Will you be able to die in your home? Gretchen Kingma Occupational Therapist turned real estate

About this episode

Vance interviews Gretchen Kingma, a St. Louis occupational therapist turned real estate agent who has built a niche helping aging parents and their "sandwich generation" children navigate housing decisions. Kingma explains her origin story: after years working in senior rehab, she grew frustrated watching patients discharge into homes that hadn't changed, guaranteeing repeat falls and hospital readmissions — a "revolving door" problem that pushed her into real estate so she could fix the built environment proactively rather than treat injuries reactively. The conversation's emotional core is her family's own story: her father's stage-four cancer diagnosis forced an urgent home search in 2021, and Kingma used her professional eye to spot an overlooked bungalow with a sloped lot that could be converted into a fully accessible one-level living space — the ramp she built later served as her sister's wedding aisle and the backyard where her father watched his final Cardinals season before passing at home. They discuss the "Universal Design Ready" criteria her advocacy group developed (two or fewer entry steps, ground-floor bed/bath/kitchen, 34"+ hallways) and its uphill battle for MLS adoption, the coming "silver tsunami" demographic inversion by 2035, funding/insurance gaps (long-term care insurance, HUD/Medicaid inconsistency across states), and practical advice — start planning around age 55-60, build proactively rather than reactively (most families act only after a hospital-bed crisis). Vance connects her thesis to his own Legacy Interviews business, noting how object-hoarding among the elderly is often really about preserving unspoken stories, and Kingma agrees, describing her planned "Downsizers Club" as a proactive, celebratory alternative to reactive decline. The episode closes with municipal zoning barriers to accessory dwelling units (grandparent suites) and a call for builders to design elevator-ready closet stacks into new construction from day one.

“The statistic is 2035, which is essentially tomorrow, there'll be more people 65 and older than 18 and under for the first time in US history.”

“That ramp served as the aisle for my sister's wedding because she got married in my parents' backyard so that he could be present... So it was one of those things... but with a little bit more forethought, planning and background, I was able to identify this could be awesome.”

“I am an occupational therapist turned realtor, and I help seniors answer the question, where do we go next? I marry healthcare with housing and I educate and equip seniors so that they're empowered to experience joyful aging on their own terms.”

Key moments

• early ~1-5%: Kingma cites the 2035 demographic statistic — more Americans 65+ than under 18 for the first time in US history.
• early ~10-20%: Her career pivot story — repeat hospital readmissions as an OT convinced her the "environment," not the patient, was the real problem, prompting a real-estate license during maternity leave.
• middle ~25-35%: The family crisis — her father's stage-four cancer diagnosis and sudden need to sell the two-story family home led her to spot an accessible bungalow others would have overlooked.
• middle ~35-40%: The emotional payoff — the accessible ramp/patio became the site of her sister's backyard wedding and her father's final months and death at home.
• middle ~55-60%: The "Universal Design Ready" (UDR) criteria her advocacy alliance proposed to the Governor's Council and the MLS (rejected for now).