Sam Dean | The Roanoke Times

Patricia Buckner had a stroke in January. Prior to having a ramp installed at her home, it took two men to carry her in and out of the house.

For those who have had a stroke, knee-replacement surgery or arthritic joints, it's common knowledge that stairs, narrow doorways and bathrooms can be tricky to navigate on unsteady legs or in a wheelchair.

With an aging population in the Roanoke Valley, and the ensuing health concerns, more health care providers and real estate experts are realizing a growing need for ramps, open floor plans, accessible bathrooms and even elevators.

"You can ride down any street and find any one person that's elderly, and I'm sure they could have some changes to their home to make easier for them to maneuver," said Patrick O'Quinn, occupational therapist and co-owner of the Roanoke home health business Interim Healthcare. "Their old homes are just not practical."

It's something Dorothy Jones realized when she saw her 86-year-old mother had to hoist herself into her Roanoke home by grabbing onto the door frame.

"Everybody was young when they moved into the house so naturally everyone could get into the house, but now it's sort of hard for her to pull herself up," said Jones, 67.

O'Quinn estimates that seven out of 10 homes he visits on the job could use some type of home improvement to make it easier for people to get around their living spaces.

Determining just how many houses in the Roanoke Valley are accessible isn't easy. There is no database. But real estate agents, health care providers, contractors and housing experts are convinced that the housing market isn't suited for an aging population.

"The aging housing stock in the valley is difficult to retrofit for accessibility features, and those folks who are planning a move are looking to new communities that have the opportunity to age in place," said Kit Hale, general manager of MKB Realtors in Roanoke.

In some instances, the situation is forcing people to move, but for many that is not ideal. "Aging in place" has become a buzzword of sorts among those in or nearing the senior citizen label.

It's the reason contractors such as Cornerstone Builders, which specializes in home improvements and renovations, are catering to this crowd by incorporating many features that allow people to age in their homes during a renovation project.

"Very few people call and say I need a shower that's handicap accessible. Usually its part of a larger scope," said Martin Pruitt, owner of Cornerstone. "When we go in as a design and build company for an initial discussion, I will bring these things up. A lot of times the response is, 'Oh I haven't thought of that,' but they like it."

In some cases Pruitt said homeowners have embraced the idea so much that they've opted to put an elevator in, or at least do the initial work so one could easily be installed later. Still, the price tag of about $80,000 is out of reach for most.

O'Quinn said he visits a lot of people who can't even afford to hire a contractor to do minor improvements such as widening a doorway or installing a ramp. The result, he said, are ramps that are too steep and other well-intended, do-it-yourself projects that aren't always an improvement.

O'Quinn said contractors and therapists should be working together to address the problem, but that they aren't right now.

"One of the biggest needs that would be of value to the community would be a group that could come out and assess a home and would have a therapist involved," he said. "Someone who would come out and assess the home with a contractor and make the changes in an affordable way."

Stairs after a stroke

Patricia Buckner learned just how limiting some buildings can be when she had a stroke in January at the age of 45. Stroke is the leading cause of disability nationally.

"It shocked me," Buckner said.

At the time she was living in an apartment with a flight of stairs she could no longer climb. Unable to live by herself, Buckner moved in with her sister Janice, into the house where they were raised.

While the home is one-story, it is not wheelchair accessible. The bathroom is small. The hallway is narrow.

But the biggest obstacle was getting in and out of the house.

Steps led to every entrance.

A couple of months ago, the Buckners' home got an upgrade in the form of a long wooden ramp.

"The ramp has been a blessing because it has allowed her to be more independent and because she can walk out on her own," Janice Buckner said.

Before the ramp, it took two men to carry Patricia Buckner in and out of the house.

The ramp came courtesy of a community development block grant given to the nonprofit Blue Ridge Independent Living Center.

The center has received money for about a decade to build ramps, widen doorways and install grab bars, but in recent years the requests for these improvements have been growing, said Karen Michalski-Karney, executive director of the center.

"Our mission is to assist people with disabilities to be independent," Michalski-Karney said. "But there is not enough accessible housing units for folks in this area. Through [community development block grant] funds we are also increasing the accessible housing stock in the community. That's important."

This year the center requested $81,000 in funding from the city of Roanoke but received $58,000, the same amount granted through the U.S. Department of Housing and Urban Development's Community Development Block Grant program last year. The money goes specifically to help people such as the Buckners living in the city.

Last year the center set a goal to help 25 people make accommodations to their homes, but ended up assisting 35 and left 14 people on the waiting list.

Fixing Jones' mother's entrance to make it easy for her to walk inside is one of the next projects that the center has on its list.

"We've had people staying in a nursing home two to three months longer then they wanted or needed to be there just because it was so difficult for them to find affordable accessible housing," Michalski-Karney said.

Changing building habits

Recognizing the need, some developers are starting to make changes.

Two years ago Fralin & Waldron of Roanoke finished a development of patio homes in Roanoke County only to realize that more than half of the buyers wanted some type of modification to the home.

"I can't tell you how many people asked us to alter the bathroom or some other part of the home to make it easier for them," said Kathy Gentry, sales and marketing manager. "They wanted grab bars or other modifications. I'm talking about 60 percent of the buyers."

So when the company set out to design another community, Keswick Court, Gentry said they started out with a plan that included wider entrances and other small changes that make the home and bathroom more accessible.

"It's no cost at all if you do it on the front end, if you do it during the building," Gentry said. "If you try and go back and retrofit, that's very expensive and becomes a big project."

The motto of being prepared and designing for the future taps into what Michalski-Karney said is something even younger homeowners should start to consider.

"The most important thing for people to realize, is most likely in their life -- if it isn't something that directly affects them -- they will have a family member who will become disabled," she said.

At Fralin & Waldron, Gentry said the small changes in designing the Keswick Court community have proved to be a good selling point, something that she welcomes given the economic downturn and the local slowdown in the housing market.

"We were selling houses when no one else was selling houses because we had these great plans," she said.

So far, of the eight built, six homes have been sold. The plan is for a 17-home community that is not just being sold to the elderly but also to professionals.

That's a concept that Bill Fuller, with the Virginia Housing and Development Authority, has been trying to get across to builders, real estate agents and architects for a while.

His theory is if you make a home's entrance more accessible for a person in a wheelchair, you are also making it easier for a mom with two kids and six grocery bags to enter.

"There are lots of reasons to have zero-step entrances," Fuller said. "They work better for everybody. It's not just better for people with disabilities. It's just better design."

The struggle has been in breaking conventions.

"There is that social stigma that you don't want to be sick and you don't want to be seen as frail," Fuller said.

As the state's mortgage finance agency created to help low- and moderate-income Virginians attain affordable housing, VHDA has had a strong hand in increasing new construction of accessible housing by awarding projects to companies that build accessible housing.

Builders are starting to catch on, Fuller said, but there is still a ways to go.

"These conventions we have in building homes have become habit and we're very slow to change habit," Fuller said. "It's going to have to be consumer driven."