Accessible Home design vs. Assisted Living. A graphic cost and benefit analysis for children with aging parents can use to discuss long term living and investment strategies for the benefit of all.

1. Home
Accessibility as
an Alternative to
Retirement
Community &
Assisted Living
Presented By:
DMH DESIGN LLC
All Content Contained Herein:
Copyright 2002-2011 DMH DESIGN LLC All Rights Reserved

2. Purpose
To Inform the Public About the
Benefits, Economics, Facilitation,
Design Essentials and Design
Examples of Remaining in the Home
Long Term.
Staying in the Home vs. Moving Into
Retirement & Assisted Living is Not For
Everyone. However, Many Believe
this Provides a Very Attractive
Alternative When Both Options Are
Equally Weighed, In Terms of
Finances & Familiarity With One’s
Surroundings.
(Updated for 2010 Census Data)

3. About DMH DESIGN
LLC
 10th Year as Sole Proprietor
 Designed Residential Projects in 5 States
WA/ID/MT/WY/NY
 29 Years Total Exp. In Architecture/Design
 Extensive Knowledge and Experience in
Accessible and Universal Design
(Worked on Covenant Community &
Emeritus Projects From1998-2000)
 MBA Built Green Member
 Designed/Built Mother an Accessible Home in
2005
 Designed an Addition to Seattle Home w/ Acc.
Baths & Fut. Elev. In 2007
 Designed Elevator Addition to Lk. WA Home
in 2010
 Current Projects Include (2) Remodels, one in
Capitol Hill and one in View Ridge For Clients w/
ALS.

4. Statement of Intent:
To Educate The Public About What Choices
Need to Be Made as Part of Any
Comprehensive Retirement Strategy.
Beginning Early On With a Strong Foundation of
Insurance & Diversified Investments, Followed
By Timely Real Estate Purchases and Legal
Advice, Most Can Ensure Creating a Sound
Financial Vehicle For Their Retirement.
Many Believe the Ultimate Reward of Life’s
Effort is To Build a “Dream Home.” This Should
be Defined as a Home They Will Never Have to
Leave, Except By Choice, or Health. This
Blueprint is to Assist Those Wishing to Stay
in the Home.

5. Staying In The Home
as an Alternative to
Selling the Home to
Enter Assisted Living
Part 1: Benefits

6. Stay In Home or
Sell Home/Move into
ALF
 Pros:  Cons:
 Equity  Loneliness
 Familiarity  Maint. $400/Mo.
 Family Functions  Food $200/PP/Mo.
 Holidays w/ Family  Prop. Taxes/Insur.
 Family Memories $350/Mo.
 Possessions  Utilities $100/PP/Mo.
 Space  Isolation
 Freedom  Housekpg $300/Mo.
 Driving  Driving
 Memories
 No “24-Hr.” Care

7. Moving to an ALF or
Staying in Home
 Pros:  Cons:
 2-3 Meals/Day  “Buy In” Facilities ($$)
 Monthly Rental = No
 No Equity
Maintenance  No Sense of Place
 No Taxes  400 s.f. Apt. (Average)
 Lonely For Family
 No Utilities Members
 Group  Few Immediate Friends
Activities  Few Can Visit You in
Room at Same Time
 Socialization  Relatives Can’t
 “24-Hr.” Care Stay(Small Apt.) Without
Prior Notice & Extra
Unused Apts.
 Few Personal
Possessions
 Requires Transport
Between Relatives
Homes & ALF During
Home Visits

8. Staying In The
Home as an
Alternative to
Selling the Home
to Enter Assisted
Living
Part 2: Economics

9. Target Audience
Primary
Seniors Aged 65+
Empty Nesters
Secondary
Multi-Generational Households
Families w/ Special Needs
or w/ Spinal Cord Injured

10. Case Study:
Seattle, WA
Population 608,660 (2010 Census)
Average Age = 38 Yrs. Old
Aged 65+ = 65,735 (10.8% of Population)
Home Ownership = 49.6% of Total Pop.
Therefore:
65,735 x .496 (49.6%) = 32,605 (min. est.)
Persons Aged 65+ Living in Homes
Median Home Value = $446,900
Closing/Taxes/Commissions= $44690 (10%)
Net Proceeds After Sale = $400,210

11. Typical
Independent/ Assisted
Living Facility Costs
(SEATTLE):
(According to LTCG Members/General
Research)
$3k- 5k /PP/Month
$36k – 60k/PP/Yr.
*Average Stay: 5 yrs. +/-
Therefore, Based Upon Net Proceeds From an
Average Seattle Home Sale, Your Length of
Stay in a Private Pay ILF/ ALF Would Be:
$400,210 /1P x $36k/Yr = 10 Yrs +/- (infl.)
2P x $36k/Yr = 5 Yrs*
Or
$400,210/1P x $60k/Yr = 6.5 Yrs +/- (infl.)
2P x $60k/Yr = 3.25 Yrs*

12. Case Study:
King County, WA
Population 1,931,249 (2010 Census)
Aged 65+ = 193,630 (10.6 % of Population)
Home Ownership = 60.9% of Total Pop.
Therefore:
193630 x .609 (60.9%) = 117,921 (min. est.)
Persons Aged 65+ Living in Homes
Median Home Value = $398,600
Closing /Taxes/Commissions= $39860 (10%)
Net Proceeds After Sale = $358,740

13. Typical
Independent/Assisted
Living Facility Costs
(King County):
(According to LTCG Members/General
Research)
$3k- 5k /PP/Month
$36k – 60k/PP/Yr.
*Average Stay: 5 yrs. +/-
Therefore, Based Upon Net Proceeds From an
Average King County Home Sale, Your Length
of Stay in a Private Pay ILF/ALF Would Be:
$358,740 /1P x $36k/Yr = 9.8 Yrs +/- (infl.)
2P x $36k/Yr = 4.9Yrs*
Or
$358,740 /1P x $60k/Yr = 4.9 Yrs *+/- (infl.)
2P x $60k/Yr = 2.95 Yrs*

14. Case Study:
Seattle, WA
Typical Average Costs
1 Person: At Home vs. ILF/ALF*
Avg. Monthly Cost /1 Person
1 Stay @ Home 1 Rental Costs
ILF/ALF Rent (avg.)* $ - $ 4,000.00
Maintenance/HOA Dues $ 400.00 $ -
Food $ 300.00 $ -
Prop Taxes/Insurance $ 350.00 $ -
Utlities E/Ph/W/S $ 250.00 $ -
Cable/Internet $ 130.00 $ -
Housekeeping $ 300.00 $ -
Monthly Total $ 1,730.00 $ 4,000.00 *
12 Month Total $ 20,760.00 $ 48,000.00*
*Assumes No “Buy-In” Fees @ ALF
Assumes No Added Care @ ALF
Assumes No Mortgage Balance
Assumes No Auto Expense
Assumes No CNA/LPN Home Care
Assumes No MediCare Suppl. Premium

15. Case Study:
Seattle, WA
Typical Average Costs
2 Persons: At Home vs. ILF/ALF*
Avg. Monthly Cost /2 Person
2 Stay @ Home 2 Rental Costs
ILF/ALF Rent (avg.)* $ - $ 8,000.00
Maintenance/HOA Dues $ 400.00 $ -
Food $ 600.00 $ -
Prop Taxes/Insurance $ 350.00 $ -
Utlities E/Ph/W/S $ 300.00 $ -
Cable/Internet $ 130.00 $ -
Housekeeping $ 300.00 $ -
Monthly Total $ 2,280.00 $ 8,000.00*
12 Month Total $ 27360.00 $ 96,000.00*
*Assumes No “Buy-In” Fees @ ALF
Assumes No Added Care @ ALF
Assumes No Mortgage Balance
Assumes No Auto Expense
Assumes No CNA/LPN Home Care
Assumes No MediCare Suppl. Premium

16. Typical Annual Cost
Comparison
(From Previous Charts) At Home vs. ALF*
1 Person/2 Persons
$21,000 -27,000/Yr. To Stay at Home
$48,000 -96,000/Yr. To Rent an ILF/ALF
Apartment*
*Not including Any “Buy In” Fees, Adding
as Much as $100k –$700k While in Residence
at a Retirement Community/ALF.
The Result: A Dramatic Cost Difference:
$27,000 – 70,000 LESS PER
YEAR*, AT A MINIMUM , TO
REMAIN IN YOUR HOME While
Maintaining Equity!

17. Staying In The
Home as an
Alternative to
Selling the Home
to Enter Assisted
Living
Part 3: Facilitation

18. Essential Financial
Components For
Retiring Comfortably
(Allowing Flexibility to Stay In
Home,
If You Prefer)
 Insurance  Real Estate
 Life (T/W/U)  Existing Home
 Health (HSA) Equity
 LTC ($ Pool/$ Home  Rental Properties?
Access Modif.)
 Retirement (?)
 Financial  Pensions
 Sound Investment  Buyouts
Strategy
 Inheritance (?)
 Legal  Limited Ptshps.
 Will  Trusts et al
 Business Plan

19. Essential Components
of Your Lifetime
Financial Strategy
Retirement
Real
Estate
Legal/
Business
Health/ Finance/
Insure Invest
Working Life

20. Relevant Statistics:
80% of US Population Wants To Stay
in Their Homes Throughout Life,
Given a choice.
Long Term Care Insurance Is Approx 7-10%
Cheaper When a Policy is Enacted Prior to
Age 50.
LTC Policy Benefits Are Typically Paid Out
From a Pool of Money, to Those Remaining in
Their Homes &/or Residing in ALFs.
2 Out of 5 People aged 60 are in
Adult Homes or Assisted Living Care.
People Who Own Their Present Homes,
Aged62
& Over Are Eligible For Reverse Mortgages
on Their Existing Properties, or to Purchase a
Different Property, if They Desire.
(Dependant on Available Equity/Liquidity)

21. Reverse Mortgages:
Given the Current Economy,
Investments Have Lost Value, as
Have Home Values, Putting Many
Well Laid Plans at Risk.
A RM May Facilitate Your Ability to Keep
Your Existing Home and Any Equity You
Have, in Order to Fulfill Existing Financial
Obligations or to Purchase a Different Home
Which Is More Appropriate For Long Term
Residence.
A RM Can Also Provide Monies for
a Long Term Care Policy
A RM Can Provide Money for Partial
Accessible Retrofit of an Existing or New
Home
A RM Can Provide Money for In-Home
Care, Should You Wish to Stay in Your Home
Long Term

22. Staying In The Home as
an Alternative to
Selling the Home to Enter
Assisted Living
Part 4: Design Essentials

23. Your “Retirement
Environment”
If 80% of the Population Wants to
Spend
Their Lives Living in Their Homes,
What Long Term Design Priorities
Should Be Considered?:
Accessibility:
Building Access & Orientation
Minimize Interior Travel Distances
All Rooms Close to Core Home Functions
Functionality:
Outside Meets Inside
Room Flexibility
Comfortable
Practicality:
Location
Safety
Size

24. What is Accessible
Home Design?
 Design For Long Term Needs--
NOT For Ego
 Level Building Access; Level Site
Access Throughout is Also Desirable!
 Eliminate Steps From Outside to
Inside of Home & Within Home as
Possible
 Minimize Need for Vertical
Circulation (If 2-Story Leave Room
for Fut. Elev.)
 Maintain Short Travel Distances
Throughout Main Level of Home
 Wider Halls/Larger Doors/ADA Levers
 Adaptable Cabinetry/Lower
Appliances/Shallow Pantry/Grab
Bars @ Baths

25. What is Functional
Home Design?
 Design For Long Term Needs--
NOT For Ego
 Bauhaus Principles:
Form Follows Function=“Design
Within Reach”
 Miesian Principles:
Less IS More—Common Rooms
Serve Multiple Uses, Reduces Home
Size
 Kitchens are the “Hub” of Home
Activity:
Design Your Home Accordingly
 Emphasize Property Positives:
Orientation, View, Landscaping

26. What is Practical
Home Design?
 Location x 4
Schools/Work/Shopping/Activities
 Design to Client Budget--Not For Ego
 “Fits in” With Neighborhood Style
 Promotes Family Safety & Outdoor
Activity, Whether On the Property or
at the Park Down the Block
 Not Too large, Not Too Small:
Designed to YOUR Needs, Wants &
Furnishings

27. Schematic Design of an
Accessible Home
(Room Relationships Are Very
Important!)
Kitchens are the “Hub” of All Home
Activity; All Rooms Should be in
Close Proximity

28. Staying In The
Home as an
Alternative to
Selling the Home to
Enter Assisted Living
Part 5: Design
Examples

29. Accessible Home Plan
Typical Features
Heat Pump
Van Access Garage
Accessible Bdrm.
Accessible Bath
Accessible Utility
Level @ Gar/House
Accessible Kit/Nook DRIVEWAY
/
PARKING
Level Entry @ Foyer
Accessible Dining &
Living Rooms
Panel in Mstr. Suite
w/ Gen. Switch
Accessible WIC/Bath/
Mstr. Suite
Accessible Cov.
Porch N MAIN FLOOR
Level Entry @ Ext. PLAN
Porch & Garage
Gas Fireplace
OPTIONAL UPPER
FLR (Via Future
Elevator)

30. Accessible Home
Design
Flat Site = Easy Access/Before
Flat Site = Easy Access/After

31. Accessible Home Design
Rambler w/ Upper Story Over
Garage
Level Entry

32. Accessible Home
Design
Kitchens w/ Adaptable Cabinetry &
Lower Appliances in Close Proximity
Optimizing Functionality.
Kitchen/Utility
Utility Room Beyond (Core Functions)

33. Accessible Home
Design
Bedrooms
Bathrooms/En Suite

34. Accessible Home
Design
Guest Suite (Wheelchair Accessible)
Great Room (Wheelchair Accessible)

35. Accessible Home Design
Modern Home on a Steep Slope:
Garage/Entry on Low Side
NORTH
WEST

36. Home Remodel w/
Accessible
Addition
(See “Practical” Floor Plans)
Existing Bungalow
Remodeled/Expanded Bungalow

37. Functional Home
Remodel/
Addition
(Part. Accessible)
 Existing Main Floor Plan
 Existing/Remodeled Main Floor Plan
New Stair Loc’n
New Acc. Bath
New Acc. Alcove
New Fut. Elev.
Abandon Exist.
Bsmt. Stair/
Door Loc’n
Acc. Ramp/
New Door Loc’n

38. Practical Home
Remodel/Addition
(Part. Accessible)
 New Upper Story
Addition New Acc. Bath
New Acc. Hall
New Fut. Elev.
New Acc. Bdrm.

39. Accessible Homes:
Regardless of Your Stylistic Preferences,
Homes Can Be Designed to Meet Your
Long Term Needs, While Protecting
Valuable Assets: Home Equity &
Marketability.
Duplex/Tri-Plex/Four-Plex Homes: Providing Safe, Level
& Open Residences for the Owners w/ Rental or Sales
Income, as Needed.
Mid-Century Modern Craftsman

40. DMH DESIGN:
Home Design For a
Lifetime.
Copyright 2002-2011 DMH DESIGN LLC All Rights Reserved