Of the 308 million or so people in the United States, more than 72 million are now 55 or older. Census figures predict that by 2030, nearly one in five U.S. residents is expected to be 65 and older. In fact, another person probably turned 65 in the time it took to read this paragraph (approximately one every eight seconds).
As these baby boomers retire at a rapid pace, they will be looking to maintain quality of life in their later years. Most want to avoid assisted living as long as possible, and many have the financial resources to achieve that goal. The resulting trend toward aging in place offers multiple opportunities, most of them representing a lucrative untapped source of revenue — based on cash — for home medical equipment providers.
As well as construction designs (think wider doors and level thresholds), accessible living trends impact various types of equipment: Think access ramps, stair lifts, overhead track systems, bathroom products, environmental controls and more.
"Consumers are starting to learn more about these products, and they realize there are alternatives to selling their homes or moving into an assisted living facility," says Conor Sullivan, director of marketing, Harmar Mobility.
To build this business, Sullivan says, "the best place for DME/HME providers to start is with their existing customer base." For example, he says, "There's a good chance if a customer is using a power chair or scooter they could also be in the market for a vertical platform lift or a stair lift." Advertising in local media is another good way to find clients, including those who may not yet need a power chair or scooter but can use assistance going up or down stairs, Sullivan adds.
The NextGen Medtrade Accessible Home, built on the show floor at Medtrade in November, offered attendees a glimpse of the opportunities available in the accessible living market. The 1,500-sq.-ft. home featured home health care scenarios in real-life settings with actual equipment used to provide care. The Heartland Home for Independent Living, a similar display at VGM's Heartland Conference last June, also alerted providers to the opportunities in the accessible living market.
Reaction to the NextGen home was "overwhelmingly positive," says Sullivan, noting interest from providers who might previously never have paid attention to products such as lifts.
Start in the Bathroom
Brad Crozier, senior product/brand manager, Moen Home Care, says his company was also pleased with response to the NextGen home. "It was another nice destination for our customers to go and see how products look in the real-world environment," he says.
Crozier even admits there were products displayed in the home that he didn't know existed.
The bathroom is a good place to start when making a home accessible, he notes, and Moen offers a range of products to help ranging from shower seats and grab bars to toilet seats, rails and single-handle or high-arching faucets that can work along with low-barrier or no-barrier showers and other features to enable elderly or disabled residents to maneuver safely.
"The bathroom is definitely a high-traffic area in the home, and anything you can do to make it accessible will have an impact on someone who is older," says Crozier.
New technologies such as digital shower controls (that use a remote control) can be helpful, as can strategic placement of fixtures and faucets and additional area under the sink to promote maneuverability. Moen offers the ioDigital system, introduced last year, which provides precise control of shower temperature and flow.
To help providers promote such accessible living products, Moen offers a course on universal design. New products from the manufacturer include a line being introduced in February that integrates grab bar functionality with familiar bathroom accessories such as towel bars, toilet paper holders and shelves.
"Individuals tend to grab the toilet paper holder when they are standing up," Crozier notes.
Showing the Possibilities
The success of the accessible home displays at Heartland and Medtrade offers a lesson that providers can apply by creating a realistic home environment in their showrooms.
"It's a nice way to show what possibilities are out there," says Crozier. He advises providers to "create an environment in the store that allows a customer to picture how [a product] would look in the home … If you can show it and show how to use it, it's much better."
Another high-profile company at the NextGen home was EZ-Access, which partnered with Homecare Products sister division Access One to show modular access ramps.
"As a manufacturer of wheelchair ramps, we have experienced record growth in an uncertain economy," says Frank Westby, manager of business development, EZ-Access. "We are looking at a record year. DME dealers are coming to the conclusion that they can't service their mobility customers without providing ramps," he says. "Anybody offering mobility devices should be offering a ramp to go with it. When customers buy a wheelchair or scooter they are looking for mobility. If we don't sell them ramps, we are only selling them the device, not the freedom it provides."
But Westby sees a Catch-22 situation related to HME suppliers and the ramps business. That is, providers are not offering ramps because customers aren't asking for them, and customers aren't asking because providers are not offering them. However, he notes, consumers are calling in contractors to build needed ramps; in fact, Westby says, his company's biggest competitor is wood, even though building a wood ramp takes longer, involves pouring a concrete footing and requires a building permit for a permanent structure.
"In most cases, aluminum modular ramps aren't considered a permanent structure," says Westby, and they can be installed over existing steps and other structures without having to rip out infrastructure. The home owner doesn't have to rebuild the porch, "and they can take the aluminum ramp with them when they move."
Westby says his company's ideal business model is to sell through mobility suppliers, but he finds that a lot of contractors are also getting into home modification and aging-in-place solutions. One strategy for providers, he says, is to make local builders aware of the simplicity of installing aluminum ramps versus building wood ramps.
Westby sees synergy between aging-in-place contractors and HME providers. "I assure you that the customer who bought that mobility device is going to buy a ramp, either from you or from the contractor down the street. In some cases we are making introductions to connect dealers with contractors. The less the end-user has to do, the happier he or she is."
Neither should providers be intimidated by choosing the right ramp for a customer's needs or ramp installation. "We will teach you as much as we can about what you need to know," he says. "We will also take the customer's specification and create an engineer's drawing of what the ramp will be, along with costs, estimated time to install and the suggested retail price."
The manufacturer encourages providers to exhibit a ramp on the showroom floor. "Sometimes they avoid talking about ramps because they don't know where to begin," Westby says.
Overcoming Obstacles
"Putting products in a real-life situation really drives it home," says Gary Nowitz of his company's participation in the Medtrade NextGen home.
Nowitz, vice president of lift maker Ergolet, agrees that selling only a wheelchair or scooter is equivalent to providing half a solution, and he points out that customers look to their HME providers as professional consultants for information about what other products they might need. For example, no one would go to a construction company for a wheelchair or walker, and it's the same customer base looking to make their homes more accessible.
But one obstacle to selling lifts, Nowitz says, is convincing providers that installation is not a problem; it can be as simple as a site evaluation. Ergolet works with providers to develop autoCAD drawings to present to customers based on data from a site accessibility survey. Information needed to put a plan together includes questions about attic access, whether a system will be wall mounted, what type of transfer is needed and the ceiling height.
"The dealer sends a site evaluation to us, we analyze the information and send an autoCAD drawing," says Nowitz. Alternatively, the manufacturer can create an animation video to demonstrate the proposed solution based on photographs taken of the room with actual familiar objects incorporated into the video. If a provider can install a stair lift or a modular ramp system, says Nowitz, "they can do this as well."
Ergolet's products include the Luna overhead track system that can function as a fixed lift, a portable lift and provide room-to-room transfer. The company also makes the E Track wall-mounted lift; the Sole battery-powered mobile lift for patients who are not weight-bearing; and the Stella sit-to-stand lift.
Providers are "leaving revenue on the table if they aren't considering all the possible solutions," says Nowitz. "In many cases, dealers are going out to offer home evaluations or assessments before providing a mobility device. It's a best practice for rehab providers and a perfect opportunity to point out obstacles in the home."
Some HME companies are training delivery personnel to perform home evaluations and are using various certification programs, including the Certified Aging In Place Specialist (CAPS) designation provided by the National Association of Home Builders or VGM's Certified Environmental Access Consultant (CEAC) (see "Homing in on a New Idea").
All About Solutions
Also on display at the Medtrade home, AbleNet demonstrated electronic aids for daily living, including switch-activated systems to enable residents to answer the phone, open a door, turn on a bedside lamp or fan or change the television channel. The company offers more than 700 products in five different divisions, all falling under the assistive technology umbrella and aimed at allowing people with physical limitations or other disabilities to maintain quality of life.
For example, someone with a spinal cord injury might drive a power wheelchair with a head-control and have an environmental control unit mounted on the chair. Alternatively, a sip-and-puff straw could be used to dial the phone, change the channel or raise and lower a hospital bed. There are some 40 different styles of switches that can be matched up to the ability of the user, says Thomas Nikola, AbleNet national account manager, environmental controls.
The company also offers a lower-end Easy-Tech line of environmental control products.
"The industry is looking at how we can provide independence cost-effectively," says Nikola. "There is definitely a need for easy-to-install, easy-to-train and cost-effective systems. There may be products people are not aware of, so we try to educate them as much as possible. It's all about solutions: What are the solutions out there? I still have dealers who tell me, 'Hey, I didn't know that stuff was available.'"
Adds Moen's Crozier, "When you talk about accessible design, it doesn't need to be just about old people, but a design that can benefit people of all ages. As we get smarter about products we design, they can benefit all ages."
- Read the "Homing in on a New Idea" sidebar to learn why HME providers should enter the accessible home arena.
Experts Interviewed
- Brad Crozier, senior product/brand manager, Moen Home Care, North Olmsted, Ohio
- Conor Sullivan, director of marketing, Harmar Mobility, Sarasota, Fla.
- Thomas Nikola, national account manager, environmental controls, AbleNet, Roseville, Minn.
- Gary Nowitz, vice president, Ergolet, Minneapolis
- Frank Westby, manager of business development, EZ-Access, division of Home Care Products, Algona, Wash.
