Why COVID-19 Has Made Universal Design More Important for Seniors, Home-Based Care Providers

Seniors overwhelmingly prefer to age in place. That preference has only grown following the COVID-19 pandemic and a general shift toward home-based care, making home safety more important than ever.

But for a home to be safe for seniors and caregivers alike, it must adhere to building best practices, including universal design. Broadly, universal design provides a framework for designing products and spaces in order to ensure accessibility and safety for people, regardless of age, physical ability or other factors.

“Universal design emphasizes equitable use and low physical effort,” Rosemarie Rossetti, president of Rossetti Enterprises, told Home Health Care News. “It’s a great way to look at good design right from the beginning, so that if people have a temporary or a permanent disability — if they are short, tall, young or old — it doesn’t matter.”


As part of her business, Rossetti built the “Universal Design Living Laboratory,” a 3,500 square-foot Columbus, Ohio-based ranch-style national demonstration home and garden, with her husband.

The laboratory, designed by Patrick Manley of Manley Architecture Group, has served as inspiration for the building industry and consumers alike. It has also given home-based care providers a model for what aging in place — bolstered by home design — can look like.

Kendal at Home is one of the many providers to have visited the lab, HHCN previously reported.


“[It’s] a home designed to be sustainable, so aging in place is achievable,” Kendal at Home Executive Director Lynne Giacobbe told HHCN in 2018. “They have a classroom, and we were able to go participate in a week-long training and become certified.”

While the home design aspect of aging in place has always been a factor for providers, the public health emergency has arguably created an environment where this becomes even more of a priority.

Between the strain the COVID-19 pandemic has placed on the U.S. hospital system and the considerable toll it has had on nursing homes and other long-term care facilities, it’s not surprising that demand for home-based care has risen.

With more people receiving care at home, there has been an uptick in home modifications, Sean Fitzgerald, CEO of TruBlue, told HHCN.

“We’ve seen a huge increase in bathroom remodels,” Fitzgerald said. “That’s where it starts — stairs and bathrooms — but we want to expand beyond that. It’s really looking at the whole home. That means the outside, the walkways, lighting. With so many seniors, falls could be prevented if they just had the proper lighting.”

Fitzgerald also noted that home modifications that made light switches more accessible and door handles easier to use are common ways to increase safety for seniors.

“That’s where I think today’s technology is helpful,” he said. “The use of motion detection, for example, so the senior doesn’t have to go look for the light switch.”

Ohio-based TruBlue is a national franchise company that specializes in house care, home maintenance and safety modifications to help seniors age in place.

In recent years, TruBlue has positioned itself as a potential partner for home-based care providers. The idea is that traditional home health and home care agencies would deliver actual care, while TruBlue focuses on the homes they live in.

As a company, one of TruBlue’s value propositions is that many of its services help lower fall risks. Falls continue to be an ongoing hazard for older adults, as about 3 million seniors are treated in emergency departments for fall injuries annually, according to CDC statistics.

Along those partnership lines, TruBlue partnered with home care franchise company Right at Home in a preferred provider agreement last year.

“In that aging journey, we want to be alongside that senior, helping them to navigate all the hurdles and the challenges that they face,” Kerin Zuger, chief of strategic growth at Right at Home, told HHCN at the time. “For us, that means providing them home care and doing everything that we can from a personal companion and skilled level, but also recognizing what community resources, tools, services and other providers need to come to the table to ensure they stay in the home as long as possible.”

Another organization, Living in Place Institute, has made a name for itself by providing an educational program aimed at health care organizations, including home-based care companies, that focuses on safe homes.

Louisville, Colorado-based Living in Place Institute works with the Universal Design Living Laboratory for its Certified Living in Place Professional (CLIPP) program. The program is a 16-hour course, divided into 10 classes, including a mix of live and pre-recorded modules.

CLIPP courses focus on the combination of design, construction and medical measures.

Erik Listou, Living in Place Institute’s co-founder, has seen an increase in CLIPP participants since the public health emergency.

“When COVID-19 safety measure was first instituted the housing industry and the medical community wasn’t sure what was going to happen,” he said. “What we found now is the need increased for people’s personal safety and comfort in their homes — it didn’t go away. Our graduates have increased in this past year, particularly in the medical community.”

Similarly, TruBlue’s business has doubled since the start of the COVID-19 emergency.

Looking ahead, Fitzgerald sees a huge opportunity for growth.

“Home-based care and aging in place were huge before,” he said. “It’s going to be explosive post-COVID because the senior care and home care industry have done a great job educating the community about aging at home versus in a long-term care facility. We’re going to be a great complement to all the senior care and home care companies.”

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