maximizing flexible, easy-access living spaces to meet the abilities of anyone — not just age-related challenges. It’s an approach she calls enabling design. Here, Greenhouse walks through the design and buildout of her own home, which has accommodated her family in ways she never imagined. 

In March, my 20-year-old son unexpectedly returned home from college because of the coronavirus outbreak. I was relieved to have him under my roof but worried that he could be an asymptomatic carrier, bringing the virus home to me or my husband, Brooke. For two weeks, our son self-isolated in our walkout basement, which we had designed to function as an independent living space.

When my husband and I designed and built our home, I never guessed I would need a place where my son could keep to himself during a pandemic. I’m a design expert, and my husband is a builder. We wanted a home that suited our family at the time — and would meet our needs as we got older. But we also wanted a home that could meet the needs of anyone, at any stage of life, living in the house after us. Yet, if you walked through our home, you might barely register the details we spent countless hours planning and designing. And that is the point.

We designed for the unexpected

We’re a small family — just me, my husband and our son. But we have a close extended family, and I love having them come to stay, so we built a 3,500-square-foot, three-level home. (Keep in mind, a large home is not at all a requirement for putting this guidance into practice.)

People enter our home via a walkway that slopes gently up to the front door, with no steps. On the first floor, we built a den that meets code for a bedroom, plus a full bathroom with a curbless shower. If one of us were no longer able to climb stairs, we could live on just the first floor. My 90-year-old mom, who uses a walker, can’t safely visit my sister’s home but she can easily stay at mine.

The second floor has three bedrooms and two bathrooms — a pretty typical set-up, but with widened doorways and elevated outlets. We didn’t put in curbless showers upstairs, since they’re more expensive, and we really only need one in the house.

The basement has more flexible space. It has its own door to the outside, reached by another stone pathway with no steps. Inside is my office (which meets code for a bedroom), a recreation room, a storage and utility room and space for a future bathroom. If our son or parents ever need to live with us, or we need to hire an in-home caregiver in the future, we could easily convert the basement into an in-law suite.

Having flexible spaces means our home can adjust to our needs, rather than us adjusting to our space. In just the first few months we lived there, we had three different visitors who couldn’t use stairs — and they all stayed in the main-floor den. More recently, I had peace of mind knowing that my son could be safe at home during the coronavirus outbreak without exposing me or my husband.

Five small design choices I wouldn’t want to live without

Our home’s layout gives my son his privacy; my mom can shuffle in without stairs; my clients with accessibility challenges can come to my office. Then, there are more nuanced touches: electrical outlets are two feet off the floor so they’re easier for everyone to reach, and the kitchen has a table instead of an island. While Americans love kitchen islands, they’re hard for short people to reach and bar stools can be awkward to climb on and off of; at a table, people of all heights and ages can cook together comfortably.

These five choices have made our day-to-day lives more comfortable and encouraged my extended family to spend time at my home.

1. No-step entry. Steps are problematic not just for the elderly. They’re also difficult or impossible for parents with strollers, young kids and anyone who uses a walker or wheelchair.
   
   
2. A full bathroom on the first floor. And because ours has a curbless shower, my mom can shower with her walker and my sister-in-law can bathe her kids easily.
   
   
3. Wider doors and hallways. Most interior doors are 28 or 32 inches wide, but we chose 36-inch doors. My mom’s walker fits with no problem, and we can easily carry laundry baskets or other bulky items through. Widening doorways in a retrofit can run $600 to $1,600 per doorway but may cost only $10 more per door when a house is being built.
   
   
4. Reach range. Most people, standing or seated, have no trouble reaching things that are 24 to 44 inches off the floor. We used that range for our outlets, but our light switches were missed in the final plan, and I wish they were a bit lower. We also considered reach range when we put our microwave at counter height, rather than above the range. Above-the-range microwaves may save space but can be difficult for many people to reach.
5. Lighting and display. I have a visual processing disorder, so having adjustable lighting is critical. And many people experience changes to their vision as they age. Smart lights can be controlled from a tablet, making them easier to adjust without getting up. And in the same way, smart thermostats and door locks can be controlled by tablets or phones, which allow users to adjust font size and brightness to make the numbers and settings easier to see.

When a home becomes a haven

I’m only 5-foot-1. As a short woman, I know the world isn’t built for me. I have a hard time reaching high cabinets or getting things off shelves because most design standards are sized for average-height men between 20 and 40 years old. I think it’s silly that most people continue to design for this small sliver of the population.

Think about school-age children: if they are able to reach the pantry and the microwave, they can make themselves lunch. But if the cabinets and microwave are too high, they can’t: their natural abilities are thwarted. Bad design can limit independence, but enabling design encourages it.

Enabling design isn’t theoretical for me — it’s personal. My grandmother had to move to a nursing home even though she lived in a one-story home, because her walker wouldn’t fit through the bathroom door, and she couldn’t safely bathe herself.

On the other hand, we built my mom’s home with aging in mind. In addition to basic changes like wider doorways and grab bars, we made sure that the kitchen cabinets and countertops were low. She was 4-foot-11 at her tallest, and osteoporosis has left her even shorter.

As she loses some of her abilities, she has been able to stay at home by making just a few small adjustments — nothing that has required a major remodel. 

She requested a bidet seat, which became important as it became harder for her to shower independently. These seats cost between $450 and $850, including installation, but the investment more than paid for itself. It has helped my mom maintain good hygiene and dignity. And she only needs a home health aide to come bathe her once a week, rather than twice, which saves her $4,500 a year on health aide visits alone.

Recently, my mom was having trouble using the oven. Short as she is, reaching over the oven door was becoming too precarious. So we spent $270 on a quality countertop oven. It lets her prepare her own food rather than ordering out or hiring someone to cook for her.

People tend to think enabling design choices are costly. But consider the alternative: assisted living facilities can cost $48,000 or more a year. Home health aides can be expensive, too. 

Home safe home

Homeowners I work with also inevitably ask about the dangers of over-customizing and making their homes hard to sell. But by designing to enable, you can expand your pool of potential buyers.

Of course, there will be times when it makes sense to customize for your needs — like my mom’s lower counters. They might not appeal to future buyers, but for years she’ll have a space that works well for her and encourages activity and independence.  

Bottom line: Home design is about health. Most people I know spend a lot of time, effort and money preparing for their futures. They eat healthy food and exercise. They manage retirement accounts and go to the doctor for preventive care. But they often forget that their homes are untapped resources that can help them function at their best.

This year, many of us are spending more time than ever at home. Being able to welcome my son home without increasing my risk for exposure to the virus was such a relief. I never could have predicted the pandemic, but I knew I wanted a home that could adjust to my family’s needs, whatever they were. Today, I’m glad to have one.

How to Plan for Enabling Design Renovation

My husband and I have both spent decades studying building and design, and we also spent time perfecting our home. These are a few of the things we considered and recommend for homeowners planning to build or renovate.

1. Consider your goals for living. For me, family visits are a priority. So, we used flexible space and design choices to make it easier for my mom and other family members to stay over. Think in broad terms about what’s important to you. Do you want to be able to entertain regularly? Are you focused on independent living? Don’t get bogged down in the details (yet). Instead, think about what values you want your space to enable.
   
   
2. Evaluate your current space. What features help or hinder your independence and abilities? Since I’m short, working at a table is much more comfortable than a countertop, so I knew I wanted one in our kitchen. You can use the AARP HomeFit Guide or the National Association of Home Builders’ Aging-in-Place Remodeling Checklist, which ask questions like, “Does your kitchen have a workspace you can use while seated?” and “Do you have light switches at the top and bottom of stairs?” Often, we adapt to our living space without even noticing. These guides can help you see the impact your home’s design has on you and your family.
   
   
3. Find a knowledgeable contractor. That would be someone who has experience designing across the lifespan. The AARP and the National Association of Home Builders provide training for contractors who want to become Certified Aging-in-Place Specialists (CAPS). These contractors — who I have helped train — should come in with a base knowledge of enabling design, which can help get your project started on the right foot.

Esther Greenhouse is a built environment strategist, consulting for municipalities, senior housing providers, and organizations to leverage design to enable people to thrive. She is the Strategic Director for one of the nation’s first Age-Friendly Centers for Excellence and is collaborating with AARP International to generate a quantum leap for Age-Friendly Housing and Multigenerational Communities. 

Written by

Esther Greenhouse, as told to Kelly Burch

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