By 2034, the country’s population of residents 65 and older will overtake the number of children for the first time in U.S. history, according to Census Bureau estimates. These adults are confronting choices about the homes they’ll live in as they age.

Homeowners who are past considering school districts or career moves may need to be closer to doctors or grocery stores. They may face health challenges and difficulty navigating an increasingly inaccessible home. Maybe they are newly alone in a too-large house. Maybe they can no longer afford property taxes or handle maintenance.

Many homeowners who want to live the rest of their lives in their current homes can’t because their homes don’t fit their needs.

“A dream home can become a nightmare home,” said Rodney Harrell, AARP’s vice president of family, home and community.

Circumstances change. Here are some considerations for aging homeowners deciding their next move.

Preparations should start early

Carefully considering options, including whether and where to move, is easier when there’s no rush.

Stuart Dubbs, an agent with Re/MAX Real Estate based in Allentown, said she worked with a husband and wife who never wanted to consider leaving their home. Within a few years, they both got sick.

“And then it got to a point where they had to make a decision in a hurry, which made the whole process very upsetting,” Dubbs said. “Whereas if they had realized what they were up against, they might have made a move two years earlier.”

Harrell said home buyers of all ages should keep potential long-term needs in mind if they think they might want to stay in their home for a while. And homeowners who remodel should consider including adaptations or eliminating barriers so they can age in place if they want.

“The idea would be to think about the kind of home that doesn’t force you to compromise as you age, that allows you to thrive,” he said.

Deciding whether to age in place, move to a smaller home, or move into some type of senior living community is stressful.

» READ MORE: Couple find novel way to downsize after 45 years in the same house

“It’s important for people to recognize it’s very common to be anxious about that feeling of loss, of transition and change, and be gentle with themselves,” said Karen Buck, executive director of the SeniorLaw Center in Philadelphia. People should make plans for their future housing right alongside estate plans, she said.

Jill Kearney, founder of Allentown-based Specialty Moves by Design, said she’s found that questions about what to do with belongings and how to sell homes hold people back from making a move. (In the current strong seller’s market, selling is less of an obstacle now. Buying may take longer.)

Tackling a house — and decades worth of stuff — takes time

Senior homeowners may reduce their space by a thousand square feet or more when they move. Even if downsizing is years away, it’s never too early to start decluttering. Yet parting with belongings accumulated over 40, 50, or 60 years can be overwhelming.

“I always tell clients whoever said ‘don’t sweat the small stuff’ was not downsizing a house,” said Megan Bond, who founded the move management company Complete Transitions in Chester County about five years ago to help older adults downsize.

She suggests that homeowners stick to binary yes-or-no questions such as “Do I love this?” and “Is this going to fit?” as they go through belongings, rather than trying to find new homes for each item.

“You will run out of time and run out of energy super quickly,” she said.

Downsizing and moving specialists can help

Professionals called senior move managers, such as Bond and Kearney, specialize in moving older homeowners and are busier than ever.

First, the move manager visits the client’s home to assess needs, recommend services, and estimate cost. Consultations are usually free, so people with limited disposable income can at least get an idea of what they need to consider.

» READ MORE: After being downsized, a career in paring down began

Move managers use the floor plan for the client’s new home to gauge what will fit. They act as an impartial party to help sort belongings, which can be emotional. They help clients donate, sell, or trash what doesn’t make the cut.

Some clients want someone to go through every drawer with them. Others need help only with their move.

“Senior move managers will do as much or as little as you need or you can afford,” Kearney said.

» READ MORE: Welcome to ‘Café Diane,’ proof that downsizing to a studio apartment doesn’t have to be horrible

Move managers can fully pack and unpack boxes and arrange items in the new space. They make beds, connect TVs, and hang artwork.

Cost depends on the extent of the work move managers do, the amount of belongings, and the distance of the move. Most clients of Bond’s Complete Transitions pay $3,000 to $5,500.

In September, Jim and Deanna Robinson, who are in their mid-70s, used Specialty Moves by Design to move from their ranch-style house with an attic and basement in Allentown to a full-service retirement community just outside the city. Their cottage is about half the size of their old home, where they’d collected “an impossible amount of stuff after 49 years,” Jim said.

The company packed anything they didn’t want to or couldn’t pack themselves, coordinated with the movers, and helped unpack.

“It was much less stress than I anticipated,” he said.

Options vary for unwanted belongings

Habitat for Humanity, the Salvation Army, Goodwill, and Vietnam Veterans of America are a few nonprofits that take household donations. Homeowners can sell items through yard sales, consignment shops, and online marketplaces.

To speed up the process and avoid interactions with strangers, some homeowners outsource sales to companies such as the online auctioneer MaxSold. The company, which has a U.S. headquarters in New York, specializes in selling items in bulk for people downsizing and settling estates.

» READ MORE: Why many older homebuyers are ‘smart sizing,’ not downsizing

MaxSold sends a team to photograph and catalog items from cleaning supplies and boxes of extension cords to china and cars. The company posts the items on its website for auction and charges clients 30% of sales and a $700 fee.

MaxSold oversees payment collection and pickup of items. The process from photographing to pickup takes about two weeks.

“It’s really magic,” said Sushee Perumal, chief executive officer at MaxSold. “Forty years worth of goods just go away in that 14-day period.”

Aging in place takes planning

Decluttering also can help people stay in their homes by eliminating tripping hazards and creating a healthier space.

Some people relocate to their home’s first floor to avoid steps. If they have the means, they expand powder rooms to full bathrooms and turn living rooms into bedrooms. Some homeowners move into an in-law suite while adult children move into the main section. Sometimes a group of friends moves in together.

» READ MORE: Seniors in Philly are aging in place with the help of community ‘villages’

“We know people want to stay in their homes and communities as they age,” Harrell at AARP said. But “there’s a huge gap” between those who want to stay and those who can because of incompatible home features such as narrow hallways, stairs, and fall hazards.

Older adults can receive help — often for free if they meet income limits — to repair and modify their homes so they can age in place.

The Philadelphia Corporation for Aging, for example, offers the Senior Housing Assistance Repair Program. Philadelphians age 60 and older can get doors, steps, toilets, and electrical fixtures repaired or replaced. The program installs railings, peepholes in doors, and porch cameras and intercoms. Most modifications happen in bathrooms, where workers install grab bars, tub benches, and handheld showers.

» READ MORE: Philadelphia’s affordable housing strategy depends on repairing existing homes

The goal is to make sure people who want to stay in their homes are safe, said Mark Myers, the Philadelphia Corporation for Aging’s housing director.

Seniors can call 215-765-9040 to apply for the program, which has a wait list.

Needs — and means — drive choices for senior communities

Options for planned communities vary depending on needs and income. Age-restricted places that limit residents to 55 or 62 and older generally offer private homes and assistance with maintenance. Residences can include detached homes, townhouses, condos, or apartments. Community centers offer activities, meals, and companionship. Communities also can be expensive.

Residents can choose independent living, assisted living, or skilled nursing care. Continuing care retirement communities offer all of these in one place, so people can stay as their needs change. Potential residents need to figure out what kind of help they want or need and what they can afford.

» READ MORE: Choosing a retirement community isn’t easy. Here’s what you need to know.

Anyone considering moving to a community should visit several options, see all parts — independent living through nursing care — talk to residents, calculate long-term costs, and ask about COVID-19 vaccination, testing, and quarantine policies, said Buck of the SeniorLAW Center.

They should review contracts carefully with loved ones or a lawyer and negotiate provisions, including those restricting the right to go to court over disputes and appointing a person to make decisions about the levels of care they receive as they age.