Livable Later

Practical home changes for staying safely at home

Costs, contractors, and paying

What to change first when the budget is limited

Loose rails, dark landings, and sliding rugs this week. A therapist's list next. A bathroom or a stair machine only after the frequent hazards are gone.

Livable Later editorial team · Updated November 1, 2026 · About 6 minutes

Limited money is the normal case. The Joint Center for Housing Studies has documented for years that many older homeowners' modification projects are modest, while a full bathroom or a lift is not. The CDC's checklist is built so the first items are the ones a household can do without a loan: clear the stairs, fix or add rails, add light, remove or secure rugs, coil the cords, put a lamp by the bed, add a non-slip surface in the tub. Start there even if a remodel is the eventual plan. A household that saves for a perfect shower and leaves the night rug in place has the hazard and the hope at the same time.

This sequence is about risk and disruption, not about a product ladder. It is not medical advice. If falls are happening, tell a clinician while you tape the rug. STEADI's point is that home hazards are one factor among several.

This week, with a hardware store and a screwdriver

Walk the house using the method guide. Then do the starred items that do not need a permit.

Clear every stair and keep it clear. Tighten or add a rail on at least the open side, and plan the second side. Replace a dead bulb at the top and bottom of the stair, with a switch that glows if you can get one. Remove the rug beside the bed and the loose bath mat. Put non-slip strips in the tub. Move the lamp and the phone to the side of the bed the person uses. Coil cords along the wall. Lower the everyday dishes and the everyday clothes so a stool is unnecessary. Put a bench or a shelf at the door so bags have a place that is not the other hand.

None of that is glamorous. The NIA checklist and the CDC brochure are unglamorous on purpose. Do them before you look at catalogs. The rug guide and the stair guide are the detailed versions.

This month, with a small contractor or a skilled friend

Grab bars into real blocking at the toilet, if transfers are already hard. A lever handle on the bathroom and the entry. A beveled threshold where the lip is between a quarter and a half inch. An outlet so an extension cord can go away. A handheld shower on the existing tub. These are the projects the 2015 JCHS summary put, as a group, often under $1,200 in the older studies it cited. Your price may be higher. It will still usually be below a bathroom gut. Use a licensed person where the trade requires it. Electrical and gas are not friendship projects.

If the person has already fallen or is clearly changing, book the occupational therapist in this same month. The Saturday work does not wait for the appointment. The appointment keeps you from buying the wrong large thing.

This year, if the small work is not enough

Choose one large project, not three. The candidates are usually: a bathroom the person can use, a zero-step or ramped entrance, a downstairs place to sleep, or a way between floors. Pick the one that matches the route that is actually failing. A stairlift to a bathroom with a 24-inch door does not fix the bathroom. A beautiful bathroom upstairs does not fix a night stair the person has started to avoid. The first-floor bedroom is often the project that deletes a machine.

Price it with itemized bids, using the cost guide. Ask the public programs whether they will pay before you demolish anything. USDA, VA, and Medicaid waivers all have versions of "do not start early." A no from all of them is a useful no. It means the project is phased with your own money: the toilet and the door this year, the curbless shower next year, if you still need it.

Disruption is part of the cost

A bathroom out of service for two weeks is a safety problem of its own. The contract should say where the person toilets and washes in the meantime, as the hiring guide notes. A ramp that blocks the only stair during construction needs a plan for the mail and the groceries. Do the large project when a helper can be around, not during the week everyone is away. If the resident has memory loss, a house full of strangers and missing landmarks can cause a crisis that looks like a construction delay and is really a health event. Tell the clinician you are remodeling. NIA's Alzheimer's home-safety materials are the extra reading if that is the situation.

Leave a finished, lit path at the end of every workday. That sentence belongs in the contract.

A sample month when the list is long

Suppose the walk found a loose rail, a dark top landing, a rug beside the bed, a three-quarter-inch bathroom saddle, no grab bar, a microwave over the stove, and a wish for a curbless shower. Week one is the rail, the bulb, the rug, and moving the microwave to the counter. That is a hardware-store week. Week two is a carpenter for the saddle and a quoted price for toilet bars into blocking, not a shower gut. The occupational therapist, if falls are part of the story, happens in that same month and may say the shower can wait because the toilet transfer was the actual failure.

The shower quote, if it is still wanted, waits until those items are done and until you know whether a program will pay. Opening the wall first would trap you without the toilet bars and without the grant. The dated cost studies are useful here only as a scale: the week-one list is in a different financial category from a bathroom rebuild. Treat them as different projects with different deadlines. The rebuild can slip a season. The loose rail should not slip a weekend.

Write the month on paper and put a name next to each line. "Someone" is how the rail stays loose. A name, even if it is yours, is how it gets tightened. Recheck the paper at day thirty. Lines that moved from "this week" to "someday" without a reason are the ones to do the following Saturday, before any new catalog arrives.

Order of work

  • Week one: stairs clear, rails tight, lights on, rugs and cords off the night path, lamp and phone by the bed, strips in the tub, daily items at waist height.
  • This month: bars into blocking if transfers need them, levers, small threshold repairs, an outlet to kill the worst cord, an OT visit if falls have started.
  • This year: one large project chosen from the route that fails, priced in writing, with funding asked before demolition.
  • Always: a toilet and a lit path at night while the work is underway.
  • Six months later: walk the house again. The NIA worksheet asks you to recheck because people change.

If you do only the first week, you have still done what the federal checklists put first. The rest of this site is here when that week is not enough. Start with the walk so the week is aimed at your floor, not at a generic house.

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