For many elder Americans, growing older often means uncomfortable changes in the ability to do day-to-day tasks and even basic mobility. One aspect of aging that millions of seniors are clear on is that they do not want to move out of familiar surroundings and into a nursing home.

For many elder Americans, growing older often means uncomfortable changes in the ability to do day-to-day tasks and even basic mobility. One aspect of aging that millions of seniors are clear on is that they do not want to move out of familiar surroundings and into a nursing home.

One alternative that is becoming increasingly more popular is to adapt the home to make it more user-friendly as we age. There are now even experts in the aging-in-place concept who can assist in these modifications.

The National Association of Home Builders, one of the largest organizations for contractors, engineers and home designers, offers a certification for licensed builders who want to concentrate and expand their skills for the aging population.

The Certified Aging-in-Place, or CAPS, designation is earned after a three-day workshop, with testing each day, and must be maintained with regular continuing education. More than 170 such workshops were offered by the NAHB in 2012 to nearly 2,000 people. The 5,000th certification was awarded to an Ohio builder last March.

The first day of training starts with several sensitivity exercises, explains Theresa Crahan, NAHB executive director for remodelers. Students are asked to wear sunglasses smeared with Vaseline, to simulate aging eyesight. They are told to sit in a wheelchair and then maneuver in and out of rooms, opening and closing doors.

Perhaps the most telling exercise, Crahan notes, is when students are told to place a tennis ball in their non-handwriting hand, cover it with a sock and then write a check — to simulate arthritis. "That's an aha moment" for many, she says.

Occupational therapists often are involved when an older person transits from the hospital or rehab center to home, so many take the course to be better informed, Crahan says.

"The majority of people age 55 and older say they want to remain in their homes for as long as possible," according to Joseph Irons, chair of the CAPS board of governors. "We want to help consumers make their homes their homes for a lifetime," he said, "even when their needs and abilities change."

Glenn J. Gullo, who has been a general contractor for a dozen years, says his Tampa, Fla.-based company, Home Safe, focuses almost full-time on remodeling homes, townhouses and condos for aging consumers and customers with disabilities.

"That's our core business," he says.

Gullo, who took the CAPS course about five years ago, says there are three categories of people who need help making their homes safer and more ready to support an aging resident. The first category includes items they can do themselves. "They don't cost anything," he says. Like picking up throw rugs. "Throw rugs are dangerous."

Put night lights along the path from your bed to your bathroom. Stub your toes a lot on the foot of the bed, on the feet posts and footboard? Put foam rubber around them.

The second category of changes are ones a neighbor or relative might be able to help with. Electrical plugs, for example, "are never in the right place," Gullo says. "They're behind couches and under tables, hard to reach without bending over." He suggests buying a surge protector that can be mounted to the wall so the plugs are easy to reach.

And the third category is where Gullo and his fellow remodelers come in. A professional is required, someone who has the tools and skills to make significant additions or modifications without damaging the home.

There are more modifications that Gullo recommends consumers consider, according to their specific needs and budgets:

Grab bars in the bathroom over the tub and/or in the shower. Gullo, 57, says he has grab bars in his shower. "They're great to hold onto when you wash your face and your eyes are closed." For people in wheelchairs or using a walker, consider a ramp over the stairs. This would apply even for an apartment or condo with a low threshold. Reduce the step-up on stairs from the traditional 7 inches to 4 inches. Take out the tub and put in a shower — with the proper safeguards. Gullo says 65,000 serious injuries happen in showers each year. A roll-in shower for people in wheelchairs can be built, with no lip or step and a drain slightly below floor level. Keep the tub and turn it into a walk-in. There are replacement walk-in tubs that can be expensive, Gullo notes, or a less-expensive kit can be used to create a door that can be cut into the side of a tub and the edges smoothed. Standard bathroom doors are 24 inches wide; the doorway can be widened to 30 or 32 inches by using off-set hinges. Replace round door knobs with levers. "Can you pass the closed-fist test?" Gullo asks. "Can you open the door or turn on the faucet with a closed fist?" If not, then a lever door knob is much more practical and paddle levers for faucets. Tables and kitchen counters can be made to accommodate residents in wheelchairs. These are custom-made jobs, Gullo notes. Exact measurements are made with the customer in his or her wheelchair. Kitchen ranges can be installed with controls in the front. Microwaves can be mounted lower for easier access. For residents with walkers or wheelchairs, "carpets aren't all that great," he says. Vinyl or wooden floors are clearly better. Dead-bolt locks can be installed with a remote button, similar to what is used on many new cars, along with the traditional key.

Every home is different," Gullo says, with different designs, ages, layouts and challenges. Some homes cannot be remodeled for an aging-in-place resident. "I've seen so many people who moved to Florida when they were 50 years old and now they are 70 or 75 years old. If they live in a townhouse, there's very little we can do."

To find a CAPS remodeler, architect, contractor, home designer or engineer in your area, go to