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Posted by Positive Aging Community on 04/20/2023

Tackling the Caregiving Crisis by Design with Esther Greenhouse

A live & interactive discussion with Esther Greenhouse, the visionary creator of the innovative Enabling Design Approach to address multiple challenges caused by the built environment with a single approach that enables to people to thrive. Raising awareness of the dis-abling impacts of the built environment on us as we age, how this increases demand for care, and how it impacts caregivers...while creating solutions via the Enabling Design Approach

  • reduce the demand for caregiving 
  • reduce long-term care costs 
  • improve lives 

Esther Greenhouse An internationally recognized expert on Universal Design, Aging in Place, and Age-Friendly Community Planning, Esther’s leading-edge perspectives are contributing to positive change.

Esther Greenhouse, M.S., CAPS (pronouns:  she/her) CEO, Silver to Gold Strategic Consulting

Listen on your favorite podcast platform

Questions Asked

  • Thank you, Esther, for considering both paid and family caregivers in your approach to design. Considering the triad is the only way forward!
  • Great comment Steve that “Aging in Place is often an excuse to do nothing.” I think there’s a tremendous amount of fear around the costs of doing anything. People don’t realize the benefits of giving up home maintenance, etc. to go into affordable senior housing.

Chat Transcript

12:10:29     From  Steve Gurney - ProAging Community : https://silvertogoldstrategies.com/

12:14:51     From  Sabrina Smith : what is considered a living wage?

12:14:56     From  Susan Cann   to   Hosts and panelists : Thanks for acknowledging the caregivers...I may have to leave the field due to the low pay...

12:15:38     From  Maggie Ornstein : Thank you, Esther, for considering both paid and family caregivers in your approach to design. Considering the triad is the only way forward!

12:18:02     From  Karen Vassar : I viewed a Webinar sponsored by WellSky recently. These were some of the statistics: Private duty caregiving is the fastest growing job in America. 63% of CNA's and HHA's have a net worth of less than $24,999. 61% of CNA's and HHA's have ZERO discretionary income. 54% of homecare workers and 36% of CNA's rely on some form of public assistance. 90% of caregivers do not have a credit card. This is so upsetting. 95% of our agency's caregivers are from Northern Africa so there is another level of discrimination there as well.

12:19:23     From  Elizabeth Magallon Fleury : That is a very straight forward approach and makes total sense.

12:19:27     From  Arizette Carrinho : thank you for bringing up this topic

12:22:31     From  Elizabeth Magallon Fleury : Aging in Place is not just about adding grab bars in the shower.

12:24:40     From  Arizette Carrinho : We need to make sure that families know what their options are and normalizing it

12:24:45     From  Arizette Carrinho : yes!

12:25:22     From  Elizabeth Magallon Fleury : It needs to be thought about, have a conversation and put in place before we need it not once something has happened.

12:25:36     From  Joe Sperling : Aging in place, or aging in a care community, really requires a plan!  Planning for physical comfort, social comfort and financial capabilities.

12:26:17     From  Arizette Carrinho : falls are the highest risk of death (36million falls a year)and I believe the shame in loosing the independence plays a part in decreasing the falls

12:27:22     From  Steve Gurney - ProAging Community : Enabling by Design Article https://silvertogoldstrategies.com/wp-content/uploads/2022/11/Enabling-by-Design-Esther-Greenhouse-CSA-journal-article.pdf

12:27:46     From  Joe Sperling : Looking for options and solutions for when care is needed?

Insurance and other creative suggestions.

Joe Sperling 

Independent insurance broker

Participant with Senior Services Alliance




12:30:49     From  Jeanne Edwards : Are there any national builders taking these needs into their designs?

12:32:26     From  Elizabeth Magallon Fleury : Once I was thrust into the caregiving roll and also be part of the Sandwich Generation I started Life's Encore Planning.  I serve people who are struggling to care for and support their aging loved one.

12:35:47     From  Elizabeth Magallon Fleury : Choice is paramount and you lose that if you do not plan ahead.

12:36:48     From  Janet Gritz : We need to promote "universal design"

12:37:17     From  Joe Sperling : Absolutely correct.  Lack of planning will likely - perhaps certainly - eliminate options and choice.

12:38:44     From  Steve Gurney - ProAging Community : @karen vassar thanks for referencing WellSky here is the library of webinars! https://wellsky.com/resources/webinars,on-demand-webinars/

12:40:10     From  Eve Hill   to   Hosts and panelists : Yes - Universal Design! 

The National Aging-in-Place Council is getting behind new legislation to offer tax breaks for making  home modifications that increase home accessibility

- next advocacy meeting is Monday 4/24 - all are welcome 

National Aging In Place Council

Advocacy Meeting

4/24 11am Pacific


12:40:49     From  Elizabeth Magallon Fleury : The options for paying for upgrades to your home gets harder as you get older as such as with a home equity loan.  Banks can be  ageist and may not loan you the money to make needed updates.

12:40:54     From  ellen belk : preparing for aging thru education & build design should be given as much thoughtful attention as planning a wedding, a retirement party or family vacation. These are things people spend time, money & resources on....yet, properly preparing to remaing independent as long as possible within one's home (and end-of-life planning too, btw)

12:41:31     From  Steve Gurney - ProAging Community : Certified Aging-in-Place Specialist (CAPS) https://www.nahb.org/education-and-events/education/designations/Certified-Aging-in-Place-Specialist-CAPS

12:41:57     From  Elizabeth Magallon Fleury : @Ellen  Absolutely

12:42:08     From  ellen belk : Thanks to Esther and others like her - who are AMPLIFYING this message! Housing & FInancial planning should be a priority for ALL families, singles, couples, etc.

12:42:48     From  Matt Thornhill : There are new companies trying to solve for aging-in-place modifications. https://trubluehousecare.com/services/aging-in-place

Another: https://www.sagehomenow.com

12:43:52     From  Matt Thornhill : They partner with local builders on training. I think it’s a more substantial approach than the CAPS designation, which is more for marketing purposes (it seems).

12:44:01     From  Steve Gurney - ProAging Community : Here are recordings from our previous safe and accessible home discussions https://www.retirementlivingsourcebook.com/videos?q=Safe+and+Accessible

12:44:10     From  ellen belk : CAPS needs to do better PR! lol

12:45:08     From  Steve Gurney - ProAging Community : Here are some individual providers in the mid-atlantic who are Positive Aging Community Champions https://www.retirementlivingsourcebook.com/search_results?sid=30&tid=12

12:45:15     From  ellen belk : And educate the populace - whom they are trying to serve. AARP, Area Agencies on Aging and a host of others within the eldercare economy should be able to 'suggest CAPS

12:45:33     From  ellen belk : builders to those in need. Or, simply for education purposes.

12:46:18     From  ellen belk : Esther is AWESOME!

12:46:22     From  Lynda Shrager : I took the CAPS course in November of 2012 and you were my teacher! I have been working  in this field  ever since-great to see you. @organizedcaregiver

12:49:38     From  Elizabeth Magallon Fleury : Two story home designs should not be approved without a bedroom and full bath downstairs

12:50:32     From  Maggie Ornstein : I love this: “How simple can this be? It isn’t rocket science” So true for so many helpful things. Innovation often isn’t the answer

12:53:48     From  Steve Gurney - ProAging Community : Mission: To significantly increase the number of American homes prepared for residents to live throughout the modern lifespan by conducting research and educating consumers and legislators https://www.homesrenewed.org/

12:54:07     From  Glory Dierker   to   Hosts and panelists : I am so sorry for the loss of your mom.  What a wonderful daughter you are

12:54:36     From  Elizabeth Magallon Fleury : @Maggie  YES

12:56:45     From  Eve Hill   to   Hosts and panelists : Yes - homesrenewed began the push for legislation & NAIPC is picking it up and joining forces - as mentioned above we are all meeting 4/24 see ageinplace.org events to sign up or please reach out to me  for more info (Eve Hill) at customizedaging@gmail.com

12:56:58     From  ellen belk : The bedet seat is a genious suggestion! Dignitiy, minimizing UTI's - total benefits of that small tweak. RAISED toilet seats are another suggestion - As most falls for elders happen in the bathroom

12:57:10     From  Lynda Shrager : 2012 !!!!!

12:58:49     From  Ruth DeHart   to   Hosts and panelists : I would love to work with you on local codes.  I'm in Fairfax, VA-Northern VA area. Such good information. Ruth

12:58:51     From  Elizabeth Magallon Fleury : THANK YOU so much for this much needed discussion.

12:59:51     From  Meryl Schaffer : Fabulous presentation!!!

12:59:59     From  Arizette Carrinho : Thank you Esther

13:00:07     From  Elizabeth Magallon Fleury : Elizabeth@lifesencore.com 


13:00:20     From  TRACY BLAND : Thank you!

13:01:16     From  Sabrina Smith : been talking about building out our master bedroom to 'suite'. we will definitely consider this now.

13:01:35     From  Sabrina Smith : thank you!

13:01:44     From  Steve Gurney - ProAging Community : Esther Greenhouse, M.S., CAPS (pronouns:  she/her)

CEO, Silver to Gold Strategic Consulting

Built Environment Strategist

Industry Scholar, Cornell Institute for Healthy Futures


13:03:47     From  Maggie Ornstein : Thank you, Esther!

13:04:24     From  Kristen Eichleay   to   Hosts and panelists : Great discussion! Thank you!

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