| Observations of a Newly Minted Older Person
| Louis Tenenbaum
| Part 3 of a 4-part series: The Only Test That Matters
A home that works is worth having whether you stay 2 years or 20
The same issue has come up twice recently, from very different directions. It’s a basic one — and persistent. This four-column series is my attempt to clarify it.
The problem is that we approach building backwards. We wait for a diagnosis, an injury, or a moment of crisis — and then we respond. Since remodeling takes time to be done well, urgency undermines the functional process.
And all along, we celebrate aging in place while continuing to design and build homes that fall short in the critical details. They work right up to the moment they’re needed. That’s when the details start to matter.
Timed for the 2026 American Society on Aging and National Aging in Place Council meetings, this series looks at that gap — and what we may do to fill it.
A significant portion of home modification work is driven by medical need — after stroke, Parkinson’s, ALS, spinal cord injury, or other events. Occupational therapists assess and recommend adaptations. This work is essential, but it is also reactive — and often too late.
This remodeling is ‘medicalized,’ so to speak. It happens after something has gone wrong, and even then the process of modifying a home is a poor match for the timing of a health crisis. Remodeling takes time to plan and execute well. Health events are not planned. As a result, many people never get the modifications they need, or get them too late, after the moment of greatest need has passed.
Over time, this pattern has shaped expectations. Home modifications have become associated with crisis, but the system itself struggles to respond effectively within that window.
Universal Design gets pulled into that same frame. It is often seen as something you do in anticipation of decline, rather than as a baseline for good design. That framing has consequences: it delays action, introduces stigma, and ties decisions — and often funding — to diagnosis.
But Universal Design is not a response to medical conditions. It is a response to longevity.
We are living longer in homes that were not built for that reality. Updating them is no different from adding insulation or upgrading wiring. It is modernization — and it works in both directions: it supports people when something goes wrong, and it reduces the likelihood that things go wrong in the first place.
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The work has to move upstream. So how do we shift?
We stop tying design to diagnosis. We stop confusing finishes with function. We stop waiting. And we normalize what works — not hidden reinforcements or “just in case,” but real features that are visible, usable, and expected.
Reframing the issue this way leads to a more practical question: what does “upstream” actually look like in practice?
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.
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