Interior Design Suitable For The Elderly

Interior design firms in the United States are seeing more requests for aging-in-place projects. Ten years ago, this type of work mostly went to remodeling contractors. Clients would ask for grab bars and ramps. The results were functional but often looked institutional. Now families want spaces that accommodate an aging parent without looking like a hospital ward.

The design challenge is real. Safety features tend to have a clinical appearance. Handrails, shower seats, and non-slip flooring all signal "old person lives here." Many clients push back against that. They want the home to remain a home.

Traditional aging-in-place products were developed for healthcare facilities. Grab bars came in white or stainless steel. Shower seats were molded plastic. These items work, but they clash with most residential interiors.

Jennifer Marsh runs a design firm in Scottsdale, Arizona. Her team started taking on senior living projects in 2018 after her own mother had a fall. "We did Mom's bathroom with the standard stuff from the medical supply store," Marsh says. "She hated it. Wouldn't use the shower seat because she said it made her feel like an invalid. That's when I realized there had to be a better approach."

Her firm now sources grab bars from manufacturers that offer finishes in oil-rubbed bronze, matte black, brushed nickel. These match the faucets and cabinet hardware in a typical bathroom. The function is identical to hospital-grade bars, but the appearance fits a residential space.

Shower seats have more options now too. Teak fold-down benches look like something from a spa. Some wall-mounted models come in solid surface materials that match the shower surround. The plastic institutional seat costs around $35. A teak bench runs $180 to $400. Solid surface custom seats can go up to $800.

We did a master bath in Paradise Valley last fall. The client's mother was moving in with them. We installed a curbless shower with a linear drain, a teak seat, grab bars in brushed gold to match the fixtures. When it was done, the daughter said her friends didn't even notice the accessibility features. That's the goal.

— Jennifer Marsh

Flooring affects both safety and the overall look of a space. The design industry has moved toward hard surfaces in the past decade—concrete, large-format tile, hardwood. These materials photograph well but can be problematic for older adults.

Polished concrete is slippery when wet. Large porcelain tiles with rectified edges have almost no grout lines, which means almost no texture for traction. High-gloss hardwood has the same issue.

Nathan Cole is a senior designer at a firm in Portland, Oregon. He describes the trade-offs. "Clients come in with inspiration photos from Architectural Digest. Big open floor plans, polished concrete, floor-to-ceiling glass. Then they mention that Grandma is going to be living in the guest suite. We have to talk them through what that actually means."

Cole's team avoids area rugs in most cases. "Rugs are a trip hazard. The edges curl up, people catch their feet. If a client really wants a rug, we put non-slip pads underneath and tape down the edges. But honestly, we try to talk them out of it."

Transitions between flooring materials need to be flush or nearly flush. A threshold strip that sticks up even a quarter inch can catch a shuffling foot. Some projects require custom transition pieces milled to match the exact heights of adjacent materials.

Older eyes need more light. The Illuminating Engineering Society recommends 300 lux for general room lighting for adults over 65. Most residential spaces are designed for 150 to 200 lux.

Adding light fixtures is straightforward. The design challenge is doing it without making the space feel like an office building.

Marsh's firm layers lighting in every room. Ambient light comes from cove fixtures or recessed cans with wide beam angles. Task lighting goes where it's needed—under cabinets in the kitchen, flanking the bathroom mirror, on the nightstand. Accent lighting highlights architectural features or artwork and adds visual interest without adding glare.

The mistake people make is putting in one big overhead fixture. That creates harsh shadows. An older person walks from a bright room into a dim hallway and their eyes can't adjust fast enough. Layered lighting keeps the levels more consistent throughout the house.

— Jennifer Marsh

Her team also pays attention to color temperature. Warm light (2700K to 3000K) is easier on aging eyes than cool light (4000K and above). Cool light also makes skin look sallow, which matters in bathrooms.

Night lighting is a separate consideration. Motion-activated fixtures in hallways and bathrooms should put out 5 to 15 lumens in amber or warm white. Amber light doesn't disrupt sleep patterns the way blue-white light does.

Clear pathways matter more than most clients realize. A walker needs 24 inches of clearance. A wheelchair needs 36 inches for straight travel and a 60-inch turning radius.

Standard residential hallways are 36 inches wide. That's enough for a walker but tight for a wheelchair. Doorways are typically 30 to 32 inches. A standard wheelchair is 25 inches wide, which leaves very little margin.

Cole describes how his firm approaches floor plans. "We map out circulation paths with the furniture in place. Not just the open floor, but the actual route someone would take from the bed to the bathroom, from the living room to the kitchen. Then we check widths. A lot of times there's a pinch point—a console table in the hallway, a chair that sticks out. Those things have to move or go."

Furniture placement also affects grab points. An older person walking across a room might steady themselves on the back of a sofa or the edge of a dining table. These surfaces need to be stable and at a usable height.

Design firms that do this work regularly develop relationships with occupational therapists. An OT can assess a client's specific physical limitations and make recommendations that go beyond general guidelines.

Marsh partners with an OT named Sandra Niles who is based in Phoenix. "Sandra comes to client meetings when we're starting a project," Marsh says. "She watches how the person moves, asks about their daily routine, looks at what medications they take. Then she gives us a list of requirements. Grab bar on the right side because the left shoulder has limited range. Lever handles instead of knobs because of arthritis in the hands. That level of detail."

The OT assessment adds $300 to $600 to the project cost. Marsh considers it worthwhile. "We guessed wrong on a project early on. Put the shower controls on the wrong side. Had to tear out tile and redo plumbing. That cost more than a hundred OT assessments."

Cole's firm takes a similar approach. "We're designers, not clinicians. We know the general principles. But every person's body is different. The OT fills in the gaps."

Design fees for aging-in-place projects follow the same structure as other residential work. Hourly rates for designers range from $100 to $250 depending on the market and the firm's reputation. Some firms charge a flat fee or a percentage of construction cost.

Construction costs vary widely:

High-end finishes push costs up. A grab bar in polished nickel costs three times as much as the same bar in chrome. Custom cabinetry with pull-out shelves and soft-close drawers adds thousands to a kitchen budget. Clients who want the accessibility features to disappear into a luxury interior should expect to pay for that.

Marsh notes that some clients phase the work. "They'll do the bathroom and bedroom now, while Mom is still pretty mobile. Then we come back in a year or two and do the kitchen, maybe widen some doorways. Spreading it out makes the cost easier to manage."

Firms that specialize in this area are still a small segment of the residential design market. But the segment is growing. The American Society of Interior Designers added aging-in-place content to its continuing education offerings in 2019. Design schools have started including universal design principles in their curricula.

Product manufacturers have noticed the demand. Five years ago, finding a grab bar that didn't look medical required searching specialty catalogs. Now companies like Kohler and Moen have full product lines designed for accessibility with finishes that match their standard fixtures.

Every project has a potential aging-in-place component. A couple in their forties building a new house—they might not need the features now, but if we design the floor plan right, the blocking goes in the walls, the bathroom is big enough, it's easy to add things later. We call it future-proofing.

— Nathan Cole

Cole sees the work expanding. "Every project has a potential aging-in-place component," he says. "A couple in their forties building a new house—they might not need the features now, but if we design the floor plan right, the blocking goes in the walls, the bathroom is big enough, it's easy to add things later. We call it future-proofing."

Marsh's firm has grown from three people to nine since shifting focus to senior living projects. She attributes some of that to demographics. "There are a lot of Baby Boomers with aging parents, and a lot of them have money. They want their mom's apartment to look nice. That's a design problem, and design problems are what we solve."