According to a February Pew Research Survey, 93% of older adults in the US (65+) say they currently live in their own home or apartment and prefer to age in place. However, achieving this goal depends on health, safety, finances, and social support. The reality of living independently hinges on several factors: people 65 and older have a 69% chance of needing some type of care and support as they age, according to data cited in the article. Home adaptations for mobility and fall reduction, as well as preventing loneliness, are critical.
Defining what aging in place means
Kate Granigan, a geriatric social worker and CEO of Alder in Boston, helps clients plan through her talk "Should I Stay or Should I Go?" She encourages considering whether to remain in the current home and modify it, downsize, or explore community-modeled living. "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. She emphasizes that housing decisions should be part of a larger set of directives, including healthcare proxy, power of attorney, and financial affairs. "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. "Are you going to be able to go to the grocery store independently without having somebody assist you significantly? Or do you have a chronic condition that might really limit your ability to interact with your environment?" he asks. Social isolation and loneliness are risks for older adults, 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 in the US, while skilled nursing costs about $90 per hour—nearly $206,000 annually. Granigan says this is often "a tipping point of having to leave, not just by choice, but by funding issues."
Home modifications for safety
Lasta advises a top-to-bottom review: no stairs or barriers between rooms, wheelchair-accessible doorframes, walk-in showers, and accessible countertops. Falls are the leading cause of injury for those 65 or older. Task lighting and non-skid flooring can help. Costs for adaptations range from $3,000 to $15,000 (national average $9,500), according to a Fixr report cited by Emily Nabors of the National Council on Aging. Major renovations like kitchen ($50,000), bathroom ($25,000), bedroom ($12,000), or stairs ($45,000) add up. Nabors recommends state aging agencies and non-profits like Rebuilding Together and Habitat for Humanity for financial help.
Renovation or relocation?
Granigan notes that adapting a home may change its character. "If we have to install grab bars, and expand a bathroom or a bedroom on the first floor for access, and widen doorways for mobility issues – is it still going to be the home you love?" she asks. If not, moving may be better. For renters, basic accessibility accommodations are protected under the Fair Housing Act. Alternative housing options include accessory dwelling units (ADUs, average $180,000), Village to Village Network, Senior Cohousing, and continuing care retirement communities (CCRCs, initial buy-in $402,000).
