Sheryl and Ray Brunner's '50s-era rambler in Maplewood is homey and warm. The place is well-kept and full of family pictures, and it appears to be in great shape.
The Brunners paid off their mortgage a few years ago and they want to stay put. They live on a fixed income and know how expensive new senior housing is.
But at ages 70 and 69, and with health problems, Sheryl and Ray knew they needed to make some changes to make their home safer.
"I've already fallen a number of times," Sheryl said recently.
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Falls are common. According to government statistics, more than 1 in 3 people age 65 years or older fall each year, causing injuries that can require a move to a nursing home.
The Brunners heard about a nonprofit organization that could help, called Rebuilding Together Twin Cities. Staff member Brent Suski met with Sheryl to review a list of recommended improvements.
"And we've got the handrail in the front, the handrail in the back for the exterior stairs and then two grab bars in the basement bathroom and two grab bars in the upstairs bathroom," he said.
That back entry handrail will replace a garbage bin that's been serving as a makeshift support.
"That's why we have the trash can there," Sheryl explained. "I can put my hand on the trash can — just to steady me."
The bathroom grab bars mean that, for the first time in years, she will not have to negotiate steep basement stairs to shower. The basement bathroom was her only option, because a leg problem prevented her from stepping into the upstairs tub. Being able to steady herself with grab bars solves that problem.
"For me it's a very big deal," she said. "I haven't had a shower in there for over five years."
All told, the Brunners are getting safety upgrades worth a total of about $1,000 free of charge from Rebuilding Together.
Even for people who have to pay for them, safety upgrades are a good investment. The Centers for Disease Control and Prevention estimates the average hospital cost for a fall injury is $35,000. Medicare patients are on the hook for almost $8,000 of that.
Harvard University researchers have found that much of the nation's housing stock lacks the safety and accessibility features that older adults need in order to stay in their homes. Suski, of Rebuilding Together Twin Cities, said that in many cases just a few hundred dollars can make a home significantly safer.
"Those small, preventative things that really don't cost a lot can ultimately provide a huge impact in financial savings, not only to the consumer but also to the taxpayers in general, because a lot of that is being paid for through Medicare," Suski said.
Despite the compelling economics, there's a lot of inertia to overcome.
A Caring.com survey of 2,000 adults found that nearly 4 in 5 worry about the safety of their parent or grandparent living alone or with a spouse or partner. But the majority haven't provided safety upgrades.
And making a home safer isn't that hard.
"Usually when someone falls, it's in what we call a transition area," said Jon Burkhow, who works for a nonprofit called Senior Community Services. Stairways, entryways and bathrooms tend to be higher-risk areas.
Burkhow's hit parade of perils includes some fairly common household features.
"Items on stairwells, throw rugs ... a lot of times it's at the top or bottom of the steps, where you don't want them," he said. Many homes, he said, need improvements in lighting, like outdoor security lights and lights in basement stairwells.
Identifying needed improvements might well be easier than persuading parents or grandparents to make their home safer. Burkhow said it can be helpful to bring in an outsider. A neutral third party, like him, can help make the case for changes.
And he's got this holiday advice for people whose loved ones are balking at safety upgrades:
"Offer it as a gift," he said. "It's a great gift!"
People looking for help with safety enhancements can call the Senior LinkAge Line at (800) 333-2433 or a social service agency. Not all programs are free, but there are many options to help low-income seniors.