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Aging in Place

Article provided courtesy of International Association of Certified Home Inspectors

By Nick Gromicko and Rob London

"Aging in place" is the phenomenon describing senior citizens' ability to live independently in their homes for as long as possible. Those who age in place will not have to move from their present residence in order to secure necessary support services in response to their changing needs.

The Baby Boomers

As the baby boomers age, the 60+ population will spike from roughly 45 million in recent years to more than 70 million by 2020. Research shows that baby boomers’ expectations of how they will receive care differ from that of their parents’ generation. Overwhelmingly, they will seek care in their own homes and will be less likely to move into congregate living settings.

Why do many senior citizens prefer to age in place?

Nursing homes, to many, represent a loss of freedom and a reduced quality of life. Here are a few good reasons why these fears are justified:

• In 2007, inspectors received 37,150 complaints about conditions in nursing homes. Roughly one-fifth of the complaints verified by federal and state authorities involved the abuse or neglect of patients. Specific problems included infected bedsores, medication mix-ups, poor nutrition, and other forms of neglect.
• The proportion of nursing homes cited for deficiencies ranged from 76% in Rhode Island to as high as 100% in Alaska, Idaho, Wyoming and Washington, D.C.
• Many cases have been exposed in which nursing homes billed Medicare and Medicaid for services that were not provided.
• A significant percentage of nursing homes had deficiencies that caused immediate jeopardy or actual harm to patients.

Aging-in-Place Inspections

Inspectors may recommend corrections and adaptations to the home to improve maneuverability, accessibility, and safety for elderly occupants. Some such alterations and recommendations for a home are as follows:

Appliances

• microwave oven in wall or on counter;
• refrigerator and freezer side by side;
• side-swing or wall oven;
• controls that are easy to read;
• raised washing machine and dryer;
• front-loading washing machines;
• raised dishwasher with push-button controls;
• stoves having electric cooktops with level burners for safely transferring between the burners; front controls and downdraft feature to pull heat away from user; light to indicate when surface is hot; and
• replace old stoves with induction cooktops to help prevent burns.

Bathroom

• fold-down seat installed in the shower;
• adjustable showerheads with 6-foot hose;
• light in shower stall;
• wall support, and provision for adjustable and/or varied-height counters and removable base cabinets;
• contrasting color edge border at countertops;
• at least one wheelchair-maneuverable bath on main level;
• bracing in walls around tub, shower, shower seat and toilet for installation of grab bars;
• if stand-up shower is used in main bath, it is curbless and wide;
• low bathtub;
• toilet higher than standard toilet, or height-adjustable;
• design of the toilet paper holder allows rolls to be changed with one hand;
• wall-hung sink with knee space and panel to protect user from pipes; and
• slip-resistant flooring in bathroom and shower.

Counters

• base cabinet with roll-out trays;
• pull-down shelving;
• wall support, and provision for adjustable and/or varied-height counters and removable base cabinets;
• upper wall cabinetry lower than conventional height;
• accented stripes on edge of countertops to provide visual orientation to the workspace;
• counter space for dish landing adjacent to or opposite all appliances;
• glass-front cabinet doors; and
• open shelving for easy access to frequently used items.

Exterior

• low-maintenance exterior (vinyl, brick, etc); and
• low-maintenance shrubs and plants.

Entry

• sensor light at exterior no-step entry focusing on the front-door lock;
• non-slip flooring in foyer;
• accessible path of travel to the home;
• at least one no-step entry with a cover;
• entry door sidelight or high/low peep hole viewer; sidelight should provide both privacy and safety;
• doorbell in accessible location; and
• a surface on which to place packages while opening door.

Electrical, Lighting, Safety and Security

• install new smoke and CO detectors;
• install automated lighting, an emergency alert system, or a video-monitoring system;
• easy-to-see and read thermostats;
• light switches by each entrance to halls and rooms;
• light receptacles with at least two bulbs in vital places (exits, bathroom);
• light switches, thermostats and other environmental controls placed in accessible locations no higher than 48 inches from floor;
• move electrical cords out of the flow of traffic;
• replace standard light switches with rocker or touch-light switches; and
• pre-programmed thermostats.

Faucets

• thermostatic or anti-scald controls;
• lever handles or pedal-controlled; and
• pressure-balanced faucets.

Flooring

• if carpeted, use low-density with firm pad;
• smooth, non-glare, slip-resistant surfaces, interior and exterior; and
• color and texture contrast to indicate change in surface levels.

Hallways

• wide;
• well-lit; and
• fasten down rugs and floor runners, and remove any that are not necessary.

Heating, Ventilation and Air Conditioning

• install energy-efficient units;
• HVAC should be designed so filters are easily accessible; and
• windows that can be opened for cross-ventilation and fresh air.

Miscellaneous

• 30-inch by 48-inch clear space at appliances, or 60-inch diameter clear space for turns;
• multi-level work areas to accommodate cooks of different heights;
• loop handles for easy grip and pull;
• pull-out spray faucet;
• levered handles;
• in multi-story homes, laundry chute or laundry facilities in master bedroom;
• open under-counter seated work areas; and
• placement of task lighting in appropriate work areas.

Overall Floor Plan

• main living on a single story, including full bath;
• 5-foot by 5-foot clear turn space in living area, kitchen, a bedroom and a bathroom; and
• no steps between rooms on a single level.

Reduced Maintenance and Convenience Features

• easy-to-clean surfaces;
• built-in recycling system;
• video phones;
• central vacuum;
• built-in pet feeding system; and
• intercom system.

Stairways, Lifts and Elevators

• adequate hand rails on both sides of stairway;
• residential elevator or lift; and
• increased visibility of stairs through contrast strip on top and bottom stairs, and color contrast between treads and risers on stairs with use of lighting.

Storage

• lighting in closets;
• adjustable closet rods and shelves; and
• easy-open doors that do not obstruct access.

Windows

• plenty of windows for natural light;
• low-maintenance exterior and interior finishes;
• lowered windows, or taller windows with lower sill height; and
• easy-to-operate hardware.

Advice for those who wish to age in place:

• Talk with family members about your long-term living preferences. Do you want to downsize to a smaller single-family home, or do you plan to stay put in your traditional family home?
• Take a look at your finances and retirement funds. With your current savings and assets, will you be able to pay for home maintenance? Consider starting a separate retirement savings account strictly for home maintenance.
• Remodel your home before your mobility becomes limited. As you age, changes in mobility, hearing, vision and overall health and flexibility will affect how easily you function in your home. Consider making your home “age-friendly” as a phased-in and budgeted home improvement, rather than waiting until you need many modifications at a time due to a health crisis.
• If you decide before you retire that you want to live in your current home through the remainder of life, consider paying for “big ticket – long life” home projects while you still have a healthy income. Such items may include having the roof assessed or replaced, replacing and upgrading the water heater or cooling unit, completing termite inspections and treatment, having a septic tank inspection and replacement, as needed, and purchasing a riding lawn mower.
• InterNACHI advocates healthy living, as it plays a vital role in your ability to age in place. Most seniors leave their homes due to functional and mobility limitations that result from medical crises, and an inability to pay for support to stay with them in their home. Effectively managing health risks and maintaining a healthy lifestyle can help you stay strong, age well, and live long at your own home.

In summary, aging in place is a way by which senior citizens can avoid being dependent on others due to declining health and mobility.

Moisture Intrusion

Article Courtesy of International Association of Certified Home Inspectors

By Nick Gromicko, Rob London and Kenton Shepard

Moisture intrusion can be the cause of building defects, as well as health ailments for the building's occupants. Inspectors should have at least a basic understanding of how moisture may enter a building, and where problem areas commonly occur.

Some common moisture-related problems include:

• structural wood decay;
• high indoor humidity and resulting condensation;
• expansive soil, which may crack the foundation through changes in volume, or softened soil, which may lose its ability to support an overlying structure;
• undermined foundations;
• metal corrosion;
• ice dams; and
• mold growth. Mold can only grow in the presence of high levels of moisture. People who suffer from the following conditions can be seriously (even fatally) harmed if exposed to elevated levels of airborne mold spores:
  • asthma;
  • allergies;
  • lung disease; and/or
  • compromised immune systems.

Note: People who do not suffer from these ailments may still be harmed by elevated levels of airborne mold spores.

How does moisture get into the house?

Moisture or water vapor moves into a house in the following ways:

• air infiltration. Air movement accounts for more than 98% of all water vapor movement in building cavities. Air naturally moves from high-pressure areas to lower ones by the easiest path possible, such as a hole or crack in the building envelope. Moisture transfer by air currents is very fast (in the range of several hundred cubic feet of air per minute). Replacement air will infiltrate through the building envelope unless unintended air paths are carefully and permanently sealed;
• by diffusion through building material. Most building materials slow moisture diffusion, to a large degree, although they never stop it completely;
• leaks from roof;
• plumbing leaks;
• flooding, which can be caused by seepage from runoff or rising groundwater; it may be seasonal or catastrophic; and
• human activities, including bathing, cooking, dishwashing and washing clothes. Indoor plants, too, may be a significant source of high levels of humidity.

Climate Zones

In the northern U.S., moisture vapor problems are driven primarily by high indoor relative humidity levels, combined with low outdoor temperatures during the winter. In the southern U.S. (especially the southeast), the problem is largely driven by high outdoor humidity and low indoor temperatures during summer months. Mixed climates are exposed to both conditions and can experience both types of problems. Humid climates, in general, will be more of a problem than dry climates. Wind-driven rain is the main cause of leaks through the building envelope.

Inspectors can check for moisture intrusion in the following areas:

Roofs

A roof leak may lead to the growth of visible mold colonies in the attic that can grow unnoticed. Roof penetrations increase the likelihood of water leaks due to failed gaskets, sealants and flashing. The number of roof penetrations may be reduced by a variety of technologies and strategies, including:

• consolidation of vent stacks below the roof;
• exhaust fan caps routed through walls instead of the roof;
• high-efficiency combustion appliances, which can be sidewall-vented;
• electrically powered HVAC equipment and hot water heaters that do not require flue; and
• adequate flashing. Oftentimes, inspectors discover missing, incorrectly installed or corroded flashing pipes.

Plumbing

• Distribution pipes and plumbing fixtures can be the source of large amounts of moisture intrusion. If the wall is moist and/or discolored, then moisture damage is already in progress. Most plumbing is hidden in the walls, so serious problems can begin unnoticed.
• One of the most important means of moisture management in the bathroom is the exhaust fan. A non-functioning exhaust fan overloads the bathroom with damp air. If the exhaust fan doesn’t turn on automatically when the bathroom is in use, consider recommending switching the wiring or switch. The lack of an exhaust fan should be called out in the inspection report. The fan should vent into the exterior, not into the attic.
• The bathroom sink, in particular, is a common source of moisture intrusion and damage. Although overflow drains can prevent the spillage of water onto the floor, they can become corroded and allow water to enter the cabinet.
• Use a moisture meter to check for elevated moisture levels in the sub-floor around the toilet and tub.
• Bathroom windows need to perform properly in a wide range of humidity and temperature conditions. Check to see if there are any obvious breaks in the weatherstripping and seals. Are there are stains or flaking on the painted surfaces?
• Check showers and bathtubs. Is the caulking is cracked, stiff or loose in spots? Are there cracked tiles or missing grout that may channel water to vulnerable areas? If some water remains in the bathtub after draining, it may be a warning sign of possible structural weakening and settlement in the floor beneath the tub.

Utility Room

• The water heater tank should be clean and rust-free.
• The area around the water softener tank should be clean and dry.
• Check that all through-the-wall penetrations for fuel lines, ducts, and electrical systems of heating system are well-sealed. All ducts should be clean and dust-free. Inspect the air supply registers in the house for dust accumulation.
• Filters, supply lines, exterior wall penetrations, vents, ductwork and drainage of the cooling system must all be in good working order to avoid moisture problems.

Attic

• Look for stains or discolorations at all roof penetrations. Chimneys, plumbing vents and skylight wells are common places where moisture may pass through the roof. Any such locations must be inspected for wetness, a musty smell and/or visible signs of mold.
• Are there areas of the insulation that appear unusually thin?
• Rust or corrosion around recessed lights are signs of a potential electrical hazard.

Foundations

Model building codes typically require damp-proofing of foundation walls. The damp-proofing shall be applied from the top of the footing to the finished grade. Parging of foundation walls should be damp-proofed in one of the following ways:

• bituminous coating;
• 3 pounds per square yard of acrylic modified cement;
• 1/8-inch coat of surface-bonding cement; or
• any material permitted for water-proofing.

In summary, moisture can enter a building in a number of different ways. High levels of moisture can cause building defects and health ailments.

Elements of an Energy-Efficient House

Article courtesy of International Association of Certified Home Inspectors (InterNACHI)

Designing and building an energy-efficient home that conforms to the many considerations faced by home builders can be a challenge. However, at InterNACHI, we believe that any house style can be made to require relatively minimal amounts of energy to heat and cool, and be comfortable. It's easier now to get your architect and builder to use improved designs and construction methods. Even though there are many different design options available, they all have several things in common: a high R-value; a tightly sealed thermal envelope; controlled ventilation; and lower heating and cooling bills.

Some designs are more expensive to build than others, but none of them needs to be extremely expensive to construct. Recent technological improvements in building components and construction techniques, and heating, ventilation, and cooling (HVAC) systems, allow most modern energy0saving ideas to be seamlessly integrated into any type of house design without sacrificing comfort, health or aesthetics. The following is a discussion of the major elements of energy-efficient home design and construction systems.

The Thermal Envelope

A "thermal envelope" is everything about the house that serves to shield the living space from the outdoors. It includes the wall and roof assemblies, insulation, windows, doors, finishes, weather-stripping, and air/vapor-retarders. Specific items to consider in these areas are described below.

Wall and Roof Assemblies

There are several alternatives to the conventional "stick" (wood-stud) framed wall and roof construction now available, and they're growing in popularity. They include:

• Optimum Value Engineering (OVE)
  This is a method of using wood only where it does the most work, thus reducing costly wood use and saving space for insulation. However, workmanship must be of the highest order since, there is very little room for construction errors.
  
• Structural Insulated Panels (SIP)
  These are generally plywood or oriented strand board (OSB) sheets laminated to a core of foam board. The foam may be 4 to 8 inches thick. Since the SIP acts as both the framing and the insulation, construction is much faster than OVE or its older counterpart, "stick-framing." The quality of construction is often superior, too, since there are fewer places for workers to make mistakes.
  
• Insulating Concrete Forms (ICF)
  These often consist of two layers of extruded foam board (one inside the house and one outside the house) that act as the form for a steel-reinforced concrete center. This is the fastest and least likely technique to have construction mistakes. Such buildings are also very strong and easily exceed code requirements for tornado- and hurricane-prone areas.
  

Insulation

An energy-efficient house has much higher insulation R-values than required by most local building codes. For example, a typical house in New York state might contain haphazardly installed R-11 fiberglass insulation in the exterior walls and R-19 in the ceiling, while the floors and foundation walls may not be insulated at all. A similar but well-designed and constructed house's insulation levels would be in the range of R-20 to R-30 in the walls (including the foundation) and R-50 and R-70 in the ceilings. Carefully applied fiberglass batt or roll, wet-spray cellulose, or foam insulation will fill wall cavities completely.

Air / Vapor Retarders

These are two things that sometimes can do the same job. How to design and install them depend a great deal on the climate and what method of construction is chosen. No matter where you are building, water-vapor condensation is a major threat to the structure of a house. In cold climates, pressure differences can drive warm, moist indoor air into exterior walls and attics. It condenses as it cools. The same can be said for southern climates, just in reverse. As the humid outdoor air enters the walls to find cooler wall cavities, it condenses into liquid water. This is the main reason that some of the old buildings in the South that have been retrofitted with air conditioners now have mold and rotten wood problems.

Regardless of your climate, it is important to minimize water vapor migration by using a carefully designed thermal envelope and sound construction practices. Any water vapor that does manage to get into the walls or attics must be allowed to get out again. Some construction methods and climates lend themselves to allowing the vapor to flow towards the outdoors. Others are better suited to letting it flow towards the interior so that the house ventilation system can deal with it.

The "airtight drywall approach" and the "simple CS" system are other methods to control air and water-vapor movement in a residential building. These systems rely on the nearly airtight installation of sheet materials, such as drywall and gypsum board, on the interior as the main barrier, and carefully sealed foam board and/or plywood on the exterior.

Foundations and Slabs
Foundation walls and slabs should be at least as well-insulated as the living space walls. Uninsulated foundations have a negative impact on home energy use and comfort, especially if the family uses the lower parts of the house as living space. Also, appliances that supply heat as a by-product, such as domestic hot water heaters, washers, dryers and freezers, are often located in basements. By carefully insulating the foundation walls and floor of the basement, these appliances can assist in the heating of the house.

Windows

The typical home loses over 25% of its heat through windows. Since even modern windows insulate less than a wall, in general, an energy-efficient home in heating-dominated climates should have few windows on the north, east, and west exposures. A rule-of-thumb is that window area should not exceed 8% to 9% of the floor area, unless your designer is experienced in passive solar techniques. If this is the case, then increasing window area on the southern side of the house to about 12% of the floor area is recommended. In cooling-dominated climates, it's important to select east-, west- and south-facing windows with low solar heat-gain coefficients (these block solar heat gain). A properly designed roof overhang for south-facing windows is important to avoid overheating in the summer in most areas of the continental United States. At the very least, Energy Star-rated windows (or their equivalents) should be specified according to the Energy Star Regional Climatic Guidelines.

In general, the best-sealing windows are awning and casement styles, since these often close tighter than sliding types. Metal window frames should be avoided, especially in cold climates. Always seal the wall air/vapor diffusion-retarder tightly around the edges of the window frame to prevent air and water vapor from entering the wall cavities.

Air-Sealing
A well-constructed thermal envelope requires that insulating and sealing be precise and thorough. Sealing air leaks everywhere in the thermal envelope reduces energy loss significantly. Good air-sealing alone may reduce utility costs by as much as 50% when compared to other houses of the same type and age. Homes built in this way are so energy-efficient that specifying the correct sizing heating/cooling system can be tricky. Rules-of-thumb system-sizing is often inaccurate, resulting in oversizing and wasteful operation.

Controlled Ventilation

Since an energy-efficient home is tightly sealed, it's also important and fairly simple to deliberately ventilate the building in a controlled way. Controlled, mechanical ventilation of the building reduces air moisture infiltration and thus the health risks from indoor air pollutants. This also promotes a more comfortable atmosphere, and reduces the likelihood of structural damage from excessive moisture accumulation.

A carefully engineered ventilation system is important for other reasons, too. Since devices such as furnaces, water heaters, clothes dryers, and bathroom and kitchen exhaust fans exhaust air from the house, it's easier to depressurize a tight house, if all else is ignored. Natural-draft appliances, such as water heaters, wood stoves and furnaces may be "back-drafted" by exhaust fans, which can lead to a lethal build-up of toxic gases in the house. For this reason, it's a good idea to only use "sealed-combustion" heating appliances wherever possible, and provide make-up air for all other appliances that can pull air out of the building.

Heat-recovery ventilators (HRV) or energy-recovery ventilators (ERV) are growing in use for controlled ventilation in tight homes. These devices salvage about 80% of the energy from the stale exhaust air, and then deliver that energy to the entering fresh air by way of a heat exchanger inside the device. They are generally attached to the central forced-air system, but they may have their own duct system.

Other ventilation devices, such as through-the-wall and/or "trickle" vents may be used in conjunction with an exhaust fan. They are, however, more expensive to operate and possibly more uncomfortable to use, since they have no energy-recovery features to pre-condition the incoming air. Uncomfortable incoming air can be a serious problem if the house is in a northern climate, and it can create moisture problems in humid climates. This sort of ventilation strategy is recommended only for very mild to low-humidity climates.

Heating and Cooling Requirements
Houses incorporating the above elements should require relatively small heating systems (typically, less than 50,000 BTUs per hour, even for very cold climates). Some have nothing more than sunshine as the primary source of heat energy. Common choices for auxiliary heating include radiant in-floor heating from a standard gas-fired water heater, a small boiler, furnace, or electric heat pump. Also, any common appliance that gives off "waste" heat can contribute significantly to the heating requirements for such houses. Masonry, pellet and wood stoves are also options, but they must be operated carefully to avoid back-drafting.

If an air conditioner is required, a small (6,000 BTUs per hour) unit can be sufficient. Some designs use only a large fan and the cooler evening air to cool down the house. In the morning, the house is closed up and it stays comfortable until the next evening.

Beginning a Project
Houses incorporating the above features have many advantages. They feel more comfortable, since the additional insulation keeps the interior wall temperatures more stable. The indoor humidity is better controlled, and drafts are reduced. A tightly sealed air/vapor retarder reduces the likelihood of moisture and air seeping through the walls. Such houses are also very quiet because of the extra insulation and tight construction.

There are some potential drawbacks. They may cost more and take longer to build than a conventional home, especially if your builder and the contractors are not familiar with these energy-saving features. Even though the structure may differ only slightly from a conventional home, your builder and the contractors may be unwilling to deviate from what they've always done before. They may need education and training if they have no experience with these systems. Because some systems have thicker walls than a typical home, they may require a larger foundation to provide the same floor space.

Before beginning a home-building project, carefully evaluate the site and its climate to determine the optimum design and orientation. You may want to take the time to learn how to use some of the energy-related software programs that are available to assist you. Prepare a design that accommodates appropriate insulation levels, moisture dynamics, and aesthetics. Decisions regarding appropriate windows, doors, and HVAC appliances are central to an efficient design. Also evaluate the cost, ease of construction, the builder's limitations, and building code-compliance. Some schemes are simple to construct, while others can be extremely complex and thus more expensive.

An increasing number of builders are participating in the federal government's Building America and Energy Star Homes Programs, which promote energy-efficient houses. Many builders participate so that they can differentiate themselves from their competitors. Construction costs can vary significantly, depending on the materials, construction techniques, contractor profit margin, experience, and the type of HVAC chosen. However, the biggest benefits from designing and building an energy-efficient home are its superior comfort level and lower operating costs. This relates directly to an increase in its real-estate market value.