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MELISSA BLOCK, host:

This is ALL THINGS CONSIDERED from NPR News. I'm Melissa Block.

ROBERT SIEGEL, host:

And I'm Robert Siegel.

Over the next three decades, the number of Americans 65 and over will double. That means the nation will become one big retirement community. As we've been hearing this week, most of us will want to grow old in our own homes. But as people live longer than ever, those steep stairs or slippery showers can become a danger zone. One solution is change the way homes are designed.

And in the final part of our series, NPR's Jennifer Ludden reports on houses that people can stay in for life.

JENNIFER LUDDEN: For 13 years, Jim Waggoner has lived in this Veterans Administration nursing home in Tampa.

Unidentified Woman: Is it okay if I get your vital signs?

Mr. JIM WAGGONER: I don't have any.

Unidentified Woman: You don't have any? Oh, come on.

Mr. WAGGONER: Yeah, I left them at home.

Unidentified Woman: Give it up.

(Soundbite of laughter)

LUDDEN: Cancer in his back and spine left Waggoner in a wheelchair. A confirmed bachelor, he's been unable to live on his own.

(Soundbite of machinery)

Unidentified Woman: All right. Let me check your temperature in your ear.

LUDDEN: As he passed age 80, Waggoner figured he'd end up dying in this institution. But then he hit it off with a nurse he met here. He and Cheryl got married and they wanted a cozy place to live.

Mr. WAGGONER: We had nothing to go on until we got our home.

Ms. CHERYL WAGGONER: We had discussed about just remodeling my place, but there would have been too much to do. We would have had to have taken everything down, all the walls, the works.

LUDDEN: It's a common problem and an expensive one. Making a home accessible can cost tens of thousands of dollars. So Cheryl went online, and that's where she discovered the kind of homes Keith Collins is building. I went to take a look.

Mr. KEITH COLLINS (Director of Special Adapted Housing, New Millennial Homes): There it is, this house right here.

LUDDEN: That's beautiful.

Mr. COLLINS: It's gorgeous.

LUDDEN: We pull up to a white bungalow in the Pinellas Park neighborhood of Tampa Bay. Collins brings a personal passion to homebuilding. He spent time in a wheelchair after serving in Vietnam and sees overlap between the needs of injured vets and the elderly. Florida, as it happens, has a lot of both.

Standing in the empty garage, Collins explains his company, New Millennial Homes, uses what's called universal design.

Mr. COLLINS: The design allows a person to remain independent and keep their dignity.

LUDDEN: This is the house where Jim and Cheryl Waggoner will live. In countless ways, it's being tailored to make life easier for them.

The mailbox...

(Soundbite of creaking and ripping)

LUDDEN: ...is being sized so Jim can collect the mail in his wheelchair. Steps? There are none, just flat entries. Doorways are wide and door handles, all levers. Traditional knobs can be tricky as seniors lose dexterity.

In the kitchen...

(Soundbite of closing drawers)

LUDDEN: ...shelves pull out like drawers for easy access. Even the wood in the walls is tailored: 2 by 8s instead of 2 by 4s. That lets you pop in a grab bar without ripping out the wall, and that saves money.

Collins is adamant about building for the middle class.

Mr. COLLINS: If you do it right then from the beginning, it would normally cost you no more or very little compared in cost to any other conventional home.

LUDDEN: Collins is also proud that his homes look like any other. He loves it when people walk in and ask, where's the handicapped house?

Take that sleek water faucet hanging right over the stove, it's so you don't have to lug a pot of water from the sink.

Mr. COLLINS: You're asking somebody to move a 30 or 40-pound pot. And if that person just happens to have just a touch of arthritis, somebody could get hurt, or they're going to be complaining and saying, God, I wish I didn't have to pick up that pot and move it.

LUDDEN: I do believe I have seen this feature in some of those fancy home design magazines.

Mr. COLLINS: Oprah has one.

Ms. ELINOR GINZLER (Director of Livable Communities, AARP): We absolutely recognize that if these are pitched as they help you when you're old, that's a recipe for disaster.

LUDDEN: Elinor Ginzler is with AARP. She'd like to see boomers plan ahead, buy a home with universal design now or use it for that kitchen renovation. But here's the problem - no one ever thinks they'll grow old.

Ms. GINZLER: We have polled people to ask them about the whole concept of what is old. And no matter what decade they are in, they believe that old is the next decade. And if you're even in your 80s, old is in your 90s.

LUDDEN: So advocates, and builders like Keith Collins, are trying to broaden the appeal. Those flat entries and wide doors? Great for young moms with strollers. Levered door handles? So convenient if your arms are full of groceries.

But some communities aren't leaving it to the marketplace. In recent years, dozens of states and localities have passed laws promoting aspects of universal design. In part, that's because a lot of money is at stake. Medicaid and Medicare pay for a huge chunk of nursing home costs.

AARP's Ginzler says the fewer people that must move into nursing homes, the more public money these states and cities save.

Ms. GINZLER: Sometimes they pass a stick and sometimes they pass a carrot. So an example of a carrot is that they would say to builders, you'll have an expedited building permit process if you design your home to have these features in it.

Mr. WAGGONER: Everything is going to be different, completely different.

LUDDEN: For Jim Waggoner, moving out of a nursing home into his own house at last simply means freedom.

Mr. WAGGONER: The ability to do what I want, when I want and how I want and not have somebody telling me that I can't do that or I can't do this.

LUDDEN: It's a privilege millions of Americans don't want to lose just because they're old.

Jennifer Ludden, NPR News.

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