This article is part of the Under the Lens series
Three-quarters of older adults in the U.S. want to remain in their homes or communities as they age, according to national surveys by AARP. While the desire to live at home collides with numerous challenges—from worsening health conditions and mobility impairments that make navigating a home difficult to the financial toll of necessary home repairs, rising property taxes, and in-home help—there is a range of local, state, and national supports that can help older adults live where they please.
But experts say the policies and programs designed to support aging in place are often inconsistent, disconnected, and underfunded.
“We have a wealth of wonderful programs … and really dedicated workers who try to meet all the older people’s needs—but they’re operating in a fragmented, [uncoordinated] system,” says Jennifer Molinsky, director of the Housing an Aging Society Program at the Joint Center for Housing Studies (JCHS) at Harvard University, which researches the needs of older adults.
What could help people achieve their goal of staying home—or at least nearby—and spending their later years as they wish? Shelterforce spoke with experts and service providers about which programs and policies are effective and where service and coordination gaps remain.
Programs That Keep Homes Livable
Research by JCHS has highlighted that adults over 65 tend to live in larger, older homes, and that housing repairs and upkeep can be especially burdensome for older adults on fixed incomes.
Without home modifications, many older adults become vulnerable to falls, the leading cause of injuries among those 65 and older and a major factor in moves to nursing homes. Without modifications, they’re also less likely to independently manage daily living tasks such as cooking, bathing, and laundry.
For cash-strapped older homeowners, the inability to afford repairs, maintenance, or accessibility modifications can dash hopes of aging in place. Programs that offer free or low-cost home repairs and modifications—from fixing roofs to installing grab bars, handrails, and ramps—can be a game changer.
At the national level, Habitat for Humanity is one of the most prominent nonprofit providers of free home repairs and accessibility accommodations, offered to lower-income older adults through its Aging in Place program. The program operates through a network of local affiliates across the U.S., using a mix of contractors and volunteers to complete repairs.
Adrienne Goolsby, Habitat for Humanity’s senior vice president for the U.S. and Canada, says that the program, with its Housing Plus model, serves 11,000 households annually and has helped more than 50,000 older homeowners remain in their homes.
Key to the model’s effectiveness, Goolsby says, is its two-step assessment for each household. To start, a health or human services professional meets with the homeowner and their family members to understand their daily activities and movements.
“They get an understanding of things like how they do meal prep [and] what things they do outside and inside the home and in the backyard,” she says. “That gives us a pretty comprehensive picture of the priorities [for] repairs or modifications that need to be made.”
After that initial step, a repair team assesses the work to be done. The program is modeled after CAPABLE (Community Aging in Place: Advancing Better Living for Elders), developed by the Johns Hopkins School of Nursing. In its pure form, CAPABLE calls for integrating the services of an occupational therapist, a registered nurse, and a repair worker to assess and recommend changes that best ensure a home’s safety and livability for a particular household.
The National Council on Aging (NCOA) has approved CAPABLE as an evidence-based aging-in-place program. The program has been shown to improve residents’ self-care and their ability to grocery shop and manage medications, while also reducing depression symptoms and reducing the length of hospital stays. Each $3,000 in program costs saves an estimated $30,000 in medical costs, the CAPABLE program reports.
Home repair programs also operate locally, often as partnerships between state or local governments and community organizations.
For instance, the Comfortably Home program in Bath, Maine, is managed by the local public housing agency but offers repairs at no cost to lower-income senior homeowners. The program is the brainchild of Bath Housing Executive Director Debora Keller. When she took the reins 10 years ago, Keller says she learned that many people in Bath’s public housing were living there because their former homes could no longer accommodate them.
“Maybe the washer and dryer were in the basement. Maybe they couldn’t get upstairs to the bedroom,” she says. “I had the idea that we could just start a simple home modification program where we took our maintenance staff, who are already employed by [the] Bath Housing Authority and already doing work orders in older adults’ homes day in and day out. Why couldn’t we just offer their services out in the community?”
The program’s impact exceeded expectations from the start. A 2017 survey of participants showed a 54 percent reduction in hospitalizations and ER visits and an 85 percent reduction in falls in the first 15 months, according to figures Keller shared. The early evidence led MaineHousing, the state-level housing authority, to develop a Community Aging in Place (CAIP) grant program for other communities to replicate. Between 2017 and 2025, CAIP served more than 1,600 older, low-income households in Maine with a range of accessibility modifications and minor repairs.
While home repairs can be a significant factor in helping older adults remain in their homes, these efforts face a host of challenges.
One of those is funding. To put it simply, there’s never enough money to meet the need.
Does it make sense to fix a roof for someone living in a house [that is] totally inaccessible to them? Conversely, does it make sense to build a ramp and modify a bathroom if the roof is falling in?”
Steve Hansler, president of MaxHousing
Bath’s program, for instance, is limited to $3,000 per household. While that amount can cover minor repairs and modifications, such as installing grab bars, adding double stair rails, and replacing doorknobs with lever handles, it isn’t enough to build an accessibility ramp or fix a roof.
In Cleveland, Ohio, the city’s Age-Friendly Home Investment Program can help only 40 percent of the more than 600 applicants this year, according to Jennifer Rosich of the city’s Department of Aging. Selected households are limited to one repair at a maximum of $12,000.
Such limits make it difficult to determine which repairs to prioritize.
“Funding for home repairs is often for general repairs, not necessarily for accessibility—so maybe they’re putting on roofs instead of building ramps. And often, code violations need to be addressed first, so if there are limits on per-home funding, there may be no money left for modifications,” says Steve Hansler, president of MaxHousing, a Cleveland-based nonprofit that provides housing for people with mobility disabilities. “But does it make sense to fix a roof for someone living in a house [that is] totally inaccessible to them? Conversely, does it make sense to build a ramp and modify a bathroom if the roof is falling in?”
Hansler’s organization advocates for funding set-asides dedicated to home modifications.
For small organizations that work with cities to perform repairs, waiting for reimbursement can also be an issue.
Pam Schuellerman, executive director of Community Housing Solutions, which works with the city of Cleveland to perform home repairs, says, “The organization has to pay the contractors first, and then we get reimbursed by the city. We’re fortunate that the Department of Aging and [its] team are very quick, but it’s not right away. So we’re putting out all that money up front, and that’s a challenge for a lot of small folks. They don’t have that cash flow.”
Policies That Lower Housing-Related Costs
For many older homeowners, rising property taxes and utility bills create a cost burden that can eventually become untenable.
To ease those burdens and help longtime homeowners remain in their homes and avoid displacement, most states have policies that provide some form of property tax relief to older adults.
According to a Realtor.com report, older residents in 16 states and Washington, D.C., are exempt from paying part or all of their property taxes. Eighteen other state-level policies offer tax credits; 6 offer tax deferral programs, typically with the debt paid upon property sale or the owner’s death; and 5 have enacted property tax freezes to help keep bills stable when home values increase.
Some city governments offer their own forms of property tax relief. The city of Boston’s Older Adult Property Tax Work-Off program offers a tax break of up to $2,000 to local seniors in exchange for volunteer hours. Participants perform work such as assisting at city-hosted events, conducting outreach to seniors about city programs for older adults, and working with children at a youth and family center. The city also offers a $1,000 tax exemption for seniors who meet income and asset requirements.
Property tax relief can be an effective tool for easing older homeowners’ financial burden, but outright cuts and exemptions, as opposed to deferral programs in which states recoup tax revenue later, can be controversial if costs are shouldered by state or local governments or shifted to non-senior homeowners.
In Maine, which has the oldest population in the U.S., lawmakers recently considered a bill that would eliminate property taxes for longtime senior residents, but it died quickly amid resistance from residents and officials who feared it would shift an undue burden onto younger residents. Also in Maine, a senior property tax freeze implemented in 2022 was repealed after 11 months because of its high cost. The state offers property tax credits and deferrals to disabled or income-eligible seniors.
Another challenge with property tax relief programs: Homeowners are often unaware of these programs or confused about eligibility requirements. In a blog post about Massachusetts’s senior property tax deferral program, for which the state legislature is currently reviewing a bill to expand eligibility, Alicia H. Munnell, senior advisor at Boston College’s Center for Retirement Research, wrote, “Eligible homeowners are not aware of the program. … and often confuse it with other tax credit and exemption programs. [And] homeowners who are eligible and aware often do not know how to apply, are concerned about a stigma attached to an income-tested program, or hesitate to place a lien on their home.”
In Boston, the Age Strong Commission works to counteract this barrier through an annual series of in-person clinics where people can learn about property tax relief, fuel assistance, and home repair programs.
Besides property taxes, financial barriers to aging in place include rising home insurance costs, especially in areas at greatest risk of climate-related disasters, and utility bills, says JCHS’s Molinsky. While she says there isn’t much happening yet in the way of insurance relief programs—except perhaps disaster-protective home retrofits that could make insurance more readily available—the federal Low-Income Home Energy Assistance Program (LIHEAP), which funds local energy assistance programs, provides a crucial safety-net resource. LIHEAP and other federal energy programs face an uncertain future, however, as Shelterforce recently reported, though some states and cities are stepping up their efforts.
AARP reports that older adults are often forced to make painful trade-offs, including selling a beloved home, because of untenable electricity costs. The organization has lobbied for policies to prohibit service shutoffs, provide bill-pay assistance, and ensure funding for LIHEAP. In addition to providing information about LIHEAP eligibility, AARP directs seniors to the U.S. Department of Energy’s Weatherization Assistance Program, which is administered at the state and local levels to make homes more energy-efficient at no cost, with priority for low-income elderly residents and other vulnerable groups.
Programs that Provide Efficient Services and Reduce Isolation
In some cases, multifamily buildings or complexes not originally designated as senior-specific attract older residents over time or develop long-standing resident populations that become majority-senior. Some of these properties have brought in social services to support these older adults, like naturally occurring retirement communities, or NORCs. A variation of that is the “village” model, in which older adults who live in the same neighborhood band together in a grassroots, community-driven effort to provide social support and mutual aid for the types of assistive service needs that arise later in life.
“Villages do a really good job, in many cases, in helping people engage socially and … contribute,” says JCHS’s Molinsky. “Many are layperson-led and rely on members to do things for each other, host book clubs, … and help with shopping and light home repairs. There’s a lot of value in that little bit of extra help.”
The earliest example—and the model other villages cite as inspiration—is Boston Village. Originally called Beacon Hill Village, it emerged in 1999 when a group of older homeowners began discussing ways to band together to offer mutual support for a host of new needs that come with old age, from minor home repairs to transportation for medical appointments or shopping.
Today, Boston Village covers nine neighborhoods and offers a range of social and educational events, along with services such as escorts to medical appointments, referrals to legal help, home repair, in-home health services, housekeeping assistance, and more.
In a 2025 study in the Journal of Aging Research, public policy expert Yi-Ting Chiu writes, “By leveraging existing community relationships and social capital, villages help older adults remain in their homes while staying socially connected and maintaining independence.”
She notes the model is valuable because it relies less on government sources and is more geographically adaptable than some other aging-in-place programs, although villages in rural areas face challenges from fewer local resources and greater distances between residents.
Many villages remain largely volunteer-driven but often maintain formal partnerships with outside organizations, such as visiting nurse services, adult day centers, area agencies on aging, faith-based organizations, and health clinics.
The national Village to Village Network, which helps communities start and manage local villages, includes nearly 280 members nationwide. Villages serve more than 50,000 older adults in 37 states, according to the network’s recent member census. Most offer members a mix of supportive services, social events, educational programs, and wellness activities. Some have evolved from grassroots groups into more formal, professionalized organizations. Boston Village, for example, is now a 501(c)(3) nonprofit with an advisory council and a five-person staff.
The village model is sometimes seen as a “boutique” option, mainly for affluent communities and serving only a tiny portion of older adults in the U.S. Chiu and other researchers confirm that village residents, on average, are more economically secure than urban NORC residents, yet Chiu finds that lower-income communities also have established villages. The formation of these villages has typically been assisted by external organizations or agencies that can help with funding, space, and staffing.
Challenges for the village model include geographic distance in rural areas; a greater need for external support in lower-income neighborhoods; language and cultural barriers in areas with greater racial and ethnic diversity; and a lack of scalability. Membership fees could be prohibitive for low-income residents, but some villages, including Boston Village, offer income-based discounts. Chiu finds that while the median annual membership fee nationally is $300, many villages have low or no fees.
The scalability issue is being tackled in some areas, including California, Colorado, and Washington, D.C., by volunteer networks or regional village coalitions that receive support from local government funding and aging-focused agencies.
Programs to Support In-Home Care and Services
While in-home support is essential for many people to avoid spending their final years in a nursing home, this option is often difficult to manage amid caregiver workforce shortages, strains on often unpaid family caregivers, and the unaffordability of sufficient services.
In general, the system for providing home care and services to older adults is rife with complexity, gaps, misalignment of services, and cost issues.
“If you have a low income, you may qualify for multiple programs, but the process and documentation requirements for each [differ], and access is challenging to navigate. The origin of all this is that policies are made in different arenas—housing, Medicaid, SNAP—so the coordination is really tough,” Molinsky says.
What struck me was [that] aging is such a universal human experience, so why has there not been more done here?”
Jenny Lee, cofounder and CEO of Hera
The system has a “last mile problem,” says Jenny Lee, cofounder and CEO of Hera, a company that has developed an AI platform to help care managers navigate options and benefits for elders and their families. In other words, despite many medical breakthroughs that can improve health in later life, the system falls apart when patients return home, with little to ensure they take their medication, eat properly, receive the mobility aids they need, or have transportation for follow-up visits.
There are about 53 million unpaid family-member caregivers across the U.S., and navigating the labyrinth of services, benefits, and insurance coverage to ensure day-to-day care for a loved one can be time-consuming and exhausting. Lee says witnessing what her aunt went through as a caregiver for her grandmother was the impetus for forming her company.
“I considered my aunt a superhero but later realized she had been silently breaking inside,” Lee says. “I talked to 100 other adult sons and daughters who’d taken care of someone, and there was this theme: ‘I’m lost. I’m spending hours on the phone and online, running into dead end after dead end. I don’t know who to turn to or what my options are.’ What struck me was [that] aging is such a universal human experience, so why has there not been more done here?”
The workforce of about 5 million paid caregivers, already inadequate for the growing need, will likely be even harder to sustain in the face of recent federal cuts to Medicaid, said Stacey Lee, a health law attorney, during a 2025 podcast Q&A.
On the positive side, experts cite the federal Program of All-Inclusive Care for the Elderly (PACE) as a comprehensive and effective approach. PACE integrates multiple services to provide individualized care coordination that can help older adults—even those in frail condition—live safely at home.
The program has limitations, though. It currently operates in only 33 states, through area aging agencies (AAAs) or other health and social services providers. Recipients must be certified by their state as needing nursing-home-level care to be eligible, and they must receive all their care from the program’s providers, which often means giving up their own doctors. The program is targeted to beneficiaries of both Medicare and Medicaid, and for them PACE services are free; it can be prohibitively costly for people on Medicare only.
The AAAs themselves are often stretched thin by requests for assistance in navigating the complex process of identifying and applying for benefits and services, Molinsky notes, with no reimbursement for the time spent helping people complete necessary paperwork.
The Bipartisan Policy Center noted in a 2022 report that PACE is a cost-effective way to address the needs of frail populations—for example, by reducing expenditures on preventable hospitalizations. The center called on federal policymakers to expand PACE’s capacity and geographic reach, increase enrollment by reducing costs for Medicare-only participants, and raise consumer awareness of the program.
Federal Support Is Uneven and Uncertain
At the federal level, the foundational 1965 Older Americans Act (OAA) has been effective, says Trista Bercarich, a New York–based age-friendly policy expert and consultant. The act, expanded over the years, authorizes grants to states and community providers for home-delivered and congregate meals, transportation, case management, personal care, and other services to support independent living.
“On the whole, the Older Americans Act works. It puts those required services in place,” Bercarich says. “It was intentionally left open and flexible, which is super helpful in a lot of ways, because when you look at something like the state of New York, Manhattan is not going to have the same needs as Albany County or the town of Ontario.”
Funding and staffing to support the act are currently in flux. A recent KFF analysis traces various shifts under the Trump administration that create uncertainty, particularly large staffing cuts and the dissolution of the Administration for Community Living, which administers the OAA’s programs and services, including some community-based fall prevention programs that had been shown to reduce emergency room and inpatient hospital costs.
The U.S. Department of Housing and Urban Development’s Older Adults Home Modification Program, launched in 2019—and informed in part by Bath’s home repair program—has shown positive results in improved self-care and independence, but has not issued a new grant opportunity since 2024. Some experts Shelterforce spoke with believe the program is not dead, however, and are waiting for word on the next grant cycle.
During the last year of the Biden administration, there was a glimmer of positive action, Molinsky notes, with the Strategic Framework for a National Plan on Aging delivered to Congress by the Department of Health and Human Services in June 2024. However, with recent changes to the Administration on Community Living that were proposed or implemented, the framework may be on hold.
Emily Nabors, associate director of innovation at NCOA’s Center for Healthy Aging and an expert in fall prevention, calls the pending federal Stopping Addiction and Falls for the Elderly (SAFE) Act a promising step. While falls risk assessment is already included in Medicare-covered annual wellness visits, she says, the bill would provide referrals to a physical and/or occupational therapist for additional no-cost falls screening and prevention services.
Nabors and other experts also note that more states are working to break down silos among agencies focused on health, aging, housing, and social services. More than half of states are implementing or considering multisector plans for aging, which the Center for Health Care Strategies, a health policy resource center, recently cited as a promising approach.
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