| Observations of a Newly Minted Older Person
| Louis Tenenbaum
| Specialty Service or Infrastructure Updates? Homes have been modernized for energy, technology, and lifestyle, but not for longevity.
| Jeff Gray, founder of AgeTech Connect, recently asked me on LinkedIn, “Am I right, Louis?”
He was responding to an article by Esther C. Kane, a geriatric care navigator who writes frequently about aging services and the aging-in-place market. (Jenny Xie also posted very wisely on this topic.) Together they raise a fair question:
If aging-in-place home modifications are so clearly needed, why does the market struggle to gain traction?
I’ve been wrestling with this question for more than 30 years. I’ve watched smart people conclude the market is simply too hard and move on to more promising opportunities.
Jeff did.
I guess I’m not that smart.
The issue may not be the need for aging-in-place modifications. The issue may be that we’ve framed them as a specialty service rather than as the next phase of housing modernization.
Where the Model Breaks
The difficulty becomes clearer when we look at how the field has tried to build the market.
Jeff and Esther point to the Certified Aging in Place Specialist (CAPS) designation, developed by the National Association of Home Builders, as the field’s backbone. CAPS seeks proactive remodeling grounded in Universal Design principles.
Universal Design is powerful. Curb cuts, closed captioning, and OXO Good Grips demonstrate that inclusive design benefits everyone. But in practice, aging-in-place projects rarely resemble elegant Universal Design exercises.
They are usually reactive following a fall, a diagnosis, or a hospital discharge deadline.
Though they begin from different premises and payer sources, both CAPS and CEAC (Certified Environmental Access Consultant), offered through VGM Live at Home, are attempting to build this market.
Their starting points differ.
CAPS aspires to proactive design and largely private pay.
CEAC accepts the market as reactive and begins with defined medical need and a clear payer, often workers’ compensation insurance.
That distinction matters because markets follow incentives.
And the current financing and policy structure rarely rewards prevention in the home.
In practice, both models begin with an assessment identifying the failure point between a person and their environment. Solutions are prescribed to resolve that breakdown.
It is problem-solving.
And it is inherently medicalized.
Most homeowners do not see themselves as medical cases. As Esther notes, humans are hardwired to avoid planning. A purely proactive, consumer-driven model struggles because people do not remodel for hypothetical future frailty.
The Real Issue: Housing Infrastructure
Maybe we need to frame the market differently.
Most American homes reflect the technological realities and demographic profile of the post–World War II housing boom including house designs, building methods, household structures, and life expectancies of that era.
Since then, we have modernized nearly every other residential system: insulation, HVAC, electrical capacity, open floor plans, and digital connectivity. Markets and policy aligned to update those systems.
But we have not modernized for longevity.
The population has changed. Medical advances have extended life, but have not eliminated chronic conditions, arthritis, balance loss, or reduced strength.
Senior housing is costly, limited, and often undesirable. Most people will age in place in homes that were never designed for the mobility, sensory, and cognitive changes that come with longer lives.
Building this market will not happen if we frame it as specialty remodeling.
It is better understood as a residential infrastructure issue.
Follow the Money
If consumer motivation is weak, traction must come from aligned financial incentives.
Two sectors stand out.
Financial planners.
Homes are not just assets; they are tools for dignified, economical aging. Forced moves triggered by health crises often move assets as well, sometimes away from long-term advisors. Helping clients modernize their homes protects well-being.
It also protects the planner’s own business. When aging in place succeeds, assets are more likely to remain under long-term management rather than being redirected to fund crisis moves or institutional transitions. Financial planners have both a fiduciary and a financial stake in getting this right.
Health insurers and public payers, including Medicare and Medicare Advantage plans.
Falls are enormously expensive and frequently cascade into extended medical and institutional care. Modest investments in proven, basic safety modifications can offer strong returns, especially before that first fall.
We routinely pay for the consequences.
We rarely invest in prevention.
A Shift in Premise
If aging-in-place remains framed as a niche, medically triggered specialty, it will continue to sputter.
If it is reframed as proactive residential modernization, not unlike energy retrofits or electrification, incentives, financing tools, and policy levers can evolve.
Solar panels and hybrid vehicles did not scale because consumers suddenly became farsighted planners. They scaled because policy and market incentives made adoption rational.
Housing for longevity may require the same shift. Federal house bill HR 7676 was modeled after these tax incentives. Similar legislation can be expected to have a similar effect on the home modifications market.
If we align policy, financing, and industry incentives, we can create business opportunities while reducing health costs and improving the aging experience.
That would move us from the business of managing crises and decline to modernizing the infrastructure that makes aging unnecessarily costly in the first place.
We built a housing system for shorter lives. Now we need one that works for longer ones.
Louis Tenenbaum is a longtime advocate for aging in place, co-founder of the HomesRenewed™ Coalition, the HomesRenewed™ Resource Center, and HomesRenewed Ventures, LLC and a nationally recognized expert on home modifications that support independent living. Discover more columns in this series.
Leave a Reply