Compared to older adults living in unassisted rental units, those living in assisted units are more likely to live in homes that have safety and accessibility features that make it easier to age in place, according to a Joint Center analysis of the 2016 National Health and Aging Trends Study (NHATS). Moreover, a greater share of those living in subsidized units receive help making and paying for these modifications.
As noted in a previous blog, housing assistance plays an important role in reducing cost burdens among very low-income older adult households. About 1.6 million older adult households receive federal rental assistance, while another 3.1 million are eligible for assistance but do not receive it. While Housing Choice Vouchers, which allow recipients to rent from private market landlords, have become the dominant subsidy for younger households, adults age 62 and over are more likely to live in units with project-based subsidies. The largest share of assisted older adults (38 percent) live in project-based Section 8 units while one in five live in public housing. Only eight percent live in Section 202 units, a program intended specifically for very low-income older adults (Figure 1).
Figure 1: Most assisted older adult households live in Project-based Section 8 units
Given higher rates of mobility and self-care-related disabilities, older households are more likely to need safety and accessibility features. Our analysis of the NHATS data found that 85 percent of assisted and 78 percent of unassisted older adult renters reported having a mobility impairment in the last month, including trouble bending over and getting up, limited strength or movement, and problems with balance or coordination.
Our analysis also found that older adults living in assisted units have greater access to safety amenities in their units than those who do not receive assistance. Assisted older adult renters are much more likely to live in units that include a ramp (or no entrance stairs), grab bars in the shower or by the toilet, or a medical emergency call system in the bathroom. They are slightly more likely to have a raised toilet seat or a bath seat for the shower or tub (Figure 2).
Figure 2: Older adult renters receiving federal housing assistance have greater access to safety and accessibility features
There are also significant differences in who bears the cost of making these modifications. Under the Fair Housing Act, all housing providers must make reasonable modifications for persons with disabilities, defined broadly as any impairment that limits one’s ability to care for oneself. Reasonable modifications can include physical changes to housing units such as installing grab bars in a bathroom. Section 504 of the Rehabilitation Act of 1973 specifies that federally subsidized housing providers, such as public housing authorities, are required to pay for reasonable modifications. In contrast, owners of rental housing without federal subsidy are not required to pay for those modifications. Renters in the private market can make reasonable modification requests but typically pay for any changes to their units. In the case of Housing Choice Vouchers, the burden also usually falls to the tenant, as voucher landlords are not considered federally subsidized housing providers for the purposes of Section 504.
Our analysis shows that assisted older adults—which includes households living in public housing, using vouchers, or residing in low-income senior housing—are less likely to pay for the installation of safety amenities than older adults renting in the private market. For example, more than half of the unassisted renters who had a raised toilet seat and grab bars around the toilet installed in the previous year paid for the modification themselves, compared to only 20 percent of older adults receiving some form of federal rental assistance.
These findings suggest subsidies can help with more than the rent. Accessibility modifications can allow older adults to age in place rather than move to more expensive residential settings with higher levels of care, such as nursing homes. As the nation’s older population continues to grow, rental subsidies will become an even more important resource for housing older adults in safe and cost-effective ways that also respect most people’s desire to stay in their homes for as long as possible.