Jack and Jill went up the hill
Up Jack got, and home did trot,
By Wayne Caswell
Jack and Jill were in their late 60s and had been married for 37 years when Jack suffered a severe stroke and required care beyond the abilities of his partner. After leaving the hospital, he went into a nursing home, and the family home was sold to pay for his care, which was expensive and projected exceed $84,000 per year.
Jill couldn’t maintain the big house herself and couldn’t afford it either, so she moved into a small apartment alone, without her lifelong mate. Being separated affected the couple’s morale, but worse was that it affected their health and their finances. Without long-term-care insurance, their life savings were depleted quickly before Medicaid finally kicked in. And now the grown children had two places to visit to support their declining parents. It didn’t have to be that way.
Just as in the nursery rhyme, Jack goes home and recovers more quickly there – in familiar and loving surroundings where Jane hires professionals to help care for him. That decision lets the couple stay together, and the kids have just one place to visit.
Universal Design was not offered when they built their home, and even though renovating the home for wheelchair accessibility often costs as much as $50,000, they felt it was financially better than the alternative. The project was entirely funded with home equity, so they didn’t even have to touch their retirement money, or the kid’s future inheritance. You see, Jack and Jill are like most American seniors, 90% of whom would rather live at home as long as possible and are willing to seek help to do that.
Jane has learned how home care can benefit loved ones and for now has hired someone for non-medical home care too. That includes help with bathing, cleaning, and transferring. If it were just her, non-medical care could also provide companion services. To give her a break and Jack some new experiences, she takes Jack to an adult day care center twice a week. Home Medical Care is another type of care provided by licensed medical professionals, but Jack no longer needs that since he’s getting better.
What Home Renovations Were Needed?
Each situation is different. Health needs and living conditions can vary dramatically, so you may want to hire a professional to advise you. Look for a Certified Aging in Place Specialist (CAPS). It’s a program of the National Association of Home Builders (NAHB) in collaboration with the NAHB Research Center, NAHB Seniors Housing Council, and AARP. The link gives good advice for your remodeling project that aren’t repeated here.
But getting back to Jack and Jill…
Here’s what they actually did; and it cost them far less than the planned $50K.
RUGS & CARPET: Some of the simplest improvements were free or cheap, such as removing throw rugs that make wheelchair navigation difficult. Jill even had Home Depot remove carpeting in the family room and master bedroom and replace it with simulated wood flooring. It cost less than $1,000 per room, but if they went with real wood it could have been over $5,000 per room.
BATHROOM: Jack and Jill kept remodeling to a minimum and spent less than $7,000 on the bathroom. Rather than a complete remodel with Ageless Designs that work well for people of any age or ability, they just paid a contractor to widen the entry with a pocket door, raise the toilet, and install a wheelchair accessible pedestal sink, sliding shower chair with grab bars, and a handheld shower head, just like Mark did in his Bathroom Remodel. When Jack recovers, the accessibility features can be removed.
KITCHEN: Jill still does most of the cooking, so adapting the kitchen was relatively simple. They moved things into lower cabinets and installed some pullouts to make glasses, plates, utensils, and food items easier to reach by wheelchair.
They only spent about $200, but a complete kitchen remodel could cost more than a bathroom. That’s because other options for wheelchair accessibility include things like height-adjustable counter and cabinet lifts, such as those shown in this photo from Woodworth Services, and stoves that only heat when a metal pot is put on top.
STAIRS: The house had about five steps up to the porch, so that meant installing a stair ramp. It cost about $800, was made out of aluminum and can be easily removed later when Jack recovers. If your situation is different, you may choose a more permanent solution.
Jack and Jill were lucky, because they live in a one-story home. My dad was confined to a bedroom upstairs after his heart attack since the home was a rambler with four floors, and there were no bedrooms downstairs or on the kitchen & living room floor. But today it’s easier for people with multi-story homes to cope, since stair lifts and elevators can fit almost any need and can even be rented or purchased used. Lifts can be removed after recovery as well.
AUTOMATION: Jack quickly learned that the simplest tasks of turning lights on and off or answering the front door became a chore with his injury, so he had someone install a wireless home automation system. It’s nothing like the elaborate systems found in high-end homes that can start at $10,000, or even the one I installed in my home, which was described in our local paper. Jack’s system just controls a few lights, a video intercom, and an electronic door lock. He can use a handheld remote to control lights from the bed or sofa, and with his iPhone he can see who’s at the door and unlock it, even remotely if he’s not home. Jack may add controls for the thermostat and other devices later and likes the fact that his starter kit cost less than $1,200 installed and that it can expand with time as needs and desires change. For now he’s keeping it simple.
TIMING: Jack and Jill were forced to make important decisions during the stress of a medical emergency, and they could easily have gone with Scenario ONE. But by remodeling and relying on home health care, they were able to save their estate. Now assuming Jack recovers and starts moving about with a walker, a cane, and then on his own, they may need to think of other ways to prevent falls, which are more likely to occur after a stroke.
MORAL OF THE STORY: The first lesson learned from Jack & Jill is that discussing your options well ahead of time with a clear mind will help you make better choices. Another is that the remodeling costs can be reasonable, in this case less than $14,000.