By Sharon Jayson, Kaiser Health News

AUSTIN, Texas — Chris and Dennis Cavner, in their early 70s, are preparing to move less than two blocks away into a 2,720-square-foot, ranch-style house they bought this year.

But first a renovation is underway, taking the 45-year-old property all the way back to its studs. When the work is completed, these baby boomers are confident the move will land them in their forever home.

“We wanted to find a house that we could live in literally for the rest of our lives,” he said. “We were looking specifically for a one-story house — and one that had a flat lot, to age in place.”

Aging in place is a major financial commitment, one that may be at odds with retirees’ plans to downsize their lives and budgets and squirrel away cash in anticipation of rising health care costs.

The Cavners are rebuilding this house — assessed at $700,000 around the time of the sale — from a shell. The updates will easily cost $300,000 in the hot Austin market.

Leaving nothing to chance, the Cavners are making a number of modifications they might never need. For instance, neither uses a wheelchair, but contractors are making all doorways 3 feet wide for accessibility throughout — just in case.

The master bath roll-in shower, flat and rimless, will provide room to maneuver and the master bath vanity is also at wheelchair-accessible height. Kitchen drawers, rather than cabinets, will allow easy access in a wheelchair. The Cavners are closely watching details of the renovation, but it wasn’t a hard decision.

For some seniors, aging in place might amount to simple home modifications, such as adding shower grab bars and handrails or replacing a standard toilet with one that sits taller. But many seniors anticipate a financial crunch as they try to plan for their future on a fixed income, uncertain their savings and retirement funds will last.

With an average 10,000 people a day turning 65, according to the U.S. Census Bureau, the 65-and-older segment of the population is the nation’s fastest-growing: By 2050, almost one-quarter of Americans will be at least 65. A host of surveys conducted over the past decade show that older adults overwhelmingly want to age in their homes. Two in 5 U.S. homeowners are baby boomers, according to a 2018 report released from Fannie Mae.

But for many people, aging at home isn’t in the cards. Abbe Will, associate project director of the Remodeling Futures Program at the Joint Center for Housing Studies of Harvard University, said that many houses aren’t suited to “aging in place.”

“Currently, a lot do not have single-floor living — especially in certain parts of the country. There are lots of stairs and multistory homes when land is more valuable,” she said. And “many households and homeowners don’t necessarily have the funds to do aging in place.”

Home modifications and costs vary widely — starting with those simple safety features in the bathroom or lever doorknobs throughout the house — to more extensive changes, such as widening doorways to accommodate wheelchairs, replacing kitchen cabinets with drawers or lowering light switches to wheelchair height. Will said simple retrofits, such as grab bars and railings, “could be several hundred dollars,” but a “whole bathroom remodel would be in the thousands or tens of thousands.”

And a lot of people won’t have the money for extensive modifications. A new survey of 1,000 people age 65 and older by the California-based nonprofit SCAN (formerly the Senior Care Action Network) found 80% of respondents were concerned about their ability to age in place.

The driver appears to be financial: About 60% said they have less than $10,000 in savings (including investments and retirement plans), while 28% reported minimal or no retirement savings.

A study in the journal Health Affairs published this spring illustrates the shaky situation for middle-class aging adults who can’t afford modifications to stay at home but who have too much money to qualify for federal housing assistance.

Over the next decade, the researchers expect the number of middle-income seniors 75 and older to more than double to over 14 million. And, of that group, more than half (54%) won’t have the assets they will need to cover the projected average yearly cost of $60,000 for assisted living and other out-of-pocket medical costs.

“We don’t know what’s coming down the pipeline as we age,” said sociologist Deborah Thorne of the University of Idaho in Moscow, Idaho, lead author of a study that found skyrocketing bankruptcy rates among those 65 and older.

The research, to be published in the journal Sociological Inquiry, finds the share of older Americans filing for bankruptcy has never been higher, with a filing rate increase of more than 200% from 1991 to 2016 among those 65 and older: “And bankrupt households are more likely than ever to be headed by a senior — the percent of older bankrupt filers has increased almost 500 percent since 1991,” the study found.

James Gaines, an economist with the Real Estate Center at Texas A&M University, attributes the increase “to the labor market and employment downsizing and letting older people go first. It can force them into retirement whether they’re ready for it or not. Retirement income may not be enough to carry their debts, and they don’t have enough savings.” 

“The leading edge of baby boomers has not hit 75 yet,” said Jennifer Molinsky, whose work at the Joint Center for Housing Studies of Harvard University focuses on housing for older adults. “When you think about the next five, 10 or 15 years when they’re in their 80s, you’re really going to see the needs shift.”

Because disability rates will rise with chronic illnesses and conditions, requiring more assistance, Molinsky said, communities need to think more about transportation for seniors, as well as “different kinds of housing than we have now.”

Don and Lynn Dille, both 75, built their Austin home with the intention of staying there for a long time. After living in California, Virginia and elsewhere in Texas, they moved to Austin in 2012 and, within a year, began drawing plans with an architect for an energy-efficient home to age in place. Their home was featured this summer in Austin’s annual Cool House Tour for its design making the most of natural light, cross-ventilation and solar panels, as well as wider-than-normal doorways and level floors for a wheelchair.

One key feature of the construction acknowledges that they might need live-in help down the road to avoid long-term nursing care. Just as the Cavners may convert a bedroom and bath on the opposite side of their new home into caregiver quarters, the Dilles constructed a second floor above their detached garage that could easily convert into living space.

“We think having a separate apartment where we could have a caretaker or part-time help to maintain our property makes us able to stay where we’d like to be and be independent,” said Don Dille, who retired from the federal government.

But, as adults consider whether to plunge ahead with simple modifications or undertake more extensive renovations, there are always unknowns.

Cavner, an investment adviser and co-founder of a new health care startup, said he believes what they’re spending to renovate the house for the years ahead will prove a sound investment. “The modifications we’re making are not going to make it less desirable. It will feel more spacious.”

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.