Moving to CA. Our daughter is planning to add a room over their 2 car garage. I would like to know where I can get info about what to build?

Dear Eddie:
One line in your statement kind of stuck me, and that is the one that states you are entering into uncharted territory. You said you live in a beautiful home in CO.
I am 67 years old, and have an incurable disease, but I have told my family that I want to stay in my home as long as possible, until I have to go into hospice care because my home is where I am and I can be most comfortable, and I am most happy staying in my home. There is no substitute for staying where you love to live. Right now, I get help once or twice a week to do my laundry and do general light cleaning, and as I get worse, I can add more in-home care to meet my needs, along with any kind of help that my family offers me that does not put too much of a strain on their lives and families.

Just think about the idea of staying where you are, equipping you current home with all the items necessary to keep your wife and you safe and happy, and any medical devices that she will need to stay in your home can be rented or purchased, or may be covered under your medical insurance plan.

I am sure that taking care of your wife is a bit taxing for you, but I do not know show much.

If you can afford it, or your medical insurance can help, I suggest that you check out some very reputable in-home care companies, who can provide 24/7 in-home care by a professional or whatever kind of daily assistance you need and can afford to keep the two of you comfortable and together, and keep your wife and you living on and on together in area and in the home the home I believe that you both love.

This is only an idea. Since I do not know either of you, this is the best bit of advice I can offer to you as a non-professional. I am just another human being who hopes every single thing works out great for the both of you, no matter what you choose to do.
With my regards, and a long distance hug to the both of you from me, in Florida.
taz0921 ( aka Stan Z. )

You are headed in the right direction. The decision to move closer to your daughter is an excellent plan. When my sister died unexpectedly and I encouraged my mother to move back to Pennsylvania to be close to us, I had no idea what the 19 year experience would be like. The move from northern California to Pennsylvania was the first, critical step.

A room over a garage is a bad idea all the way around.

Get a chair lift.

Oh dear that’s a bit like asking how long is a piece of string. Unlike some medical conditions a person with Alzheimers needs change quite dramatically. You are nearing the stage where 24/7 care will be required and with the best will in the world at 81, even with help, it will be an enormous strain for all.

Stage Five: Moderately Severe Cognitive Decline
Major memory deficiencies are present beginning in stage five, and people in this stage of the disease may require assistance with activities of daily living, such as bathing, dressing, and preparing meals. Memory deficits in this stage are severe, with individuals often forgetting prominent bits of information that affect their daily lives – such as their home address or phone number. They may not be able to identify where they are (orientation to place) or what time of day it is (orientation to time).

Stage Six: Severe Cognitive Decline
Also known as Middle Dementia, marks a period in which a person requires substantial assistance to carry out day-to-day activities. They may have little memory of recent events and forget the names of close friends or family members. Many people in stage six have limited memory of their earlier lives and will also have difficulty completing tasks or successfully exhibiting cognitive skills such as counting backwards from 10.
People in stage six may also begin to experience incontinence of bowel or bladder, and speech ability is often diminished. Significant personality changes may also be noticeable at this stage, as individuals may suffer from delusions, anxiety, or agitation.

Late-Stage Dementia 
The seventh and final stage comprises the final stage.
Stage Seven: Very Severe Cognitive Decline
Also known as Late Dementia, stage seven is the final stage in the progression of Alzheimer’s disease. At this stage, most people will have lost their ability to speak or communicate. They often require assistance with most of their activities, including toileting, eating, dressing, bathing, and other daily activities, around the clock. Because people in stage seven often lose psychomotor capabilities, they may be unable to walk or require significant assistance with ambulation.

On average, most people live between four and eight years following diagnosis. The progression of the disease may be different for each individual.

Im sorry I can’t advise you as you’d like - sure I could list a load of things, settings, furnishings that would help to a degree but I’m more concerned about both your welfare than just that of your wife’s needs.

Much as you and your family love your wife - you may find it better to have assisted care accommodation at this stage and see how things go.

My thoughts are with you - keep us informed

Taz, I think FF makes a decent and polite inquiry.   In fact, I thought the answers to this post were excellent, so much so that I've bookmarked the post for future reference.

We each bring our own perceptions and experience, and sometimes that may not be consistent or agreeable to someone else.   But your blanket condemnation is quite strong.  I would have to also ask why you feel we're wrong but you're not?  

You suggested focus on Pha's and his wife's lifestyle and medical needs, to be evaluated by a "professional."    What field?    Would an architect be expected to have information on their medical needs?   Would a doctor be expected to know about assistive designs to the point of being familiar with building codes?

These can be complex subjects and plans, and I think require contributions from professionals in affected fields.  It's not a job for "a professional."

Please note that the original writer, Eddie, has not been back to the forum since September 11th. He was glad with the advice we had given him that day, many things he hadn't thought about.

Hello Eddie B.
I would TOTALLY disregard any and all advice you get here, because in the real world, you have not provided enough information for anyone to even give you the slightest bit of good or bad advice. A professional who is well versed in all aspects of the aging process and you and your wife's condition, and if they do not drill down and ask you every single question possible that is catered directly to you and your wife's lifestyle and medical needs, ask for someone else, because they are not doing their job.
This forum is great, but you have a very complex situation and many questions , and what you have given us as far as your situation is the tip of an iceberg of your total life going forward, needs, wants, desires, and lifestyle you expect for you and your wife.
Kindly consider my advice, which is to get a qualified professional or professionals to come to you, and ask you the 100+ or possibly more questions that need to be answered to offer you options that you should investigate and finally choose, but have options within those options. in case the option you choose does not work as expected, and either needs to be changed, or modified.
Thank you, and the very very best to you and you wife!
From taz0921 ( aka The Tazzman )

I work as a receptionist in a Memory Care community which houses 57 residents suffering from dementia and Alzheimer's Disease. While walking through the resident hallway yesterday, a little lady was trying to pull out a rather large table from against the window. I asked her if I could help her, she said no. I went on my way to clock in. On my return down the hallway a few minutes later, that same little lady had pulled down her pants and briefs, and was having a bowel movement on the upholstered chair, right there in full view, likely thinking the chair was the toilet bowl.

I can tell you lots more stories about dementia and how unmanageable the symptoms can get. I won't though, but I will recommend you think long and hard about spending lots of money to add a room over a garage when you may be needing to save that money for a Memory Care Assisted Living community for your wife. It often takes a team of 24/7 care givers to manage the level of care required by a person suffering the ravages of AD.

Whatever you decide to do, wishing you good luck and Godspeed my friend.

I recommended using an architect because they are well versed in the codes concerning architectural codes as they conform to the American Disabilities Act. Those codes. General contractors may or may not be well versed in those.

My advice is different from most here. Save your money, Eventually you will NOT be able to provide he care she will need. She will need to be in a care facility that specializes in Secure memory care. Short of doing that also save your money and have an extra bedroom for the 24 hour caregiver you will need. NO ONE can provide full time 24 hour care for a loved one with AD. The physical and emotional demands are simply too great. I am an RN who has worked with elderly and disabled for more than 40 years. Otherwise all the suggestions here are very good.

The thing that surprised me the most about AD was loss of mobility and inability to take even minimal direction at later stages. Some people have written how their spouse/mother could not figure out how to make legs work to get off the toilet with assistance, something most of us take for granted. It affects people differently, so eventually there may be walkers, wheelchairs, bolting, turning on and leaving of appliances, inability to use a medical alert device. You have to plan as if you were living with a toddler. Father left 2300 sq ft senior apartment for 520 ft 1BR apartment in Memory Care and it was never big enough even without appliances. We did get a microwave - he never used the microwave so it was safe - and had a small refrigerator which was inadequate for ice cream and juice. With his queen sized bed, there was diminished turning radius from bedroom to bathroom, despite their clever use of barn door. Bathrooms need to be big enough to accomodate wheelchair access/rotation and sink needs to be lower to accomodate wheelchair. Shower needs to be walk/wheel in with handrails, seating and hand attachment. Some of the newer assisted living places have counters with lower level pullouts to accommodate wheelchairs. No rugs; flat but patterned carpeting best to avoid falls and give perspective. I just would not do second floor. Even if you install elevator, it will take up space. Sounds like your daughter wants to be involved and there for you. Are you planning to spend most of your days living in the rest of her house? You will need room.

I live in So. Calif. My brother lives in Northern Calif. Building codes can be horrendous. The house across the street didn't have permits for one room in the attic. Code Enforcement made them re-fit the entire house built in 1959 to 2013 Earthquake standards. That cost a fortune. I live in Riverside and the codes are VERY strict about "grannie" apartments. My neighbors couldn't do it.

I think you would be much better off getting someplace close by. There are many very nice assisted living apartments. You could have a social life and get aid for your wife. You said you are 80 or there-abouts. I am 85 and in the last 4 years years my health has gone down tremendously. You will not get younger or stronger.

Why are you leaving your house? If you have friends, and can afford it, I say stay. The move could be very confusing for your wife. So, you only use part of the house, so what? Have someone clean the unused rooms two or three times a year and leave the doors shut. I have two girlfriends who are widows who do this. Their places are paid for and they like the neighborhood.

Personally, I love my children, but I would rather live in a culvert than move in with either one of them.

For a host of reasons, already mentioned, I say, don't do it.

First of all, building an apartment for someone with a physical disability on the second floor over a garage is not a good idea. If your wife has mobility issues how is she going to get up and down stairs. There would need to be either a stair glide or an interior elevator. She would be better building something at ground level. Make sure that the door ways are extra wide to accon]modate wheel chairs,

Excellent comments ...especially about safety and socialization.

If you are able to tweak the plan and build on ground level - being on the same property with family isn't too bad, especially if there are nearby facilities you could use (senior center, parks, churches, library....). Just realize - you will need to be able to 'get away' from time to time. You need to really think about hiring a caregiver on some kind or regular basis (4 hours twice a week?) that can let you get out for a game of golf or dinner with friends, for example..
My sister re-modeled 2 spare rooms at one end of her house (bathroom between) for my father and his caregiver. This end of the house was then 'separated' by a sliding/folding' cabinet from the main house - so that each side could have some privacy.
The bathroom has grab bars for toilet (w/ bidet) and shower(zero entry). There is only a curtain to hide the shower, if needed... so that there is no obstacle to get a shower chair with wheels into the shower. The whole bathroom is tiled... but there are heating elements under the tile in the bathroom.
If you are going to turn one large room into 'everything' - you may want to try having a Murphy bed...less tripping on it. If you are on ground level - you might want to think about a large exit door (like French doors... and a ramp up to that French door. You may also want to have master switches for some of your appliances so that your wife can not accidentally turn things on .....
Having an intercom with the rest of the house would be helpful.
Good lighting, alarms on some doors/windows (possibly), cameras or monitors - that allow you to see her - when YOU need to use the bathroom.

One labor saving item for us, was having a Hoyer track mounted in the ceiling so that we could transfer my father from the bed to wheelchair or shower chair without too much lifting - once he was no longer able to bear his own weight for transfers.

If you can have a little yard/patio outside your French doors... you may be able to enjoy some private outdoor time too, with just a little garden, or fountain, or bird feeder, ...... if that is something that would be pleasurable.

Please try to implement as many safety, labor saving items as possible - life can be hard enough when caring for someone with dementia. Put some pleasures into this place -too, so that your days together will be as enjoyable as possible.

Overwhelming....isn't it?

California is a large state with a climate that is well renowned and the reason many people go there. The weather year round doesn't change with the seasons, it is usually sunny, lo humidity, soft breezes, no mosquitoes or flies, ideal for outdoor living, and you and your wife will be inside, upstairs in one room? The climate encourages an outdoor social life, cookouts, sitting around the pool, etc. You will need to think more about lifestyle otherwise you may be shut in to your one room, living with little or no social life. Is your wife wheelchair bound? Is she alert and communicative? My experience with an Alz. wife is that visitors are very welcome and they bring a smile to her face, and despite not being able to say more than one or two words she understands others very well and listens, showing interest. So think about getting outside during the day and socializing. How is that going to work with your daughter? You will need an elevator large enough to take a wheelchair to get up and down stairs, and it would be worth it.

Yes, California is a high tax state and also highly regulated with many nanny-type laws. If you are caring for an Alz. patient you may find health officials coming around and poking their noses into your apartment more than you would like. How are you disposing of medical and hygienic wastes, for example? Have you figured on having a solar panel and electrical system, now required in Ca. for new construction, as I understand it? California is determined to save the planet all by themselves; they are banning the use of natural gas in some areas. With high taxes and high regulation you might think you would be able to get good service - municipal service etc., probably not.

Have I alarmed you at all? My wife and I live in 1800 sq.ft. single floor house in a small community in NC. She is in a wheelchair and with no one else in the house we make use of bedroom, bathroom, living room, kitchen and dining room and enjoy the space. I could not imagine living in one room like you are planning.

A BIG CONCERN is an apartment above a garage with autos? Really? Think of those fumes. I don't know about that idea, but here is my list. --

- Higher standing toilet
- Toilet with bidet
- Bedside commode
- Walk-in shower with seat/soaking tub/accessories
- Safety latches on cabinets
- Riding stair rail if required for multiple stories
- Rollator walker
- Cassette medicine cases (different colors - one for day and one for night)
- Easy accessibility to doctor and specialists' contact info
- Respite for yourself
- Life Alert
- Secured case for vehicle keys
- Remove ALL scatter rugs

You’ve already received some excellent advice here. Perhaps looking at Independent Living or studio apartments would give you ideas about how big or little the space you are planning really is. Some over 55 communities have models around the 1000 sq ft range. Even some assisted living facilities have an open floor plan with kitchen area (minus the stove/oven). These would allow you to see physical examples of what you are planning.

I share the concerns about being upstairs and I also share the concerns of burnout. I’ve been caring for my husband 24x7 without any outside support. I’m seeking someone for 1-2 afternoons each week to give myself a break. My father had Alzheimer’s and he lived 7 years after a major stroke. The doctors had given him 90 days.

And, at the end of the day, this is your decision. There has been some valuable advice here about permits and lifts and bathrooms, etc. You know your situation best and make the best decision at the time. If things change, maybe your living conditions will change to.

Good Luck!

So many of you are suggesting Assisted Living/Memory Care Centers but are you aware of how expensive they are? They are private pay and minimally cost 5K/month. Funds can quickly be depleted. I suspect that is why he is considering building something long-term. So while making the AL/MC suggestion, do you have suggestions on alternate ways of paying for them? I would like to know because I too am in the same situation and considering an addition to my home because the funds to pay for my loved ones AL facility won't last forever.

To the gentleman that posed the question, I'd like to suggest he visit some Assisted Living facilities and take note of the layout options. You can even get floorpans from them and design the over the garage living space similar to that style should you go that route. While there take note too of the adaptive measures in place like the wide doorways, w/c accessible shower, raised toilet seats w/handrails, bright, cheery lighting, etc. I hope this helps and wishing you the best.

Department of aging in any county should be able to answer your questions Hope your healthcare is good in California, she may need more care and equipment then you can afford.

California is one of the most expensive and highly taxed states in the country. I know. I’ve lived here for 30 years. More advice than an answer: proceed carefully. Very few retire here. My friends have all left for other states: FL, TX, AZ. I plan to leave as soon as possible. Be sure you have an abundance of financial reserves. You’ll need it.

Eddie - I agree with many of the posts here that say you should NOT do this for the same reasons those posters have mentioned.

Two things I like to add. First, you mentioned in you profile that you are very concerned about your own heath since you're already 80 years old. Statistically, you will go first before your wife even though she has Alzheimer's. What will happen to her when you're gone? Who will take care of your wife 24/7? It is a huge task to take care of a dementia patient 24/7/365. If you daughter steps up, she will have to give up her entire life as she knows it.

If your daughter were to come to this site and ask for advice on whether she should be adding a second floor room to her house and have her aging dad and Alz. mother move in, she would get a resounding NO, not because we think she shouldn't take care of her parents, but because she will NOT be able to provide the care that you and your wife will eventually need without giving up her whole life and existence, and health and sanity. If that's what she prepares to do and knows what she's getting into, then go for it.

Would not even consider moving to a 2nd floor anything unless there was an ample sized elevator to get up and down. Fall risk is huge, huge, huge for either of you and then what... you both end up having to move into daughter's house. And, is that even an option if creating room for you means adding on over the garage.

If you actually go through with this, the landing and the stairs going to 2nd floor need to be wide enough to get a gurney up, turn, and get into a door in the event an ambulance has to come. You could consider a lift chair that travels up and down the stairs and add some safety features to avoid falling as you get on/off the chair.

If you are considering a move to be closer to family, why not just check out some AL facilities that are similar to apartments. They have usually set up floor plans to accommodate wheelchairs and easy access to all rooms. And you have someone on duty should you need some help. There is every possibility you could sink a lot of money into a remodel that will only work for a very brief period of time for one or both of you. I would really be thinking about the 'what if's' that would prevent you from living on a 2nd floor at this point in your life.

FF, very good insights and observations about fumes that could penetrate from he garage below.   My street has become so heavily traveled that I can't even open windows on two sides of the house  If I did, in 20 minutes of rush hour traffic (on  a residential street!), the odor reaches a level equivalent to standing behind a car...the exhaust is that strong.

(I timed it before I just stopped opening the window at all.)

I can't imagine what could happen if those kinds of fumes penetrated someone's living area.

WDale, advertising is prohibited except for those companies sanctioned by the site owners.   

Your post is thoughtful, but including reference to a commercial facility in my opinion makes it advertising.

Please, Sir, consider the answers that you are receiving on this blog. It sounds as though you really want to do the right thing by your wife. It sounds as though you have been doing the right thing for your family your whole life. It's encouraging that you are willing to state that you are facing new challenges and asking for help. Please consider that even with your best intentions, you are asking the wrong question. The right question is: "how do I find the right care and support for my wife and me during our senior years in CA?" Please check out some Assisted Living and/or Memory Care communities before you give a flat NO. These communities are NOT like the nursing homes of your parent's era. Sincere best wishes for this next challenging phase of your life.
Wynesta

Handrails on both sides of any stairs, hand rails and grab bars in bathroom and shower, hands rails in hallways and any areas where patient walks, hallways and doorways wide enough to accommodate a wheelchair or other equipment remembering there may also be extra handrails involved, great lighting and extra motion detector lights in bedroom, hallways, bathroom, all rooms, actually)for safer navigation if she is anyone gets up in the night.

phaT1paTch, two words CARBON MONOXIDE, nitrogen oxides, hydrocarbons, just to name a few gases that if the garage is used on a daily basis will drift up into your living space.

I am in my 70's. My sig other was a jogger most of his life, and he goes to the gym weekly, but he had fallen down our stairs at least 3 times in the past 5 years. All due to side effects from new medication. I am thinking about adding another stair rail so one has two rails to hang onto when descending the stairs.

Both my parents were healthy and active in their late 80's early 90's, walked 2 miles per day. But as Alva had mention, this can all change in a matter of seconds. My parents refused to move from their 3 story house, and have both fallen down the stairs on more than one occasion that they would admit. Evently my Dad moved to to Independent Living, and could kick himself for not moving years early after my Mom had passed due to a serious fall at the house.

If you can budget for Independent Living at a senior facility, it would be a better choice, plus you would be around people of your own age group. No housekeeping to worry about, no meals to prepare, etc. And a nurse is on duty around the clock. The newer facilities are like hotels.

I don't know if this was already mentioned, so I apologize if this is a repeat. I live in CA and there are new regulations about "accessory dwelling units" (ADU). Here's a link.
http://www.hcd.ca.gov/policy-research/AccessoryDwellingUnits.shtml

"We know our kids (son and his family, who live near us and our daughter and her family who live in CA) would do what they could but I am not sure if they know what the job would entail if I was out of the picture. I want to try and control or prepare for whatever I can reasonably prepare for."

While having cared for aging parents (you mentioned all 4), you did not indicate what their conditions/issues were. Caring for aging parents has many concerns and issues, but adding in any kind of dementia changes the rules. Also, although you are currently in good health, that could change at any time. Adding in the decline your wife will have and any potential medical issues either of you might develop, is your daughter and her family prepared to having to take on full care for you and your wife? Caring for our parents is idealistic and something many wish to accomplish, but many people on this site can attest to how devastating and overwhelming this can be/become. You even mention your concerns about this in your profile. My parents and my mother's sisters cared for their mother, however she was very easy to care for. My father's YB took care of his mother (he never married and lived with her to the end.) Neither had any dementia, just normal aging issues.

There's plenty of advice been given and a lot for you to digest. Having no experience with preparing and/or building a handicap access space, I suggest what the others did - seek professional advice. This will ensure you meet all building codes and pitfalls. I can say no way could my place accommodate my mother - full stairs access only, stairs are split with a landing, so even a chair lift wouldn't work and no room for bathrooms (both very small) to be modified for handicap access, etc. When we sold mom's condo, the people who bought it installed a chairlift, so the wife could access the finished basement area. Personally I thought this was a huge mistake for them! Having video cameras installed for when mom was living there and before the sale, I watched her struggle to get up the 3 steps and over the threshold to get into the place with her walker. One MC place we checked was off the list quickly for many reasons, but a big one was that it was located on the second floor. How do you get all those people with cognitive issues out, many with walkers or wheelchairs, in the event of a fire or other emergency without using an elevator?

There are many comments posted about the stairs/access. That is a big concern. While there are options, such as stair lift, lift, elevator, those may not be practical. Without knowing what area of CA this is in (fire risk?), there are and will be power outages anywhere. Will you have enough backup power to use a lift of any kind and/or run heat and A/C? In the event of a fire, elevators should not be used, so that might not be practical. Other issues are access to senior services, emergency services, etc (is it a remote area?)

Others have also suggested you consult with an Elder Care attorney. You need to protect yourselves and your assets. If you plan to put money into the building of this "apartment", will MediCal (CA form of Medicaid) consider it "gifting"? Even if there is no Medicaid issue, many states have residency requirements (I have read 2 years, but it could vary by state.) Do you (and your children, as backup) have the DPOAs and MPOAs set up for both of you? If something happened to your daughter, would SIL want to continue this arrangement? As someone else said, if they split up (it happens!), where does that leave you and any investment you make in the building? Please do find a good EC attorney and discuss everything - this arrangement, wills, trusts, POA, etc.

You have a lot more thinking/planning to do. Even with the best laid out plans, there are likely to be other issues that arise too. Although AL can be expensive (would it be more than this building?), a nice one near one of your children might be a better option.