Retrofitting for Lifelong Independence

What is retrofitting?

Retrofitting in housing is the practice of adding features in the design of a home that were not included during the initial construction.

Why is it necessary?

Retrofitting is necessary because much of our existing housing stock is missing universal and accessible design. Incorporating these features may require us to make significant changes to the home to fully implement universal design. For example, a small bathroom may require walls to be relocated in order to create the clearance necessary in both universal and accessible design. What’s more, many bathrooms do not have the reinforcements in the walls to support the addition of grab bars.

How much does it cost?

Cost is difficult to estimate because of the diversity of homes available. What we can say confidently is that retrofitting is more costly than incorporating universal design during initial construction. The cost will depend on what changes are necessary to implement home modifications.

Why does it cost more than new construction?

Retrofitting costs more than new construction for various reasons. Primarily because of the need to reconfigure spaces to support the incorporation of universal design. To reconfigure a space it is likely that walls will need to be relocated. If a wall that needs to be moved is load bearing, then additional costs will be incurred to maintain the structural integrity of the home.

Cost of retrofitting versus other options for aging

We fully acknowledge that retrofitting is expensive and may be outside of the reach for some homeowners. However, an examination of the cost of a nursing home or an assisted living provides meaningful perspective. What’s more, many of the services provided by both nursing homes and assisted living facilities can be provided in the home.

The monthly median cost of a nursing home in South Dakota is $6,509 for a private room. The average length of stay in a nursing home is two and a half years. The estimated total cost of that stay is $195,275. Now imagine we invested those dollars into retrofitting our home.

In Memphis architects were challenged to modify (retrofit) a home to be universal design. Here is the catch, their budget was limited to $85,000. Before and after pictures are available online, Home Matters: Home Today, Home Tomorrow Design Challenge – Memphis House.

Assistance and in-home care

As we age and approach the end of our life, very few of us require 24-hour custodial care. Many of us would do well with a few hours of assistance every day. The assistance we receive could be as simple as light house cleaning to more complex tasks such as bathing and grooming. This help can be provided in the home with home care or home health providers. Another important thing we should know is that Medicaid may cover the cost of in home services.

The following table provides examples of the cost of different care options as well as the cost of refinancing our home to retrofit for universal or accessible design.

Expense Item Assisted
Monthly Service Fee $ 3,370 $6,509 n/a n/a
Refinance $85,000
(15 year mortgage)
n/a n/a $625 $625
Home Care
(15 hours a week/$25 hour)
n/a n/a $1,500 n/a
Home Health
(15 hours a week/$30 hour)
n/a n/a n/a $2,000
Monthly median cost $ 3,370 $6,509 $2,025 $2,525
Annual median cost $40,440 $78,108 $24,300 $30,000
Cost after 2.5 years** $101,100 $195,270 $60,750 $75,000

*home health and home care included in the Monthly Service Fee—price also changes based on how many services needed.
**average length of stay in a nursing home

The Bottom Line

The table above provides us with interesting perspective on the cost of home modifications and traditional housing options available to us when we need additional assistance. While the cost of home modifications are high, we can expect to pay nearly the same amount for a single year in a nursing home. When we consider that the average length of stay in a nursing home is 2.5 years, the cost difference becomes more striking. If we invest in home modifications and hire either home care or home health, we can estimate that we will save approximately $100,000 on our long term care expenses. That’s an incredible amount of money for many people, especially if we dream of remaining in our home or leaving an inheritance to our children.

We have to acknowledge that the cost of hiring home care and home will be determined by how much assistance we need. And as we get closer to the end of our life, we may require additional assistance. We should talk to our loved ones about what is important to us. Our personal goals will help us know what option is best for us.

More Information

Would you like to learn more about how universal design can help us achieve our aging goals? Please visit, What is needed for aging in place? to learn more.

Additional Readings & References: