A vast majority of older Americans want to remain in their homes as they age — but the infrastructure needed to make that wish a reality is sorely lacking, according to recent research, federal data, and industry reports.
According to a 2024 survey, 95% of adults aged 55 and older consider aging in place an important goal, up from 92% the year prior. Yet a U.S. Census Bureau estimate found that only 10% of American homes qualify as “aging-ready” — meaning they feature a step-free entryway, a bedroom, and a full bathroom on the main floor. The remaining 90% require modifications before they can safely house an older adult with declining mobility.
The gap between desire and readiness is widening. By 2030, one in five Americans will be 65 or older, with roughly 10,000 people crossing that threshold every day, according to federal population projections. By 2060, the number of adults 65 and older in the United States is expected to reach 94.7 million — nearly double the current figure.
Financial Pressures Compound the Challenge
Among the most commonly cited obstacles is cost. A 2024 report found that 67% of seniors said rising costs of living made it harder to age in place. Home modifications can range from $10,000 to $50,000 depending on scope.
Federal support remains limited. The U.S. Department of Agriculture offers grants and low-interest loans to eligible rural homeowners for accessibility work, and some states provide Medicaid waivers for qualifying individuals. Still, researchers note that funding gaps leave many older adults in homes that no longer safely meet their needs.
Most Homes Were Never Built for Aging
The physical environment poses its own set of barriers. Most American homes were not designed with aging adults in mind, and even common architectural features become hazards as mobility declines.
Bathrooms are identified by accessibility professionals as the highest-risk environment — wet surfaces and hard fixtures create conditions that frequently result in falls. Falls are the leading cause of injury death among adults 65 and older, according to the Centers for Disease Control and Prevention.
Beyond the bathroom, standard-width doorways cannot accommodate wheelchairs or walkers. Narrow stairways, poorly lit hallways, and round door knobs that require grip strength all compound the difficulty. A 2025 indoor mobility review published in the National Institutes of Health database identified four main physical challenges older adults face inside their own homes: fatigability, poor balance, environmental barriers, and reduced limb strength.
Accessibility specialists point to a consistent set of high-priority modifications: grab bars near toilets and in showers, non-slip flooring, curbless shower entries, wider doorways, lever-style handles, and improved lighting — particularly motion-activated nightlights along nighttime pathways.
Workforce Shortage Strains the System
Physical modifications represent only one part of the aging-in-place equation. Demand for professional in-home care is growing far faster than the workforce can supply it.
From 2024 to 2034, the home care sector is projected to generate more than 6.1 million job openings — the second-highest total of any occupation in the country, according to federal Bureau of Labor Statistics projections. A separate analysis cited by the Home Care Association of America projects that 4.6 million jobs in the field will go unfilled by 2032.
High turnover worsens the shortage. Industry surveys find that 70% to 80% of home care workers leave their positions within the first 100 days on the job, with annual attrition running at roughly one-third of the entire workforce. Low wages are a primary factor — the average home health aide earns $16.82 per hour, and 59% of home care workers receive some form of public assistance, according to recent workforce analyses.
Program Models Demonstrate What Works
Coordinated intervention programs offer evidence-based pathways for extending safe independent living. Researchers at the Johns Hopkins Bloomberg School of Public Health have highlighted CAPABLE — Community Aging in Place, Advancing Better Living for Elders — as one of the more effective models currently in operation.
The five-month, 10-visit program pairs registered nurses, occupational therapists, and handyman services to address pain management, daily living activities, and targeted home modifications simultaneously. Studies of CAPABLE outcomes have found potential cost savings of approximately $10,000 per participant annually. As of early 2026, the program operates in 34 states.
Smart home technology is playing a growing supporting role. Voice-activated assistants, video doorbells, keypad door locks, personal emergency response systems, and motion-sensor lighting now provide monitoring and safety options that do not require full-time professional care — expanding the viable range of home-based aging for many older adults.
Why This Matters for Home Care
For families and caregivers navigating the day-to-day realities of aging at home, the bedroom environment often becomes a central concern. Falls, difficulty repositioning, and unsafe bed transfers are among the most immediate risks that home modifications must address. Adjustable home hospital beds allow for repositioning to reduce pressure injury risk, enable safer transfers in and out of bed, and provide medical positioning — head elevation, zero gravity, Trendelenburg — that standard consumer beds cannot. For families evaluating what the bedroom needs to support long-term care at home, SonderCare’s home hospital beds are built to meet clinical-grade standards in a residential design that does not make a home feel like a facility.
