According to the Census Bureau, the older population is expected to continue to grow significantly in the future. The population age 65 and over has increased from 37.2 million in 2006 to over 49 million in 2016. People age 65 and over represented 15.2% of the population in the year 2016 but are expected to grow to be 21.7% of the population by 2040. The 85 and over population is projected to more than double from 6.4 million in 2016 to 14.6 million in 2040 (a 129% increase). As a result of these sweeping demographic changes, meeting the housing-related needs of older adults will require a range of responses.
The Centers for Disease Control and Prevention (CDC) defines aging in place as “the ability to live in one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level.” Older adults overwhelmingly prefer to stay in their homes and communities as they age. According to the AARP Public Policy Institute, 87 percent of adults age 65 and over want to stay in their current home and community as they age. Studies show that some 70 percent of older adults live in single-family detached homes, and nearly 90 percent intend to remain in their homes permanently. Over 35% of older adults reported having some type of disability (i.e., difficulty in hearing, vision, cognition, ambulation, self-care, or independent living). Millions of these individuals live in homes that lack accessibility features that support the ability to live safely and independently. In fact, the Census Bureau reveals that 1 in 3 older adult has trouble using some feature of their home.
Another major concern is the risk of falling among older adults. According to CDC each year, millions of older people fall. In fact, the CDC notes that more than one out of four older people fall each year, but less than half tell their doctor. Most serious falls occur in and around the home, and can be life-changing.
Home modifications and repairs can help older adults age in place and maintain their independence. In many cases home modifications can also help prevent falls and other accidents in the home. Modifications can make it easier for older adults to navigate through and live in their homes, including brighter lighting, grab bars, stair lifts, and ramps. New technologies are also being introduced to help older adults age in their homes.
The cost of home modifications can range from very low-cost solutions like adding brighter lighting to thousands of dollars for significant adaptions, such as adding a ramp. The majority of the home modifications are paid for out-of-pocket which makes many adaptions out of reach for many low-income older adults, who tend to have higher rates of disability and may live in older homes.
The Older Americans Act (OAA), administered at the federal level by AoA, supports myriad of activities that assist older individuals to remain healthy and independent in their homes and communities, including home modifications. But there is little knowledge of how the aging network is supporting aging in place through home modifications. In addition, the Bipartisan Policy Center points out that in addition to AoA, there are numerous federal departments, such as the Department of Veterans Affairs, and the Department of Housing and Urban Development, that provide resources and expertise for home assessments and modifications but finds that there is little coordination and awareness about these programs. There are also national, state, and local efforts underway to aid in making older adult homes safer and more accessible.
In light of these facts, several key issues emerge that need to be addressed:
Lack of coordination among the range of Federal, state and local home modification programs that are available. There is a need for better centralization of information about these programs to avoid overlap/duplication and to expand reach.
Un-even knowledge of the aging network’s activities and programs for home modifications and how to find/implement them.
Barriers to consumer information and access to the range of home modification options available and the issues that go along with that proper assessment and cost.
Through this funding opportunity announcement, AoA seeks to address identified barriers to optimal access to and use of home modifications that support aging in place. AoA is seeking applications that propose a range of approaches to address the challenges associated with access to, and use of, home modifications to support aging in place. The successful applicant will be expected to provide technical assistance and serve as a national repository for home modification best practices and innovations that can be replicated at the local level. Applicants should clearly describe their proposed approaches for achieving the following broad objectives:
• Increase the aging network’s knowledge of home modification best practices and innovative programs.
• Increase older adults and their caregivers’ awareness of and access to home modifications to support aging in place with a special emphasis on low income older adults.
• Increase coordination among federal and national programs that support home modification to expand availability.
When developing their proposals, applicants should give consideration to and incorporate the following tasks and strategies in meeting desired outcomes:
Conduct an environmental scan to catalog the current state of home modification efforts at the federal, national, and local levels to better support coordination and knowledge transfer.
Propose approaches for the identification, synthesis and dissemination of best practices and innovative home modification practices and programming. (e.g. national searchable database, website, enewsletters, etc.)
Establish a Steering Committee, in consultation with ACL, to provide insight on the direction of the project. Committee should include representatives from relevant Federal and national programs and initiatives as well as local input to guide the work, encourage coordination, and serve as an avenue for dissemination of information.
Develop and implement an outreach plan that raises awareness and educates older adults and their caregivers about the benefits of home modifications, the cost of these modifications, and programs that may provide assistance. Applicant should ensure that any plan developed includes strategies that target low-income, rural, Tribal, and other underserved populations. Applicant should ensure that the outreach plan includes the development and use of educational materials, brochures, and other aids such as searchable database. Any materials developed should be made available to other ACL-supported projects like the Eldercare Locator and shared with the aging network.
Provide ongoing training and technical assistance to aging network on issues related to home modifications. Possible approaches could include telephone and email consultation, links to experts, webinars, conference presentations, on-site and online assistance, and other means identified by the applicant.
NOTE: This Funding Opportunity Announcement is not intended to fund individual home modification programs.
Applicants should propose how they will collect information to document and describe outcomes for all activities described in their application. Applications should include a brief description of expected sources for output and outcome data and methods of data collection (e.g. surveys of those utilizing products or attending trainings).
Applicants should propose how their activities will contribute to the primary goals of the project outlined in this funding announcement.
ACL. A Profile of Older Americans: 2017 https://www.acl.gov/sites/default/files/Aging%20and%20Disability%20in%2…
AARP. Livable Communities Baby Boomer Facts and Figures. 2014. https://www.aarp.org/livable-communities/info-2014/livable-communities-…
Farber, Nicholas, et al., Aging in Place: A State Survey of Livability Policies and Practices (National Conference of State Legislatures and AARP Public Policy Institute, 2011.
CDC: Important Facts about Falls
HUD. Aging in Place: Facilitating Choice and Independence. 2013. https://www.huduser.gov/portal/periodicals/em/fall13/highlight1.html
Bipartisan Policy Center. Healthy Aging Begins at Home, 2016. https://bipartisanpolicy.org/library/recommendations-for-healthy-aging/