Creating a barrier-free home also assists in-home healthcare workers

In this article we are going to discuss modifying a home to make it easer to move about for those who use wheelchairs, walkers or other mobility enhancing devices. Modifications are generally disability-specific i.e. One's specific lack of functionality dictates the needed modification. Accessibility is a fault of the environment, not the person. We live in a world that naturally caters to people without physical impairments, even though we could start making everything universally accessible.

Universal design is intended to create environments that can be used by all people, to the greatest extent possible, without the need for adaptation or specialized design. Making the entire home barrier-free for humans, regardless of apparent disability, throughout the life-span. Great universal design makes it so that you can hardly even tell that the home is barrier-free...everything blends.  These modifications are not just for people who are disabled. In many cases medications, such as the ones taken for high blood pressure, can make one feel dizzy and off balance. These simple modifications can be helpful to a wide variety of people.

Here are some of the more common universal design features that are also incorporated into aging-in-place remodels according to the National Association of Home Builders and other sources.

• No-step entry. 

No one needs to use stairs to get into a universal home or into the home's main rooms.

• One-story living. 

Places to eat, use the bathroom and sleep are all located on one level, which is barrier-free.

• Wide doorways. 

Wide doorways, hallways, all-ways, 32-36", make passage with a wheelchair doable, as does 5' turning diameters around objects (like in a bathroom). 

• Wide hallways. 

Hallways should be 36-42 inches wide. That way, everyone and everything moves more easily from room to room.

• Extra floor space. 

Everyone feel less cramped. And people in wheelchairs have more space to turn.

• Floors and bathtubs with non-slip surfaces, handrails on steps and grab bars in bathrooms.

• Thresholds that are flush with the floor make it easy for a wheelchair to get through a doorway. Good lighting helps people with poor vision. Lever door handles and rocker light switches are great for people with poor hand strength. 

• Ramps are probably the most common modification. Stairs aren't good for wheelchairs, but also not great for anyone with a mobility impairment.  Ramps come in all shapes and sizes, from portable to permanent and very large to "threshold" ramps. 

• Automatic door openers make access to the home much easier.

• Hard floors are easier to navigate than carpet and commercial padding with low-pile carpet is better than plush. 

• Use lever door handles instead of knobs

• Roll under sinks with cabinet doors that hide that it's a roll under. 

• Lower cabinets OR smart food placement (frequent foods in accessible spaces). 

• Side by side fridge vs over under makes opening and accessing easier.

• Raise the washer and dryer with the drawer accessory many offer and ensure front access vs. top access.

• Stove-top knobs should be located in the front to avoid reaching over hot surfaces.

• Stairs? Get a chair lift or spend more for a wheelchair platform lift, or get a residential elevator.

• Get rid of those rugs on the floor, especially in the kitchen. They're trip hazards and broken hips waiting to happen. 

• Roll in shower or tub transfer bench or bath seat lift (Invacare). 

• Handicapped height toilet or raised toilet seat from a local DME. Throw a toilet seat frame on there to make sitting and standing easier. 

• Prevent scalding with hot water governors

• Keep a phone in the bathroom in case of a slip and fall, or get a life alert. 

• Raised sofa or chairs make getting up easier. Also could get an auto recliner with lift function. 

• Place night lights throughout the house to help prevent falls. 

• Remote control anything can make life easier. Smart Home technology is becoming relevant to the average user. The home-owner can use Apps to control their smoke alarm, thermostat, alarm system and other home features from their smart device. There are several companies getting into this area. Google Nest has an App for smart home technology and so does Apple. Apples App is called Savant and works well on Apple products such as the ipadTM etc. Do a search for “smart home technology” or “smart home solutions” and pages of companies will pop up.

These home modifications assist the patient as well as their family or in home care services. As people age and their bones become frail it is especially important to remove barriers and obstacles that might cause them to trip and fall, or just make it difficult to move about the home. Hallways may have to accommodate home health aides that push the patient in a wheelchair or walk next to them in their walkers. Many of these suggestions improve safety and facilitate independence. Ideally one should be able to stay in their home throughout all stages and ages. These tips combined with the services of a home healthcare services company or nurse registry can significantly increase the time a person can live in their home as disabilities or progressive disease encroaches on their lives.

I would like to thank Brian F. Sheridan for much of the information that is presented in this article.

Brian F. Sheridan, OTR

Level Eleven Physical Therapy

This post is brought to you by Angel Care Nurse Registry

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