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In the Backyard, Grandma’s New
Apartment
by
Susan Seliger, The New York Times
May 1, 2012
When her father became ill just
before Christmas last year, Dr.
Socorrito Baez-Page faced an
increasingly common conundrum. Her aging
parents wanted to stay in their town
house, but her mother couldn’t handle
the caregiving alone.
So Dr. Baez-Page, a general
practitioner in Alexandria, Va., moved
her parents into her home, converting
the dining room and TV nook on the main
floor into a bedroom. But the four steps
down to the bathroom in the split-level
home have proved hazardous.
Nobody is happy. “My mother is
embarrassed to have to use the commode
by her bed at night,” said Dr.
Baez-Page. And space for everybody is
tight.
The solution? Though many
families are often forced to consider
nursing homes under these circumstances,
the Page family found another option.
They ordered a MEDCottage — a
prefabricated 12-by-24-foot
bedroom-bathroom-kitchenette unit that
can be set up as a free-standing
structure in their backyard. It’s more
than a miniature house — it’s decked out
with high-tech monitoring and safety
features that rival those of many
nursing homes.
The floors, for instance: “It’s
got special rubber floors, so even if
you fall, you’ll be safe,” noted Dr.
Baez-Page’s husband, Dr. David Page.
Indeed, according to Kenneth Dupin, a
minister and the founder of N2Care, the
Virginia company that worked with the
Virginia Tech College of Engineering to
design the MEDCottage, you can drop an
egg from 18 inches onto the special
flooring without breaking it.
The Australians, who began
building simple backyard homes for the
elderly in the ’70s, call them granny
flats. In the United States, these
self-contained units have earned another
nickname: granny pods.
This month, the Pages will
become the first family in the country
to take delivery of a high-tech
MEDCottage. The cottage is laid out as
an open-plan apartment with a kitchen
area (equipped with a microwave, small
refrigerator and washer-dryer combo), a
bed area and a bathroom large enough in
which to maneuver a wheelchair. The
utilities and plumbing connect to the
primary residence.
But the granny pod also brims
with high-tech touches. In order to make
midnight bathroom visits safer, for
instance, a runway mat stretching from
the bed to the toilet lights up
automatically when you step on it. It
turns itself off after 10 minutes.
Tracks along the ceiling
accommodate a lift or a trapeze hook.
Residents who have balance issues can
grab onto a hook to provide stability as
they move around the cottage. The lift
helps those with more serious mobility
challenges.
“One of the primary reasons
people have to go to nursing homes is
that caregivers can’t lift them anymore
and get them out of bed and keep them
mobile,” Mr. Dupin said.
If the cottage resident does
fall, she will be visible on a camera
system hooked up to the caregiver’s
computer in the main house. It’s not
exactly Big Brother: The cameras sweep
an area 12 inches above the floor, so
normally all they transmit are images of
feet and ankles.
For those needing more
elaborate medical monitoring, the
MEDCottage is equipped with a system
that tracks blood pressure, glucose,
heart rate and blood gases (changes in
blood levels of oxygen or carbon dioxide
can signal heart failure and other
serious conditions), sharing that
information with family and physicians.
If the resident fails to take medication
from a dispenser on time, the system —
speaking aloud — reminds the patient and
sends a text message to the caregiver.
Zoning rules can create
barriers. “Local zoning varies by
county, and it’s not necessarily easy to
set these pods up,” said Rodney Harrell,
housing policy specialist at the AARP
Public Policy Institute. Currently about
half of the states allow these accessory
dwellings for a family member, according
to Mr. Dupin. (Several additional
states, including New York, are
considering legislation explicitly
permitting granny pods.)
But setting one up is
especially easy in Virginia. A state law
passed in 2010 permits temporary medical
dwellings on a resident’s property, as
long as a physician verifies that the
patient needs assistance with at least
two daily functions — like bathing,
eating and dressing — and the unit is
removed when there is no longer a need
for it (so the pods don’t turn into
rental properties).
The cottage costs about $85,000
new; Mr. Dupin’s distributors will buy
it back for about $38,000 after 24
months of use. “If you compare it to
nursing home costs, which can run $6,000
to $8,000 per month in Virginia, even
higher in New York, that’s cheap,” said
Mr. Dupin.
Of course, unlike nursing
homes, granny pods don’t come equipped
with 24-hour professional care and three
meals a day. Hiring a health care aide
(around $19 an hour) just during
weekdays can easily add another $39,000
per year.
But a growing number of elderly
people — 88 percent of those over 65 —
say they want to live in their own
homes, in their own communities, as they
age, according to a 2010 AARP survey.
The government is catching on
to this trend, and to the potential
savings. According to Lynn Feinberg, a
caregiving specialist at the AARP Public
Policy Institute, a provision of the
Affordable Care Act going into effect
this year will pay for health care
delivered in the home instead of in the
doctor’s office.
If you can afford them, granny
pods have advantages: “Older adults have
their own living space and privacy,
which has the potential to reduce much
of the stress associated with caring for
aging parents,” said Bernard A.
Steinman, senior research associate at
the Institute for Community Inclusion at
the University of Massachusetts.
Still, the setup may not work
for everybody. “Some families may have
dynamics and/or history that make the
option undesirable, or the level of care
needed by the older adult may exceed
what the family is able to provide,” Dr.
Steinman said.
But for Dr. Baez-Page, the
convenience of having her mother close
but still living independently is
especially important. Her father has
died, and her mother will be living
alone in the granny pod. “The MEDCottage
will be six feet away from our kitchen
windows,” she said, adding that she will
be able to get to her mother in seconds.
For caregivers in the tristate
area who like the idea of aging in
place, there’s another prefab
alternative: P.A.L.S., short for
Practical Assisted Living Structures.
Rob Pintoff, a retired
pharmacist in Farmington, Conn., said
that toting up the numbers convinced him
that P.A.L.S. was the way to care for
his ailing 83-year-old mother-in-law,
Enid Zlotnick.
Attaching a portable pod didn’t
cost much more than retrofitting his
home, and the unit could be set up
faster and with less mess. So last year
he contacted Henry Racki, P.A.L.S.
creator and a Connecticut home builder
who also is a certified aging-in-place
specialist.
“It was amazing to watch this
modular unit come off the flatbed with a
crane,” recalled Mr. Pintoff. “One
moment there was nothing there, and the
next the walls were up, like the Amish
coming together.”
Though each P.A.L.S. unit is
customized to the client’s needs, the
standard 20-by-14-foot bedroom and
bathroom unit starts at about $67,000.
Homeowners can also lease a unit. A
five-year lease runs about $1,700 per
month, after which you own the unit.
The pod comes with phone and TV
cable lines built into the wall (no
wires to trip on), a closet with levers
that lower the clothes to wheelchair
level, motion detectors that
automatically turn the knee-high
night-light system on, showers with grab
bars and various types of no-step
entries, wheelchair-accessible sinks and
comfort-height toilets.
So far, Mr. Racki has set up 10
of these mini-homes in Connecticut,
Massachusetts and New York. Zoning in
Connecticut doesn’t usually allow for
full kitchens, Mr. Racki said, but they
can be included. He helps clients get
all the permits and zoning approvals
needed.
None of the P.A.L.S. purchasers
so far have requested high-tech medical
monitoring. But a system similar to the
MEDCottage’s can be added for $16,000.
Mr. Pintoff is convinced the
addition was the right choice. “Enid’s
happy — the only other option was a
nursing home,” he said. In fact, Mr.
Pintoff does not plan to sell his unit
in the future. “It looks like it belongs
there, it adds value, and it might be
useful for my wife and me one day.”
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