According to a February Pew Research Survey, 93% of older adults in the US aged 65 and older currently live in their own home or apartment and prefer to age in place. However, the reality of living independently depends on several factors, including health, safety, social connections, and finances.
Understanding Your Needs and Resources
Everyone has different needs and resources, such as proximity to family, access to services, and budget. Kate Granigan, a geriatric social worker and CEO at Alder, a life care management practice in Boston, created a talk titled "Should I Stay or Should I Go?" to help clients consider whether to modify their current home, downsize, or move to a community-modeled living arrangement. "We talk about their choices as they age, their options, and share all of the ins and outs of that. There's a lot of nuances," Granigan says.
Granigan emphasizes that housing decisions should be part of a larger set of directives, including healthcare proxy, power of attorney, and financial and estate affairs. Designating a care and support team and discussing plans early is crucial. "You want to make sure that those things are lined up, articulated early, and reviewed often," she adds.
Health and Support Needs
Francisco Lasta, a Chicago-based occupational therapist and inclusive design lead at GFT, notes that the choice to stay or go depends on health status and available support. Older adults have a 69% chance of needing some type of care and support as they age. Social isolation and loneliness are also significant risks, linked to dementia, depression, heart disease, and stroke.
Nursing or skilled care may be required. According to a 2025 survey by CareScout, non-medical home services average $35 per hour or $80,000 annually, while skilled nursing costs about $90 per hour, nearly $206,000 annually. "That is actually a place where a lot of people hit a tipping point of having to leave, not just by choice, but by funding issues," Granigan says.
Home Modifications for Safety
Conduct a top-to-bottom review of your home to ensure safety. Lasta advises that stairs or barriers between rooms should be eliminated for wheelchair or walker access. Doorframes should be wide enough, and walk-in showers and accessible countertops are important. Falls are the leading cause of injury for those 65 and older, so task lighting and non-skid flooring can help.
Modifications range from simple grab bars to costly bathroom renovations or stair lifts. Emily Nabors, associate director of innovation at the Center for Healthy Aging at the National Council on Aging, recommends working with a certified aging-in-place specialist through the National Association of Home Builders or the University of Southern California.
Renovation Costs and Alternatives
According to a report by Fixr, adapting a home for age-in-place needs costs between $3,000 and $15,000 (national average $9,500). Major renovations like kitchen ($50,000), bathroom ($25,000), or stairs ($45,000) add up. Nabors suggests safety net programs through state aging agencies and nonprofits like Rebuilding Together and Habitat for Humanity.
If renovation isn't suitable, alternatives include accessory dwelling units (ADUs, average $180,000), community-based models like the Village to Village Network, senior cohousing, or continuing care retirement communities (CCRCs, initial buy-in $402,000).
