About 25 million Americans who are aging in place rely on help from other people and devices such as canes, raised toilets or shower seats to perform essential daily activities, said a new study documenting how older adults adapt to their changing physical abilities.

Nearly 60 percent of seniors with seriously compromised mobility reported not leaving their homes. Twenty-five percent said they often remained in bed. Of older adults who had significant difficulty putting on clothes, 20 percent went without getting dressed.

The study, by Johns Hopkins University, focuses on how older adults respond to changes in physical function — a little-studied and poorly understood topic. It shows that about one-third of older adults who live in the community — nearly 13 million seniors — have a substantial need for assistance with daily activities.

For older adults and their families, the report is a reminder of the need to plan ahead. Yet, a companion report illustrates the complexity as many older adults who require long-term support face financial strain. Slightly more than 10 percent of seniors with high needs experienced at least one type of hardship, such as being unable to pay expenses like medical bills or prescriptions (5.9 percent), utilities (4.8 percent) or rent (3.4 percent), or skipping meals (1.8 percent).

“The reality is that most of us, as we age, will require help at one point or another,” said Bruce Chernof, president of the Scan Foundation. “We need to lean in much harder if we want to help seniors thrive at home as long as possible.”