Common Home Modifications for Aging in Place in Philadelphia

By Dawn Heiderscheidt, Licensed Occupational Therapist (OTR/L), ECHM, CAPS

If you're planning to stay in your Philadelphia-area home as you age, or helping a parent do the same, the list of possible modifications can feel endless. This guide walks through the ones that come up most often, organized by area of the home, with something most lists leave out: why each one matters and when it's actually needed, from an occupational therapist's point of view.

That last part matters. Many of these modifications are genuinely valuable. Some are oversold. The right set for any one person depends on how they actually move through their home, how they transfer, where they lose their balance, what their daily routine looks like — not on a generic checklist. That’s the difference between a modification that truly helps and money spent on the wrong thing.

A note on our older Philadelphia housing stock: rowhomes, twins, and older single-family homes here often have narrow staircases, small bathrooms, and a first floor half a flight up from the sidewalk. That shapes which modifications are simple and which are involved, so we'll flag those realities as we go.

Bathroom Modifications

The bathroom is where most falls and near-falls happen, so it's usually the first place to focus.

Grab bars. The single highest-value change in most homes, but placement is everything. A grab bar is only useful if it's where the person actually reaches as they sit, stand, or step over a threshold, and it has to be anchored into structure that will hold real body weight. A bar mounted in the wrong spot, or into drywall alone, can be worse than none because it invites weight it can't support. This is exactly the kind of thing worth getting an expert eye on rather than guessing.

Walk-in or curb-less (zero-threshold) showers

Stepping over a tub wall is one of the hardest and riskiest movements in a home. A curb-less or low-threshold shower removes that barrier. Whether you need true zero-entry or a low sill will suffice depends on whether a walker or wheelchair is in the picture now or likely later and on what your home's plumbing and floor structure allow, which in an older rowhome isn't always straightforward.

Shower seats and benches

A fixed or transfer bench lets someone bathe seated rather than standing, which matters enormously for stamina and stability. The choice between a simple seat and a transfer bench depends on how the person gets into the shower space in the first place.

Handheld shower heads

Small, inexpensive, and genuinely useful. They allow a person to bathe while seated and reduce the reaching and turning that cause slips.

Comfort-height (raised) toilets

Sitting down onto and standing up from a low toilet is a common failure point. A comfort-height toilet, or a raised seat, reduces the distance and effort. Paired with a nearby grab bar, it makes one of the day's most frequent movements safer.

Non-slip surfaces

Textured flooring, non-slip mats, and treatments on the shower floor address the wet surfaces where footing is least reliable.

Entrances and Exits

Getting in and out of the home is a barrier many families don't think about until it becomes one.

Ramps and no-step entries

For anyone using a walker or wheelchair, or who simply can't manage steps reliably, a ramp or a graded no-step entry restores independent access. In Philadelphia, where the front door often sits above a stoop, this can be more involved than a suburban install, and sometimes a side or rear entrance is the smarter route.

Threshold ramps

The small lips at doorways are easy to trip over and hard for wheels to clear. Low threshold ramps are an inexpensive fix that removes a surprising number of daily obstacles.

Railings and handrails at exterior steps 

Sturdy railings on both sides of exterior steps give a person something reliable to hold through the most exposed part of coming and going. Both sides matters, support on only one side helps in one direction and not the other.

Improved entry lighting 

A well-lit path from the sidewalk to the door reduces missteps at the times of day when vision is least reliable.

Stairs and Getting Around Inside

When stairs and tight interior spaces start limiting mobility, the goal is to make movement between rooms and floors safer and more manageable without giving up access to the home.

Stair lifts

In the multi-story rowhomes common across the city, a stair lift can be the difference between using a whole home and being confined to one floor. They are a significant but often worthwhile investment when relocating to single-floor living isn't possible or wanted.

Handrails on interior stairs

Continuous, sturdy handrails, ideally on both sides, turn a staircase from a hazard into something navigable. Older homes often have a rail on only one side, or one that ends before the last step, which is exactly where people fall.

Wider doorways and clearer circulation paths

Walkers and wheelchairs need room. Widening a doorway, removing a tight turn, or simply clearing a crowded hallway can make the difference between a home someone can move through independently and one they can't. In older homes, how much widening is feasible depends on what's in the walls.

Residential elevators

In some multi-story homes, a small residential elevator is a longer-term solution when stairs become impassable and first-floor living isn't an option.

Lighting, Flooring, and Low-Cost Safety Changes

Not every meaningful change is a construction project. Some of the highest-value ones are small.

Improved lighting throughout 

Better lighting in hallways, on stairs, and in kitchens and bathrooms helps compensate for the vision changes that come with age. Motion-activated lighting for nighttime trips to the bathroom addresses one of the most common fall scenarios.

Non-slip flooring and removing trip hazards

Securing or removing loose rugs, smoothing transitions between flooring types, and choosing non-slip surfaces eliminate hazards that cause falls at almost no cost. This is often the very first thing we'd suggest, and it rarely requires a contractor.

Lever-style handles

Replacing round doorknobs and twist faucet handles with levers makes them usable for hands that have lost grip strength or dexterity, a small change that touches dozens of daily moments.

Kitchen Modifications

The kitchen deserves special attention because small changes to storage, work surfaces, and fixtures can make everyday tasks safer and easier without requiring a full remodel.

Accessible storage and lowered work areas

Moving everyday items to reachable heights, adding pull-out shelving, and lowering a section of counter lets someone prepare food without dangerous reaching or standing beyond their stamina.

Lever faucets and easy-use fixtures

Same principle as the bathroom — fixtures that don't require fine grip or twisting keep the kitchen usable.

Bigger Projects for Long-Term Aging in Place

When someone intends to stay put for the long haul, or is managing a progressive condition, larger changes can be worth doing once, well.

First-floor bedroom and bathroom

Creating a full living setup on the ground floor, a bedroom, a full bathroom, and a clear path between them can let someone remain in a multi-story home indefinitely without navigating stairs daily. In a rowhome, this often means reconfiguring existing first-floor space.

Full accessible bathroom conversions

When the existing bathroom can't be adapted piecemeal, a full conversion designed around the person's current and anticipated needs is sometimes the most cost-effective path, especially when a bigger change is likely within a few years, since building accessibility in during a planned remodel is far cheaper than retrofitting it later.

Which of These Do You Actually Need?

Here's the honest answer: not all of them, and probably not the ones a catalog would sell you. The right set depends entirely on the specific person — how they move, where they struggle, what their home allows, and what's likely to change. A thorough assessment identifies the modifications that will actually make a difference and, just as importantly, rules out the ones that won't.

This is where working with a licensed occupational therapist differs from calling a remodeler or a product company. We assess how the person functions in their actual space, and because we sell no products and take no referral fees, we have no reason to recommend more than the situation calls for. When a $200 fix is enough, we'll tell you.

Programs That May Help Pay

for Modifications in Philadelphia

You don't always have to pay out of pocket. Depending on eligibility, several Philadelphia-area programs help fund home modifications and repairs, including city and nonprofit programs like the Senior Housing Assistance Repair Program (SHARP) and Habitat for Humanity Philadelphia, Pennsylvania's Community HealthChoices (CHC) Medicaid program, the Pennsylvania Assistive Technology Foundation (PATF), Rebuilding Together Philadelphia, VA grants for veterans, and county Area Agencies on Aging. Each has its own eligibility rules and timelines.

We've broken all of these down — who qualifies, what they cover, and where to start — in our full guide: Will Medicare Cover This? A Guide to Paying for Home Modifications in the Philadelphia Area.

Where to Start

If you're not sure which of these modifications your home actually needs, start with an assessment rather than a catalog. We're licensed occupational therapists serving Philadelphia, the Main Line, Bucks, Montgomery, and Delaware counties, and we'll help you sort out what will genuinely help and what you can skip.

Visit auroraIndependence.com, email info@auroraindependence.com, or call 267-495-4155 to book a free 15-minute discovery call.

Frequently Asked Questions

What are the most common home modifications for aging in place? 

The most common are grab bars in the bathroom, walk-in or curbless showers, comfort-height toilets, wider doorways, ramps and no-step entries, stair lifts in multi-story homes, added handrails, improved lighting, non-slip flooring, and lever-style door and faucet handles. Larger projects include first-floor bedroom and bathroom setups. The right combination depends on how the individual moves through their home, not on a standard checklist.

What is the single most important home modification for safety?

There isn't one answer for everyone, but grab bars and bathroom modifications are the most frequently recommended because the bathroom is where most falls happen. That said, placement matters more than the item itself — a grab bar only helps if it's positioned where the person actually reaches and anchored into structure that holds their weight. An assessment identifies what will make the biggest difference for a specific person.

Do I need a professional to recommend home modifications, or can I just buy them? 

You can buy many items yourself, but the value of a licensed occupational therapist is knowing which modifications a specific person needs, where they should go, and which ones aren't necessary. A poorly placed grab bar or the wrong shower solution can waste money or create new risks. An independent OT assessment matches the modifications to how the person actually functions in their home.

Are there programs in Philadelphia that help pay for home modifications? 

Yes. Depending on eligibility, programs such as the Senior Housing Assistance Repair Program (SHARP), Habitat for Humanity Philadelphia, Pennsylvania's Community HealthChoices Medicaid program, the Pennsylvania Assistive Technology Foundation, Rebuilding Together Philadelphia, VA grants for veterans, and county Area Agencies on Aging may help fund modifications for those who qualify. Each has its own rules and timelines.

When should someone start making home modifications for aging in place? 

Earlier is usually better and cheaper. Making changes before a fall or a hospital stay is less disruptive and less expensive than reacting to a crisis, and building accessibility into a planned renovation costs far less than retrofitting it later. If a progressive condition is involved, planning lets you make changes once rather than repeatedly.

About the author: Dawn Heiderscheidt is a Licensed Occupational Therapist (OTR/L) with ECHM and CAPS credentials at Aurora Independence, an independent, OT-led home accessibility practice serving Philadelphia, the Main Line, Bucks, Montgomery, and Delaware counties. Aurora sells no products and accepts no referral fees.