The Most Wonderful Time of the Year!
What is it that makes Christmastime the most wonderful time of the year? Certainly for those of us who are Christians, the celebration of the birth of our Savior is the most important part of this joyous season. A little research, however, will reveal that there is very little evidence that Jesus was born on December 25. It is considered likely that this particular date was borrowed from the pagan holiday Saturnalia. During the seventeenth century both in England and parts of the American colonies, Christmas was banned by the church because it was believed to be connected to pagan rituals and not properly reverent. Other faiths and traditions also seem to celebrate at this time of year. Maybe we all need something to celebrate when it is cold outside and many living things seem to have retreated into the earth. At any rate, for most of us, the Christmas season is a time of sights and sounds and tastes and smells that we cherish and look forward to all year. It is a time when we are more likely to pause and consider what is important in life. A time when we take to the time to ponder how important our family and friends are to each of us. Life is short and none of us is guaranteed tomorrow. Make time to enjoy the season and spend time with those you love while you have the opportunity. When you gather at the homes of family and friends to enjoy the special fellowship of the Christmas season, please be mindful of safety and accessibility in the home. Most of us never consider fall prevention or access into and out of the home until we are forced to by a fall or the loss of mobility in ourselves or a loved one. At Christmastime when we often have extended family visiting or we are visiting them is the perfect time to consider increasing the safety and accessibility of our homes. Some of these modifications can be quite simple, like removing throw rugs or trailing extension cords. Other modifications, such as adding a master suite addition for multigenerational living can involve a significant investment of time and money. Most modifications to improve safety and accessibility are somewhere between these two examples. Adding grab bars, railings, or other features to help prevent falls is often a first line of defense when creating a safer and more accessible home for people of all ages and abilities. I believe that we all benefit when we gather together with family and friends of differing ages and abilities. Young people glean the wisdom of their seniors and older folks enjoy the energy and enthusiasm of the young. As you make your plans for this holiday season, make sure you plan for safety and accessibility in your home and the homes of your loved ones. Whatever other plans you have for this festive time of the year, I hope you plan to spend time enjoying the company of those you hold most dear. Take time to consider those things in life that are most important to you. Please consider how great a gift the birth of our Lord and Savior Jesus Christ really is. I would like to thank each and every one of you for reading Housing Matters. I hope that I have made a difference in some of your lives and I would like to take this opportunity to wish you and yours a very Merry Christmas and a Happy and Prosperous New Year!
Fifth Annual Aging in Place Symposium
During the third week in October we celebrate National Aging in Place week. This week is set aside each year to draw attention to and provide resources for the millions of Americans who are choosing to remain in the home of their choice throughout the course of their lives. The idea of Aging in Place is not a new one. It has only been in the last one hundred years of human history that the idea of having our seniors move away from the rest of us into their own secluded enclaves seemed like a good idea. Now we are increasingly returning to the idea that we are all better off if our seniors remain in their own homes nestled in our communities. That way we can all benefit from their collective wisdom while they remain in comfortable surroundings. I guess my grandmother was right when she said, “New and improved is worse!” However, when Aging in Place it is up to the client and their support team to provide the services that are required in a home setting. These services include modifying the home, bringing in care as needed to help with daily activities, managing finances, providing alternate means of transportation when driving is no longer an option, and avoiding isolation and loneliness. Helping seniors and their loved ones find trusted resources to provide these services is one of the main goals of the National Aging in Place Council. Our local chapter is the Western and Central Virginia Aging in Place Council. Here in the Roanoke Valley, the Western and Central Virginia Aging in Place Council will be presenting the 5th annual Aging in Place Symposium. The event will be held on October 18th at Fostek Hall in the Jefferson Center from 5:00 to 7:30. If you or a loved one is interested in learning more about aging in place and the services and resources to help make it a reality, then this the event for you. It is also a good fit if you have been hearing about aging in place, aren’t sure what is entailed and want to learn more. In any case you will find out more about how you can find services and resources in housing, health and wellness, personal finance, transportation, and community and social interaction. These five areas represent the building blocks of successful aging in place. Among other resources, participants will receive a planning guide to help them assess their needs and build a plan to access resources in these five core areas. The keynote speaker will be Dr. Nancy Brossoie, Senior Research Scientist at the Center for Gerontology at Virginia Tech. Dr Brossoie brings a wealth of knowledge about aging and care models from around the world. She will educate and entertain you as she opens your eyes to the possibilities and the challenges of living a full and complete life in the comfort of your own home throughout the course of your life. Also featured will be a panel discussion with subject matter experts in home modifications, legal issues, medical care, audiology, financial planning, occupational therapy, transportation challenges, and many other subjects related to aging in place. Take advantage of this rare opportunity to hear this many experts answer your questions at one time. Bring the questions you have that need answers. The symposium is free and open to the public. Refreshments will be provided. If you would like more information, please feel free to call me at 540-384-2064. If you would like to register you may do so by going to carilionclinic.org/calendar or by calling 800-422-8482.
The Inevitability of Aging in Place
As I write this article I am well into my ninth year of writing Housing Matters. During that time I have espoused the benefits of aging in place. I have encouraged my readers to plan ahead. I have laid out the benefits of remaining in your own home throughout the course of your life. I have sounded the clarion call to promote aging in place. I have done all of this because I firmly believe in the benefits of aging in place. I believe that most people are happier and healthier in their own homes. I believe that our neighborhoods, communities, towns, and cities are better places to live when our seasoned citizens are living among us, sharing the benefits of their life experience with the rest of us. I also have seen time and time again that providing the care people need in a home setting is more cost effective. None of this has changed. What has changed is that as time goes on, I am feeling more and more strongly that aging in place as a predominant care model is inevitable. It is just a matter of time. Why do I say this? In the first place most people prefer to remain in the own homes. After all, that is why they are living there in the first place. Their memories are there and they are comfortable there. Even if their current residence is too large or doesn’t meet their current needs in other ways, most people prefer the independence and autonomy of a private residence to any kind of senior living. I see the need for, and am exploring the potential for building smaller, accessible, one floor living for seniors who prefer a private, accessible, easily maintained home. Regardless of how many amenities a senior living community has, many people will never see it as home. The second factor I see driving the inevitability of aging in place is cost. The cost of care continues to rise. Those paying for it, whether they are individuals, health plans, or government entitlements, continue to feel the squeeze. Ultimately, we the people are paying for all of it in one form or another. Providing care for seniors in their own homes is more cost effective and often more effective because people are happier and healthier in their own homes. The third, and perhaps most compelling reason that aging in place is inevitable is capacity. Baby boomers started turning 65 at the rate of 10,000 a day nearly eight years ago. We will continue doing for over ten years more. By the time the dust settles, the number of adults over the age of sixty five in this country will have doubled. There simply won’t be enough capacity in senior living facilities to house this influx of seniors. So in conclusion, most people want to stay home, it’s more cost effective to stay home, and it is the only place with enough room for the burgeoning population of seniors. Can you see why I say it is inevitable? Does this mean that I will quit championing the cause of aging in place? Does this mean that I will no longer be trying to convince people of the benefits of aging in place? Not on your life. I will keep right on sounding the call. Did you notice that the reasons I believe so strongly in aging in place are very similar to the reasons that I believe its implementation is inevitable? Besides, someone has to make sure that all of these homes are safe and accessible!
Aging in Place
How it all started I have been involved in construction for over thirty years and on June 1, 2001, I embarked on this journey known as self employment. I had decided that it was time for me to chart my own course. I started Solid Rock Enterprises, Inc. with the goal of providing quality building, remodeling, and consulting services to the Roanoke Valley and beyond. In the ensuing fifteen years, much has changed. When I first opened my business, I knew nothing about accessibility, aging in place, universal design, or peter pan housing. I was simply building and remodeling homes in the way that they had always been built. Like everyone else, I was building spaces for the 15% of people who will go through their lives without ever experiencing permanent or temporary mobility impairment. Wake up call My wake up call came, as it does with many of my clients, when a family member needed help getting in and out of their home. My mother had experienced a stroke and the balance and coordination issues that came with it. Having fallen several times, she was apprehensive about walking and fearful of falling again. She used a walker and sometimes a wheelchair to get around. We installed a wheelchair ramp, some grab bars, and swing clear hinges in her home to help her get around more safely and comfortably. She was very interested in aging in place although neither one of us knew the term at the time. From that point forward, I began to educate myself on the value and impact of creating homes that are safe, accessible and beautiful for people of all ages and abilities. Over the last nine and a half years I have been writing about these ideas here in Housing Matters. I have had the privilege to help many people, including dozens of disabled Veterans, stay in the homes of their choice due to the home modifications we were able to provide. I am truly thankful for the opportunity to help people stay safely and comfortably in their own homes. What’s coming next Looking forward to the next fifteen years and beyond; I know that Americans will continue turning 65 at the rate of 10,000 per day. This adds up to more than fifty million of us reaching that milestone over that timeframe. With more of us living longer and healthcare costs spiraling out of control, the current housing model for older Americans will grow increasingly obsolete. At some point during this time we will reach a tipping point when it will become painfully obvious that something needs to be done. I for one will continue to work on supplying real world, common sense solutions now to create homes that will meet the need for safe aging in place and the desire for a beautiful home to live in and enjoy. Planning Ahead If you or a loved one is planning to spend the rest of your life in your current home or you are trying to decide whether your current home is the best place to spend the rest of your life, we have the tools and resources to help you make an informed decision. Please don’t be like many people who stick their heads in the sand and refuse to consider their options until a choice is forced upon them. If you would like some help in the planning process you can download our Planning Guide. Or simply call us at 540-384-2064 and we would be happy to mail you a copy. Whatever else you do, please start the conversation. Be proactive and take steps to maintain your independence before it becomes critical. As always, thank you for reading Housing Matters and here’s to a full and independent life for each of you!
At What Cost?
All of us are getting older. There is no getting around that fact. While there are many who try to rephrase the fact or put into a fancy wrapper, it doesn’t change the reality. As we get older we often have more trouble doing the things we used to do without a second thought. A lot of people are re examining their assumptions about what kind of living arrangements to make for ourselves or our loved ones as we age. The traditional trajectory has been to move out of our homes into independent senior living, then into assisted living, and finally into a nursing home. That’s a lot of moving, which can be trying in the best of times, and downright traumatic when forced by a sudden change such as a fall. Not only is it disconcerting, but the costs continue to rise. The 2017 Genworth Cost of Care Survey found the national average nursing home cost to be $235 per day and the average assisted living cost to be $3750 per month. As the cost of these facilities continues to rise, there are several other factors that increase the challenges for those people who are reaching the stage of their life where living independently is becoming more and more difficult. First, there are a lot more people in this age group. On January 1, 2011, the first baby boomer turned 65. That was over 8 years ago. Currently, baby boomers are turning 65 at the rate of 10,000 per day. Studies show that even if the number of retirement facilities doubles over the next 20 years, there won’t be enough room for all of them. The second factor is that our homes can be peoples’ largest asset, and selling their home is how many if not most people finance a move to an assisted living or other retirement facility. The house market is always in flux and this inconsistency adds risk when overly relying on its value. Thirdly, and perhaps most important, the vast majority of people would prefer to remain in their own homes if they can. Their homes represent more than a residence, they are a home. They frequently have decades of memories connected to their homes, and the thought of leaving them behind can be very distressing. Fortunately there are answers to this conundrum. We are increasingly hearing the term “Aging in Place” used in the conversation about options for our aging loved ones. Aging in Place refers to remaining in the home we are already living in throughout our lives. In fact, studies show that 70% of seniors will spend the rest of their lives in the home where they spent their 65th birthday. A four year study conducted at the University of Missouri’s Sinclair School of Nursing confirms what I have seen in my own business. Seniors who remain in their own homes as they age not only spend thousands less on care but have greatly improved mental and physical health outcomes. As a Certified Aging in Place Specialist (CAPS) I specialize in helping seniors remain safely and comfortably in their homes as they age. At Solid Rock Enterprises, Inc. we offer home modification services such as ramps, doorway widening, bathroom and kitchen renovations to improve access, grab bars, etc. We also provide assistive technology such as remote activity and wellness monitoring, overhead lifts, stair lifts, platform lifts, and elevators. We also serve our country’s brave veterans with HISA and SAH grants. To find out more about aging in place, visit www.solidrockenterprises.com or call 540-384-2064. • Genworth: https://www.genworth.com/aging-and-you/finances/cost-of-care.html
Are you a Frazzled Caregiver?
I was talking to a client the other day who is caring for her mother. We converted her bathtub into a step in shower and we installed some hand rails on her front stoop to help prevent falls. She told me that her mother, who is almost 90 looks great, but “the rest of us are worn out”. Caregiving is an exhausting job that takes a toll on everyone who tries it. Many people with a caregiver’s heart feel guilty because they are not doing enough, even while neglecting themselves as well as their other responsibilities. If you aren’t careful, it will leave you frazzled. An internet search for “Are you a frazzled caregiver?” returned over nine million results. Maybe you think this topic is outside the realm of my usual subject matter. Caregiver burnout is a serious issue and many of the solutions that we provide can help not only the client but the caregiver as well. Many studies show that approximately 30% of caregivers die before their patients. This can be attributed to physical stress from lifting, supporting, and carrying our loved ones because of their mobility challenges as well as from the emotional stress of worrying about their safety. Many family caregivers feel that they shouldn’t ask for help because they should be able to care for their loved one by themselves. I have a news flash for you. You are not superman (or superwoman). We all need help, especially when caring for a loved one. Sometimes that help might come in the form of another family member pitching in so you can take a much needed break. Other times it might mean recruiting a professional caregiver on a full or part time basis. Or it could be that having some home modifications made can make your caregiving routine less physically and emotionally demanding. For example, adding grab bars or handrails can lessen the probability of your loved one falling and injuring themselves. Converting a bathtub to a curbless shower may eliminate the strain of lifting or assisting your loved one in or out of the bathtub. Removing throw rugs and trailing extension cords can help eliminate tripping hazards. Or a remote activity monitoring system could send alerts if activity is detected such as not taking medication or not getting up in the morning. This type of system can help provide peace of mind by knowing you will be alerted of a problem when you are not able to physically be there with your loved one. If you are a caregiver and would like a professional evaluation of your home or your loved one’s home, please give us a call. We can assess your home and tell you what modifications can increase safety and independence. We can be reached at 540-384-2064 or by logging onto our website at www.solidrockenterprises.com. If you are a caregiver, please get the help you need. If you don’t take care of yourself, you won’t be any help to anyone else. You need a support network to help support you. Resources can be found at your local area agency on aging or at the National Aging in Place Council website at www.ageinplace.org. There are numerous support groups for caregivers to get together and share their struggles and triumphs. Sometimes just knowing that there are other people experiencing the same challenges you are can help you feel less alone. If you are a frazzled caregiver please take the time and make the effort to take care of yourself. It could make all the difference for you and your loved one.
How to Simplify and Customize Your Aging Options
Life is full of options. Every day we make choices, large and small. Some choices are trivial and minor, while other choices will have a huge impact on the rest of our lives. Decisions regarding our care as we get older fall into the latter category. Decisions like, “Where will we live?”, “Who will take care of us?”, and “How will we pay for it?” are questions we all should be asking and answering long before the need arises so that we will have a plan in place when the time comes. To help you put this plan in place, the Western and Central Virginia Aging in Place Council is proud to present the 4th Annual Aging in Place Symposium, “How to Simplify and Customize your Aging Options”. The symposium will be held on October 17th from 5-7:30 pm in Fitzpatrick Hall at the Jefferson Center located at 541 Luck Ave in Roanoke. Admission is free and refreshments will be provided. Attendees will have the opportunity to hear from gifted speakers on healthcare, housing, legal considerations, and regional and state planning for the coming age wave. Bring your questions and concerns for the panel discussion. Experts in various fields relating to aging in place will be on hand to answer your questions and help allay your fears. You will leave with new tools in your toolbox and resources in hand to plan a better later life for you or a loved one. The Symposium is being hosted as part of National Aging in Place Week. Events will be held all over the country during the week of October 15-21 to help raise awareness of and find resources to successfully age in place. Our symposium will help seniors and their caregivers make and implement a plan to successfully stay in the home of their choice throughout the course of their lives. A panel discussion will bring experts from the fields of housing, health and wellness, personal finance, transportation, and community and social interaction together in one place. Bring your questions with you to ask our panel of experts. Where else can you get free answers to all your legal, medical, and other aging in place questions all in one place? In the past, many people have chosen to ignore their changing needs as they grew older. Oftentimes, decisions about housing and healthcare options in later life were made in crisis mode after a traumatic life event such as a fall. This in turn has led to less than optimal outcomes. The Western and Central Virginia Aging in Place Council intends to change all of that. Our goal is to give people the resources to make plans early and encourage people to do so. Attending this Symposium is a great place to start. We will have planning guides available for attendees to begin the process of planning for a better later life. If you would like to register for the event, please call 800-422-8482 or visit www.carilionclinic.org/calendar. Don’t let this opportunity to plan for a better future pass you by and please patronize our sponsors who have made this event possible. Here’s to your future and a better later life.
The Importance of Planning
There is an old adage that says, “If you fail to plan, you plan to fail.” This adage holds true in the area of planning for later life, whether it be for ourselves or our loved ones. Many people engage in retirement planning in the sense that they endeavor to set aside money to live on after their working lives come to an end. Relatively few people, however, carry this planning to the next logical step and plan for the other aspects of living a better later life. In addition to having the funds to pay for our needs and our wants after we retire, I believe that it is important to plan for our housing needs, our healthcare needs, our transportation needs, and our community and social interaction needs. As the new chairman of the Western and Central Virginia Aging in Place Council, my goal is to provide tools and resources to help people in this planning process. Granted, if your plan is to move into a Continuing Care Retirement Community or other senior housing community, many of these needs will be provided for you by the community. However, my research shows that upwards of 90% of people would prefer to remain in their own homes as they age. Aging in place gives you the right to make your own decisions about most of the topics regarding your care, but you will also carry the responsibility for the outcomes of these decisions. You won’t be alone however. By 2030 the number of Americans over the age of 65 is expected to be over 70 million, nearly twice the number that there were just a few years ago. The fastest growing segment of the population, those over the age of 85, is increasing at the rate of 3,000 per day. I would strongly encourage each and every one of you who is even considering aging in place to begin to put together a plan for a better later life. Your plan should include housing, healthcare, personal finance, transportation, and community and social interaction. Your plan should answer the following questions about your later life. Where will I live? Who will take care of me? How will I pay for it? If all of this seems a little overwhelming and you would like some help, the aging in place council has a 20 page planning guide that will help you walk through a questionnaire to help you assess your needs, then prioritize and summarize these needs to help you get them met. Members of the council can help you with a wide variety of goods and services to help you successfully age in place. Just give us a call at 540-339-7891 or send us an email at westernandcentralvirginia@ageinplace.org. We would be more than happy to help you plan for a better later life. In addition, as always, if you need help building a new home that will meet your changing needs as you age, remodeling to adapt your current home, or consulting to help decide which option is a better choice for you, please get in touch with me. You can reach me at 540-384-2064 or cmoore@solidrockenterprises.com. Whether you are in the market for a new home, a major addition, a bathroom remodel, or a few grab bars to help prevent falls, Senior Remodeling Experts is your trusted source for a lifespan design home for a lifetime of living. Please let me know if I can help. And thank you for reading Housing Matters.
Planning for a Better Later Life
January marks the beginning of a new year. It is a time when people often resolve to make changes in their lives. Traditionally these resolutions are not very long lived, falling by the wayside weeks, days, or even hours after they are embarked upon. I think that this is because they are most often things that we would like to do, not things that we have actually resolved to do. I suggest that rather than making New Years resolutions to do certain things in our lives, we make plans to do them instead. Planning is a powerful tool to accomplish great things in our lives. It has been said that if we fail to plan, we are actually planning to fail. I am going to talk in particular about planning a better later life. Many people are hesitant to think about getting older and the challenges it brings, preferring instead to stick their heads in the sand. When the first attempt to make adaptations for later life occurs after a fall or other crisis, there is no time for planning, only reaction. The vast majority of Americans, when questioned, state that they would prefer to live out their days in their own homes. This idea, also known as Aging in Place, is an idea whose time has come. A number of us here in the Roanoke Valley and beyond belong to the Western and Central Virginia Chapter of the National Aging in Place Council. As part of its ongoing effort to help people successfully age in place, the council has developed a planning guide to help people work through the steps to planning a better later life. The guide covers the five core areas that are essential to successful aging in place which are: Housing Health and Wellness Personal Finance Transportation Community and Social Interaction The planning guide contains a questionnaire in each of these categories to guide you in objectively determining what your needs, resources, and challenges are in each of these areas. I encourage you to take the time to go through these sections thoroughly, do it early, and have a family member or trusted advisor who knows you well go through it with you to get a more objective result. At the end of each section, there is room to write down your needs in that core area. At the end of the guide, there is a page to summarize your needs and make a list of your priorities in creating a living environment that will help make your later years safe, comfortable and enjoyable. Finally, there is a place to list the things you can do yourself and the things you need help with. At the Aging in Place Council we have professionals who can help you get the help you need in each of these core areas, whether you need home modifications, home care, legal advice, financial assistance, medical help, transportation, or a myriad of other services. The planning guide is available for download at my website which can be found at seniorremodelingexperts.com or if you would like a copy mailed to you, call me at 540-384-2064. If I have impressed upon you the value of planning for a better later life, and you have questions, please give me a call. I will be speaking at various events throughout the coming year. Two that are coming up this month are The Greater Roanoke Home and Garden Show at the Berglund Center on January 13-15 and the Salem-Roanoke County Chamber of Commerce Networking Breakfast on January 27 (contact the Chamber at 540-387-0267 for more information).
The time has come
My name is Chris Moore. I am the Director of Education for the Western and Central Virginia Aging in Place Council. I have been involved in construction in one form or another for thirty years and have owned my contracting business for fifteen. I have been actively involved in promoting Aging in Place issues for about eight years. I am passionate about people having the right, the availability, and the resources to remain in the home of their choice throughout the course of their lives. I don’t think that it is too strong of an opinion to state that the idea of the ability to stay in our own homes is as foundational to our way of life as these words from the Declaration of Independence, “We hold these truths to be self evident, that all men are created equal, that they are endowed by their Creator with certain unalienable rights, that among these are Life, Liberty, and the pursuit of Happiness.” If any of you have spent much time listening to someone who feels that circumstances are forcing them out of the home that they love into some sort of living arrangement that they detest, then you have seen someone struggling with the core issues of Life, Liberty, and the pursuit of Happiness. Studies show that more seniors fear being admitted to a nursing home than fear death. The ability to live independently on one’s own terms is really at the very heart of who we are as people. What these people desire is what we call Aging in Place. Aging in place is commonly defined as the ability to live in one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level. Aging in Place is simply the idea that we can continue living in the home we are comfortable in throughout the course of our lives rather than be forced to move somewhere else because of the consequences of aging or disability. I don’t particularly like the term Aging in Place because it seems to suggest that there is a certain point in our lives when we start aging and at that point, when most people move, we decide to stay put instead. However, we will continue to use it until someone comes up with a better term. There are some who advocate using the term living in place to indicate the idea that it is a lifelong process. Whatever we call it, our challenge as advocates is to make the “place” as conducive as possible to the process of continuing to live there throughout the course of our lives. My interest in Aging in Place began in earnest when my mother’s health began to decline. My parents had been living in Arizona for quite a few years. When she began to have health issues, they moved back to the area to be closer to family. Like most family caregivers, we found ourselves in a caregiving role quite suddenly. Being a contractor, I knew how to build a ramp for getting in and out of the house and to install some grab bars in the bathroom to help prevent falls, but I really didn’t know what other kinds of modifications to make, nor did I have any idea what other products and services my mother might need or where to find them. Since that time I have become a Certified Aging in Place Specialist, a Certified Environmental Access Consultant, earned an Executive Certificate in Home Modification, and performed dozens of home modifications and consulted with hundreds of family members and caregivers who had grave concerns about their loved one’s safety. Throughout these experiences I have found that my experience of suddenly finding myself in a caregiving role is typical. Most people simply do not anticipate that they may become the primary caregiver for a parent, a spouse, or other loved one, who to some degree, is now unable to care for themselves. Whether the need is sudden such as from a fall or accident or the knowledge of the need is sudden because it has been kept hidden due to embarrassment or not wanting to bother anyone, the result is the same. Suddenly you are a caregiver. Now what? When you suddenly find yourself in a caregiving role there are really two issues at play and it is at the point that the two issues intersect that the adjustment must be made. One issue is the physical, mental, emotional, or spiritual ability of the individual with regard to mobility, sight, hearing, balance, range of motion, cognition, memory, well being, overall health, etc. This issue generally falls into the jurisdiction of a health care practitioner, such as a doctor, nurse, or occupational, physical, or speech therapist, counselor, pastor, or minister among others. The other issue is the built environment with regard to obstacles to activities of daily living. These obstacles can include stairs, raised thresholds, narrow doorways and hallways, slippery floors, poor lighting, inaccessible bathrooms, doorknobs that are difficult to turn, and a host of other fixtures found in a typical home. These items generally fall into the realm of architects, interior designers, contractors, builders, and remodelers. However it is at the point that these two issues meet that is critically important to the individual struggling to live in their home. That is why it is so important to have professionals from different disciplines at the table in order for us to offer real world solutions to people trying to age in place in our community. A home that is perfectly suited to someone with one type of disability would be totally inappropriate for someone with a different type of disability. The solution must meet the need. As an example as long as I am wearing these glasses, I can read my notes. The minute I take them off, I have become visually handicapped. The long term approach is to build homes that we can all live in comfortably for our entire