Building project helps adult children care for aging parents

Published: Monday, January 23, 2006 at 1:02 p.m.
Last Modified: Monday, January 23, 2006 at 1:02 p.m.

Lots of people have designed a nursery - buying furniture and accessories, and painting and appointing a room for a child.

But could you do the same for a parent?

That's a task many families will face in coming years. As much as people wish to remain independent in later life, declining health will prompt millions of Americans to settle in assisted-living centers, continuing-care communities - or with their adult children. Already, about one-quarter of caregivers say the person they look after lives in their household, according to a survey published in 2004 by the National Alliance for Caregiving and AARP.

A spare bedroom, of course, makes the transition easier. But is that room - the size, the lighting, even the color - appropriate for an older adult? Is the space safe? Is there sufficient room for medical equipment, if need be? And what if there is no extra bedroom? How can a house be modified to accommodate more people?

The answers to many of these questions can be found in the home of Brenda and Howard Cook in Murfreesboro, Tenn. Over the course of about 30 days last fall, a team led by Stephen Saint-Onge, a noted home designer based in Boston; representatives from Philips Electronics NV; and Prentiss Holt, a local contractor, built a "caregiving suite" for Ms. Cook's 78-year-old mother, Mattie Porterfield.

The project has proved a welcome benefit for the Cooks, and serves as a model for would-be caregivers. Designing a space for an older adult is about more than moving in familiar furniture and favorite pictures. With some homework and effort, a room can be made healthier, safer, more livable and more flexible than many families realize. And professional help, while valuable, isn't always essential.

"I don't want people to look at this (project) and say, 'Well, I could never give that to my parents,'" says Mr. Saint-Onge. "You can take aspects of it and bring in products that are designed to make their life easier."

In July 2004, Ronn Hollis, executive director of partnerships for Saint Thomas Health Services in Nashville, Tenn., was meeting in Atlanta with representatives from Philips. The two sides were exploring ways to use the company's products and technology to help improve patient stays in Saint Thomas's five hospitals. As the talks drew to a close, Mr. Hollis asked his counterparts at Philips: "What can we do to help you?"

The answer would lead to the Cooks' front door.

Philips, as it turned out, had been doing a series of home makeovers as a way to showcase its consumer technology. The company had enlisted Mr. Saint-Onge to design rooms across the country, which are featured on a Philips Web site, One focus was, and remains, health and older adults.

"It's an area that seems to be so underserved," says Terry Fassburg, vice president-brand communications for Philips. "So many of our parents are coming back to live with us. How do you handle that - and still make it feel like home?"

Philips and Mr. Saint-Onge already had completed one caregiver makeover and were interested in doing a second. Mr. Hollis offered to ask doctors at St. Thomas if they could identify an appropriate family. After a search of several months, the Cooks were invited to participate.

Brenda Cook, age 58, says she "never dreamed" her parents would end up living with her and her husband Howard, 62. "You look at your parents and you think, 'They'll always be strong and be able to take care of themselves.' " But by the summer of 2004, Mrs. Cook's mother and father - both suffering from heart problems and emphysema - had become too frail to live alone. The couple moved in with the Cooks, settling into a small bedroom.

That space was the focus of the family's first meeting with Mr. Saint-Onge.

The idea of building an addition to the house quickly took center stage; the existing bedroom was too dark and cramped to remodel. The Cooks and Porterfields explained what they hoped could be included in a makeover: more elbow room, especially to accommodate medical equipment; easier access to the Porterfields' bedroom (a narrow hallway made passage difficult at best); and more privacy.

Mr. Saint-Onge envisioned a space that would be practical and comfortable for the parents for as long as necessary - and, in the long run, improve the value of the Cooks' home. "Especially when we're talking about caregiving and retirement situations, people tend to think that (such designs) can be a little bit more sterile, maybe a little bit more institutional looking and feeling," Mr. Saint-Onge says. "It doesn't have to be that way. It really can be warm and inviting - yet serve a purpose."

Before construction could begin, Mr. Porterfield died. Thus, the design changed somewhat, becoming "more feminine," Mrs. Cook says. Last October, Mr. Holt, the contractor, who heads his own construction and development firm in Murfreesboro, broke ground on the project.

The most obvious and striking features of the addition are generous amounts of space and light. At about 300 square feet, the new construction easily accommodates furniture and medical gear, such as Mrs. Porterfield's breathing equipment. Advances in technology also mean that such equipment takes up less room than in the past. (A Philips home defibrillator, for instance, no bigger than a briefcase, sits all but unnoticed beside a dresser.) Six large windows ring the addition, complemented by crystal lamps and track lighting on the ceiling.

Mr. Saint-Onge ended up creating two spaces in one: a sleeping area and a living area. A partial wall in the middle of the addition separates the former from the latter. That feature is among the most critical in the project - and one that all families should consider when an older adult is joining a household.

"I wanted (Mrs. Porterfield) to have more flexibility in a space that, essentially, is her domain," Mr. Saint-Onge says. "One of the key things that came from my initial conversations with her is that she loves to do crafts; she loves to do puzzles and creative things. (The living area) gives her a place to do that."

Other notable parts of the addition:

- Colors. Yellow, pale greens and cream colors dominate the walls and fabrics, which are accented with roses. Says Mr. Saint-Onge: "They all play to this palette of something uplifting. Giving her this 'garden' affects the mood in a big way."

- Doors and windows. There's not a doorknob in sight. Rather, levered handles are the rule on all doors and windows. "Especially for someone who has arthritis, the levers are much easier to open and close," Mr. Saint-Onge notes. Additionally, shades are installed inside each window (which were donated by Pella Corp. for this project). That means less dusting, a longer life for the shades, and fewer opportunities for grandchildren and pets to pull on them.

- Flooring. To reduce the possibility of falls, thresholds between the living area and bathroom, for instance, and between the new addition and the original house have been eliminated.

The cost of all this? Much of the material and labor was donated or provided at cost, says Mr. Holt, the contractor (who donated all his time and labor). But a project like this, he estimates, would total between $65,000 and $70,000. If that sounds like a lot, consider that the average annual cost in the U.S. of a private room in a nursing home is $74,095, according to MetLife, the insurance company.

Mrs. Cook, meanwhile, says the addition is "working wonderfully," particularly her mother's private living area. "When she wants, she stays there and watches TV or works on a jigsaw puzzle," Mrs. Cook says. "That's what I would tell people - even if it's just a bedroom, try to make it as much their space as you possibly can."

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