Because older Americans either don’t want to move or can’t afford to leave their homes, an industry has grown up around them. It’s going to get a lot bigger.

In 2002, Dan Bawden, a remodeling contractor based in Bellaire, Texas, came across AARP research showing that many older adults were apprehensive about finding reliable expertise to modify their homes. He responded by creating a course for the National Association of Home Builders, which he previously chaired, to develop “Certified Aging-in-Place Specialists,” or CAPS.

In the first CAPS class Bawden taught, he says the majority attending were contractors. But others showed up he wasn’t expecting: real-estate agents, estate-planning attorneys and occupational therapists. “Who are these people?” he found himself wondering. Now, about 70 percent of students in CAPS classes are in the “other” category. What appears to bind those who take the course is the need to understand the built environment people live in, not just their medical diagnoses, financial or legal needs.

Over the past 16 years, the National Association of Home Builders has CAPS-certified almost 12,000 people, and consumer awareness of aging-in-place services is widespread. Businesses are eying a market that is certain to grow: From 2022 to 2050, the number of Americans 65 and older is expected to increase by 42 percent. The aging population is living in housing that is often unsuitable for them. Less than 4 percent of American homes offer a combination of features — no-step entry, single-floor living, and halls and doors wide enough for wheelchairs — to make them appropriate for persons of any age with disabilities, according to an analysis of the 2011 American Housing Survey by researchers at the Joint Center for Housing Studies at Harvard University. 

Corporations, technology start-ups and even universities are trying to close that gap. Lowes, the home improvement retailer, has partnered with AARP to set up a Livable Home division, targeting aging-in-place renovations. Scores of startups are chasing the aging-in-place market, often seeking to layer homes with technology. Aging-in-place specialists rattle off tech services and products they are following: Dwellsafe, an app homeowners can use to scan their homes and get a clinician-reviewed assessment of needed improvements; DAR.WIN, which monitors activity in a home using sensors; myAccessibleHome, a web-based platform that seeks to take care of clients’ needs from assessment to renovations to monitoring. The USC Leonard Davis School of Gerontology offers on its website a Home Modification Toolkit and an Executive Certificate in Home Modification that takes nearly four months to earn.   

Costly Adaptations vs. More Costly Housing Alternatives

Tom Doran, a retired software engineer in Wellesley, Massachusetts, is fairly typical of Americans hoping to age in place. He recently faced balance problems that he says have left him “freaked out” and depressed as his mobility has diminished. “A lot of the yard work I can’t do anymore, and there’s lots and lots of little things that I can’t do,” he says. 

Doran had an occupational therapist assess his home for what he would need to stay, at least for now, and has gotten estimates from a contractor for two stairlifts, at $7,000 each. It’s expensive, but well under the annual median cost of $115,200 for a one-bedroom assisted-living unit in the state. A private room in a Massachusetts nursing home is about $189,800 annually. For continuing-care communities, which provide living arrangements ranging from independent living to skilled nursing care, entrance fees alone go from from $40,000 to $2 million, according to the National Investment Center for Seniors Housing & Care. 

The housing alternatives many older adults face are so forbidding they make some researchers reconsider the “aging in place” trend. “I challenge the fundamental premise that most older adults do want to stay in place,” says Jennifer Molinsky, director of the Housing an Aging Society Program at Harvard University. She understands the emotional investments people have in their homes. “But,” she says, “I think a lot of people aren’t thinking about options and what could be more suitable.” And she adds, “The options are very, very hard to find.”

Customers of aging-in-place specialists come in three main categories, Bawden of the NAHB says. One is the planners who don’t have an immediate need. Another is those with progressive illnesses, such as multiple sclerosis, who realize their ability to move around their home will decline. Lastly are clients with acute needs: Their father is getting discharged from rehabilitation and can’t get in his house. Those are the calls contractors dread, since construction takes time, and they are usually booked up.

In Oregon, Kelly Nesbitt, an occupational therapist, has started a company called Adaptable Abodes, where many of her clients are older adults. Her job, she says, is not just taking measurements and photos. She interviews clients, seeks to understand their activities and needs, and has them demonstrate how they use their home. “I want to see how you get in and out of the shower,” she says. “I want to know what’s important to you. I want to know what your routines and your habits are.”

In Columbia, Maryland, Marion Berman knows firsthand what it’s like to live with a disability. After a bout of pneumonia with sepsis, she wound up in a medically induced coma for a month, then spent another 3.5 months in the hospital and rehab. When she got home, she couldn’t get up the steps to get in. Eventually, she started a business, Living in Place Solutions, and earned multiple certificates to educate herself about the aging-in-place field. She wants to be the stress reduction person in clients’ lives, to help preserve their dignity, autonomy and independence. “I commit for life to be a resource,” she says. 

Many actions she recommends are low budget: cleaning up clutter, improving lighting, moving electrical cords. Those who have been living in houses for 30 years often don’t see hazards, she says: a loose walkway flagstone, a buckle in driveway asphalt, a ripple in carpet. If someone can’t afford a $15,000 shower replacement, a $1,000 cut-out in the side of a shower-tub might do.

Kristopher Rench, a builder in Derry, New Hampshire, who also holds a doctorate in occupational therapy, tells of having to deliver bad news to clients. He remembers walking through a house with two retired professors after one was diagnosed with amyotrophic lateral sclerosis, a degenerative neurological condition known as Lou Gehrig’s disease. He saw narrow hallways, tricky stairways and a main floor that couldn’t be turned into one-level living. He told the couple they couldn’t stay there and helped them find a home in a 62-plus community where he could add grab bars and a wheelchair elevator. 

Much of the work Rench does, though, is in the homes where he first sees clients. He does a bathroom every week, he says, 60 grab bars a month, 30 or 40 wheelchair ramps every year, and 100 stair lifts annually. The NAHB reported in a 2025 survey that the most common aging-in-place project is installing grab bars. After that, the most popular projects were, in order, curbless showers, higher toilets, wider doorways, ramps, and additional lighting.

In New Hampshire, Rench reports, as in many other states, membership-based, grassroots organizations known as “villages” have sprung up that help older adults age in place. A village is a network of neighbors, volunteers and vetted service providers offering transportation, help with errands, home repairs and social and educational programming. One study found that the strongest impact of villages was to give older adults more confidence about aging in place.

Fritzi Gros-Daillon, cofounder of Age Safe America, which offers Senior Home Safety Specialist training, emphasizes that people aren’t just trying to stay in their homes: They want to stay near their doctors, their family, their neighbors, their place of worship. When she advises older adults, she avoids the phrase “forever home.” “I can’t make you that promise,” she says. 

Incentives for Safety, Accessibility and Universal Design 

The aging-in-place trend has gone beyond individual specialists working on home modifications and is winning the attention of policymakers, says Israel Cross, a gerontologist, commander in the U.S. Public Health Service and president of the National Aging in Place Council. Cross says the conversation about aging in place should be broadened. He wants the discussion to be part of a lifelong look at how people live in their homes. He’s slipped in the shower, he says, so why is creating safe showers just an issue for older adults? Under the philosophy of universal design, builders seek to make houses accessible for all abilities and ages. A zero step entry, universal designers would suggest, is good for both toddlers and grandparents.

One group, the Homes Renewed Coalition, is fighting for national legislation that would give single people a $30,000 lifetime credit and couples a $60,000 credit for home safety, security and accessibility modifications. The nature of the credit would vary according to age. There is a patchwork of city, county and state policies already in existence. Since 2022, Los Angeles County has offered grants of up to $20,000 for mobility and habitability repairs, including ramps, grab bars and curbless showers, to homeowners 62 or over who meet certain income limits. Massachusetts makes zero-interest loans of up to $50,000 for older homeowners who meet income limits for improvements such as ramps, widening doorways and brighter lighting, a program started in 1999. Some jurisdictions are trying to smooth the regulatory way for “accessory dwelling units,” independent residences set up on someone’s property where an older adult, often a family member, can live.

The aging-in-place discussion often ignores renters, Harvard’s Molinsky says. Under federal law, renters have a right to make modifications to accommodate a disability. But renters usually have to pay for the changes, and landlords can request apartments be returned to their original condition.

Policymakers often ignore forces that make it difficult for many minorities to own their homes or build equity to use for remodeling. Harvard research found that older Black homeowners, for instance, have the lowest median equity among minority groups, at $123,000, compared to  a median of $251,000 for older white homeowners. 

Regardless of homeowners’ backgrounds, a common complaint among aging-in-place specialists is that too many people put off making home modifications until a crisis hits.  “Everything’s cheaper when you make decisions with a cool head rather than in a hot rush,” says Berman. 

Taking time to make decisions increases the chance they will be the right decisions, she says. There’s nothing sadder than someone who stays in a home and regrets it, she says, or who goes into assisted living and is miserable.