Wayne Caswell, a retired IBM technologist and founder of Modern Health Talk, discusses the importance of adapting homes and communities for an aging population in the U.S. He emphasizes the need for universal design in housing, alongside health care considerations, to allow older adults to age independently at home with adequate support. Caswell also highlights smart home technologies and remodeling as potential solutions to improve accessibility and safety for seniors.

1. 11/16/22
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WayneCaswell@mHealthTalk.com
Retired IBM technologist, futurist, market
strategist, consumer advocate, and founder
of Modern Health Talk
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The screen of Wayne
Caswell’s IBM Aptiva
shows how easy it is to
set all the controls in his
house – including the
aquarium timer that
feeds his fish.
Introduced IBM to
Smart Home in 1994
and used my home
as living laboratory.
Represented IBM in
Wireless standards
I retired in 1999
after 30 years and
started CAZITech, a
digital home
consulting firm.
Then to Siemens,
Dell, and lobbying
for Homeowners of
Texas.
Finally, Modern
Health Talk.
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2. 11/16/22
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Overlapping Skills
& Interests
Independent Living
Universal Healthcare
Universal Broadband
Universal Design
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INDEPENDENT FOR LIFE
Homes and Neighborhoods for an Aging America
(title borrowed from the book)
When you eventually retire, do you want to age independently in your
own home and neighborhood? Staying home and aging in place is most
people's preference, but most American homes and communities are
not adapted to the needs of older people. And with the fastest
population growth among people over 65, finding solutions for
successful aging is important, not just for individual families, but for
our whole society. This talk covers a wide range of smart solutions,
including:
• remodeling current housing,
• retrofitting existing neighborhoods to add needed services,
• building new homes with accessibility & safety in mind, and
• planning new communities that work well for people of all ages.
“I WON’T GROW UP!” But I might get
injured and someday retire and grow old.
SLIDES: SlideShare.net/waynecaswell/independent-for-lifepptx
https://drive.google.com/file/d/1fhr8T_ySdyfrGVpZB-usIwPwRpmAcWLo/view
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In this book, former HUD
Secretary Henry Cisneros
says “The U.S. Should
Make ‘Life-Long Homes’
a Priority.”
The book is authored by
more than a dozen
leading aging and
housing experts and co-
edited by Cisneros.
Amazon.com/Independent-Life-Homes-Neighborhoods-
America/dp/0292737920
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New Homes in Austin Must Now Be Wheelchair Accessible
In 2014, the Austin City Council changed the building code to make new homes more accessible to everyone.
Specific requirements include:
• At least one first-floor entry
32”wide without a step
• At least one bathroom or half-
bath on the first floor
• First floor baths must have a
minimum 30” opening and
accommodate grab bars
• Light switches and
thermostats no higher than 48
inches; outlets at least 15
inches above the floor
MhealthTalk.com/austin-requires-new-homes-to-be-accessible/
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4. 11/16/22
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Housing: New Directions for National Policy (mHealthTalk.com/housing-policy/)
A new Housing Report proposes a new finance system with a greater private sector, limited
federal role, elimination of Fannie Mae & Freddie Mac, and reform of FHA
SOME SELECTED ARTICLES THAT LINK TO OTHERS
Technology and the Senior Housing Industry
(mHealthTalk.com/technology-and-the-senior-housing-industry/)
Joseph F Coughlin, Director of the MIT AgeLab addresses the question, “Is Technology Disrupting
or Transforming the Senior Housing Industry?”
Designing Homes for Older Adults (mHealthTalk.com/designing-homes-for-older-adults/)
Local governments and the building industry are becoming aware of the shortage for accessible
homes for older adults and are responding.
Home Renovations that can Save the Estate
(mHealthTalk.com/home-renovations-can-save-the-estate/)
The Jack and Jill nursery rhyme shows how home renovations and home health care can speed
recovery, save the estate, and keep families together.
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THE BIG PICTURE
How will we come of age
in an aging America? (4:48)
YouTu.be/ZOA1v4-2Fos
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5. 11/16/22
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WE’RE LIVING LONG PAST RETIREMENT.
Social Security was meant
to start at age 62.
But life expectancy from birth
of American men is now 74.5
(80.2 for women). That
places the US in 52nd place.
It was 78.9 in 2014.
(WorldData.info/life-expectancy.php)
Life expectancy
for men already
age 65 is 85.
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SCARY DEMOGRAPHIC CHANGES …
Unknowns of the BABY BOOMER Generation
• How will we work, save, spend, study, help
others and vote?
• How and when will we retire?
• Once we leave paid employment, how will we
cope with a potential lack of engagement,
control, and purpose?
• Will the innovative and entrepreneurial spirit of
our generation endure?
• What new ideas will we pursue?
• And, where and how will we live?
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SOURCE: U.S. Census Bureau (2000 & 2010), https://bipartisanpolicy.org/download/?file=/wp-content/uploads/2019/03/BPC_Housing-Report_web_0.pdf
U.S. POPULATION
AGED 65 AND OLDER
2022
10,000 Americans per day
turn age 65.
As they retire, they need
more health care.
And their housing needs
change too.
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As our population ages,
fewer are left to work and
support retirees, straining
budgets and overburdened
national, state, and local
governments.
We’ll need to reexamine
both health & housing
priorities.
PROJECTED U.S. POPULATION GROWTH
Percentage change from 2012
SOURCE: U.S. Census Bureau, FiveThirtyEight.com
200%
150%
100%
50%
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AGING BRINGS HIGHER HEALTH CARE COSTS
Medicare per capita spending for physician and outpatient services
KFF.org/medicare/report/the-rising-cost-of-living-longer-analysis-of-medicare-spending-by-age-for-beneficiaries-in-traditional-medicare/
$8,300
Total
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Aging Also Brings Higher Risks of Disability, Isolation and Financial Stress
https://www.jchs.harvard.edu/sites/jchs.harvard.edu/files/jchs-housing_americas_older_adults_2014.pdf
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(government, private insurance, copays, and out-of-pocket)
Chart data is from 2018 when
total cost was $3.2 Trillion/year.
We now spend about
$4 Trillion/year on healthcare.
That’s twice the average of other
developed nations.
The savings potential of
becoming ”average” is
$2 Trillion/year.
Unsustainable U.S. Healthcare & Retirement Spending
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Age-restricted (55+) communities
These planned communities are exclusively for
older adults, with a variety of amenities such
as a health club, salon or golf course.
HOUSING OPTIONS FOR OLDER ADULTS
Independent living facilities
These complexes allow seniors to live
independently while accessing services such
as activities, housekeeping and meals.
Rehabilitation facilities
These provide skilled nursing care,
rehabilitation and temporary housing for
patients recovering from hospitalization,
injury, illness or surgery.
Memory care
Whether free-standing or in a senior living
community, these facilities provide care for
people who are living with Alzheimer’s
disease or other dementia.
Aging in Place or With Family
Many seniors can continue living in their
homes with supports such as home
modifications and professional in-home care.
SOURCES: RightAtHome.net, SeniorLiving.org/housing/, AARP.org/livable-communities/info-2014/creative-age-friendly-housing-options.html,
pro.genworth.com/riiproweb/productinfo/pdf/131168.pdf, Kiplinger.com/slideshow/retirement/t071-s014-what-s-your-retirement-housing-strategy/,
Medicare.gov/what-medicare-covers/what-part-a-covers/what-are-my-other-long-term-care-choices/
Assisted living facilities
Seniors live in their own apartment, but
can access assistance such as personal
care, medication management and
transportation. ($54,000 for 1-bedroom)
Nursing homes
Residential nursing facilities provide long-
term care for seniors who require medical
supervision and skilled nursing care.
($94,000 for semi-private room)
Continuing Care Communities
Seniors purchase their own home or
condominium and can move to a higher
level of care as their needs change.
($28,470 ($78/day))
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LEVEL OF CARE
Lawn Care, Chores,
Housecleaning
LOCATION &
ACCESSIBILITY
Healthcare, Internet,
Transportation, Shopping
SOCIAL
SUPPORT
Family, Activities,
Amenities
CAREGIVING
SUPPORT
Unpaid Family, RPM,
Skilled Nursing
FINANCIAL
OPTIONS
Rent, Buy, Travel,
Save or Spend it All
HOUSING DECISION CRITERIA
BATHING
Grooming activities
such as shaving and
brushing teeth
EATING
Being able to feed
oneself
TOILETING
Being able to use
the toilet
DRESSING
Dressing with
fasteners, zippers &
buttons
TRANSFERRING
Ability to walk or
transfer from bed to
wheelchair alone
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BoomerDilemma.org/
This documentary takes a deep dive into Pensions
(both corporate and public), Social Security, 401(k),
and Annuities.
It features retirement income experts and world-
renowned economists from MIT, Stanford, Wharton,
Berkely, York, and BYU.
AFFORDABILITY
What’s your financial position
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THE IMPORTANCE OF SOCIAL CONNECTIONS
Featuring a video from Broadband Communities 8 years ago
I kicked off a panel describing
my disappointment with a large
assisted living facility in Austin.
Next, Ruth Schoon and others
shared what they learned in an
iPad class:
• I email a lot, with attachments and
use Facebook.
• I FaceTime with my siblings, children
and grandchildren and enjoy getting
their photos.
• I watch news and studied history and
genealogy.
• I’ve read books and blogs and shared
opinions.
• I follow stock investments.
mHealthTalk.com/free-ipads-for-seniors/ video: YouTu.be/htLswR9BUD4
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Thankfully, I didn’t fall.
Before our son went off to
college, all the bedrooms of our
large two-story automated
home were upstairs, and only a
powder room was downstairs.
What if either of us had fall and
could no longer handle stairs?
We considered that as we
downsized and incorporated
Independent Living ideas from
Sun City in Georgetown.
CAN YOU COPE WITH A DISABILITY?
Jack didn’t Plan to fall down the hill.
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WHAT WAS THEIR RESPONSE?
Scenario 1:
Nursing Home plus small apartment
Scenario 2:
Remodel financed with home equity,
along with health aids, skilled nursing,
and technology
mHealthTalk.com/home-renovations-can-save-the-estate/
CAN YOU COPE WITH A DISABILITY?
Peter Pan and Wendy didn’t plan either.
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Accessible bathroom features
include:
• Grab Bars
• Raised Toilet Seat
• Lever Faucet Controls
• Knee Space under sink
• Tilted Mirror
• Adjustable Shower Seat
• Adjustable Showerhead
OCCUPATIONAL THERAPISTS
can help with a $14K Bathroom Remodel
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OCCUPATIONAL THERAPISTS
also have solutions for the Bathtub
Bathmats prevent falls
Tub
Mounted
Bar
Walk-in Tub
Hydraulic
Lifts
Hydraulic
Lifts
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RAMPS, LIFTS & ELEVATORS
can get you up stairs, sometimes as a temporary solution
But they can be expensive, hurt home
value, and scream Old and Feeble.
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HOME HEALTHCARE ROBOTS & PROSTHETICS
Retriever moves loads from place to place and brings critical items within reach.
YouTu.be/aTOyXBr9VyU?t=128 (1:40)
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UNIVERSAL DESIGN
Expand Market Reach by serving all Ages, Sizes, and Abilities
These principles can be applied to Products, Websites, and Housing
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UNIVERSAL DESIGN
This example serves people of all ages & abilities
This spacious bathroom includes
features for Aging in Place:
• Wide doors for wheelchairs,
• Zero-barrier shower threshold,
• Knee space under the counter,
• Grab bar and high toilet, and
• Lever faucets.
mHealthTalk.com/need-to-redo-your-loo/
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UNIVERSAL DESIGN
An adaptable example
This design is spacious with
zero-threshold shower entry
and under-sink cabinetry
that can be removed to
provide clearance for a
person in a wheelchair.
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UNIVERSAL DESIGN
A more elegant example
This bathroom also has features
for for Aging in Place:
• Zero-barrier shower threshold
for walkers and wheelchairs,
• Shower seat & hand-held
shower,
• Attractive grab bar, and even a
• Foot bath with whirlpool jets.
mHealthTalk.com/the-future-of-universal-design/
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A DETACHED
MED COTTAGE
mHealthTalk.com/medcottage-a-place-for-mom/
mHealthTalk.com/smart-toilets/
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THE LENNAR NextGen
Multigenerational Home within a Home
The essential guide
for turning one
house into two
homes
https://www.mhealthtalk.com/in-laws-
outlaws-and-granny-flats/
• Private garage and entry with Ring
Doorbell and Alarm Security
• Smart Home tech ready with Wi-Fi
mesh, door locks, thermostat,
appliances, garage opener, water cutoff,
and more
Lennar.com/productsandservices/nextgen
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SPEAKING OF SMART HOME TECHNOLOGIES
THE “NEXT BIG THING” FOR OVER 60 YEARS NOW
mHealthTalk.com/elusive-smart-home/
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AND THEN THERE’S THE SMART FRIDGE
The $4,000 - $5,000 Smart Fridge
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… BUT I OFTEN REMAIN SKEPTICAL …
mHealthTalk.com/smart-refrigerator/
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SMART HOME APPS & TECH THAT ACTUALLY MATTER
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MATTER: the new Smart Home standard
Will it matter and live up to the hype?
With support for Bluetooth,
Wi-Fi, and Zigbee, this new
standard promises to be:
• Simple,
• Interoperable,
• Reliable, and
• Secure.
Watch the video (6:20) at
YouTu.be/oHsnjZPuqKM
The Connectivity Standards Alliance (csa-iot.org/) is backed by dozens of promoter companies, including Amazon,
Apple, Comcast, Google, IKEA, LG, Lutron, Microsoft, Samsung, Silicon Labs, Texas Instruments, Zigbee Alliance, and
it’s it’s being used in development by over 400 companies across the globe, spanning the entire IoT value chain.
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More Devices and Functionality coming:
Cameras, Appliances, Robot Vacuums, Energy Management, Smoke & CO2 Sensors,
Environmental Sensors & Controls, Ambient Motion & Presence Sensing,
So far:
190 products certified or being tested
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CERTIFICATION TESTING – Today and Tomorrow
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SAFETY & MOBILITY
Avoid accidents caused by disability, sore joints, weakened muscles, or a lack of balance, dexterity and vision
that makes simple tasks difficult. Remember “An ounce of prevention is worth a pound of cure.”
• Rockers & Unstable Furniture. Seniors may use them to steady themselves.
• Loose Rugs. Remove this primary cause of falls and broken bones.
• Pill Dispensers. They make compliance easier.
• PERS & Monitored Alarms. An easy way to summon help.
• Stairs & steps. Make sure handrails are stable. Consider rails in hallways too.
• Mobile & Cordless Phones. They’re smart and can be put in any room or every room.
• Bathroom: Install a higher toilet seat, a seat in the shower, grab bars, and a hand-held showerhead.
• Lifts & Elevators. Critical if your two-story home lacks a bedroom and full bath downstairs.
• Doorways. Remove doors serving no useful purpose and widen doorways for walkers & wheelchairs.
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COMFORT & CONVENIENCE
• Simplify. De-clutter, reorganize, clean house, and discard everything that’s not truly needed.
• Lighten up. Replace heavy pots, pans, vacuums, and trash cans with lightweight models.
• See the Light. Bright lighting is important to people with poor eyesight. Choose warm LEDs.
• Remote Control. Handheld remotes can control lights, window blinds, and fans – all while seated.
• Friendly Furniture. Consider adjustable beds and chairs but make sure it’s easy to get in and out of.
• Stay Warm. Seniors can get cold when still, so improve insulation and weather stripping to cut drafts.
• Remodel. The National Association of Home Builders has a Certified Aging-in-Place program to teach
contractors about remodeling for seniors. Compare the total costs with that of moving.
• Appliances. Front-loaded models are easy for someone in a wheelchair to use.
• Hire out Chores. Consider home health care, weekly maid service, lawn care, and Meals on Wheels.
• Save Money and the Environment. Purchase wisely, buy second hand, recycle, and donate.
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