Accessible home design and modifications for the elderly and people with disabilities

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Accidents happen and you could find yourself using a wheelchair or walker. As we mature and grow older, getting around our home becomes more difficult.

Your home can become more accessible with a few minor home accessibility modifications.

Most of us would choose to live and retire in our own home rather than move to a nursing home or assisted living center. Your home can be modified to accommodate your changing needs.

What makes an accessible home? It's the ability to enter and move around without any of the obstacles such as steps and narrow doors.

But there is so much more to consider when making a home fully functional and accomodating for the elderly or people with disabilities.

Making your home accessible with simple home modifications, can improve your lifestyle and the ability to live at home.

The following article gives ideas for accessible home design and home accessibility modifications for various areas and rooms of your home to make them wheelchair accessible and more accessible for the elderly and people with disabilities.

Accessible home design for the elderly and people with disabilities.

Bathroom

Wheelchair users need larger bathrooms to allow for maneuvering. Allowing space for knees and toes of a person in a wheelchair below fixtures can partially meet this requirement.

Bathroom storage should accommodate an array of items. Wheelchair users’ storage needs may include extra medical equipment and disposable products. Consequently, bathrooms should include generous storage capacity.

Bathtubs can be very hazardous. Transferring from a wheelchair to the tub can be difficult. The tub area must be carefully designed to provide maximum safety. Bathtub and shower grab bars can be installed to provide support. Tub transfer seats allow persons to sit in the tub and take a bath or shower without having to lower themselves to the tub floor. Many people find it difficult to use a tub because it can be difficult to step in and out of a bathtub because of the high tub walls, so tubs can be replaced with walk-in bathtubs, wheel-in showers or walk-in showers (with a curb).

The size of most existing bathrooms limit the options to a tub to shower conversion. This limits the dimensions of the shower to the same floor area as the tub. A wheelchair will fit into the area but it is tight. The bathroom floor will get wet. Wheel-in showers are not only easy for wheelchair users to use, but can be aesthetically pleasing and even luxurious. Prefabricated, fiberglass/acrylic roll-in shower floors are available in the same size as your standard 5" tub.

Toilet seat height varies from one individual to another, usually between 17" to 19". Toilets can be replaced with special units or raised seats can be installed. Grab bars should be installed for balance and support and to allow individuals to safely transfer to and from a toilet.

Sinks can be installed to allow wheel chair access. Vanity cabinets can be removed from below the sink. This will expose the plumbing pipes requiring covering with insulation or boxed in to prevent contact with sharp edges and burns by hot water pipes.

Faucets can be replaced with single lever controls.

Consider the use of anti-scald temperature controls that prevent the water temperature from exceeding an established limit.

Install grab bars and safety hand rails to insure you won't lose your balance and provide a safe surrounding. Grab bars provide stability for everyone, including the elderly and those with disabilities and is the most cost effective home modification. Handrails and grab bars should be placed no more than 1 1/2" from a wall to prevent a person's hand from getting caught between the rail and the wall. Also, bars should be 1 1/4" to 1 1/2" in diameter to allow ease in gripping.

The Solid Mount allows the installation of grab bars into existing fiberglass shower and tub walls. The Solid Mount installs through the face of the fiberglass using a patented mounting assembly that attaches to the stud, filling the hollow space, sealing the hole and leaving a mounting surface to which a standard grab bar can be safely attached.

Vanity lighting for wheelchair users may require minor adjustments to conventional arrangements. Most wheelchair users, for example, cannot get close enough to the wall mirror for focused activities such as shaving or applying make-up. A portable self-illuminated mirror set on the vanity top is often helpful.

Doorways

In order to accommodate a wheelchair, (a standard wheelchair is 24-27" wide), doorways should be a minimum of 32" wide. If the doorway is located in the typical hallway and requires turning a wheelchair, you'll need a 36" door. It can be difficult to open a swinging door without a clear floor space (18-24") on the pull side of the door. An alternative could be the installation of an automatic door opener.

Doors can be widened for wheelchair and walker access by removing the existing door unit, relocating any light switches, widening the framed opening, installing a new wider door unit and repairing the flooring if necessary. A swing away door hinge is also an option and will increase the door width by 2".

We don't recommend a folding door because of the space it takes up in the door opening. Pocket doors can be an option.

Additional door clearance can be economically obtained by using the swing clear, expandable door, offset door hinges, increasing the width by about 2", and is often enough to provide the necessary minimum width for a wheelchair or walker to pass through the doorway.

Door closers and openers, such as automatic and delayed-action closer, will allow passage for the mobility disabled and wheelchair users.

Door knobs and locks are another major consideration in accessibility. Standard round door knobs and other types of handles which require grasping, twisting, or pressure are often unmanageable for those who are unable to use their hands or who have diminished strength and grasping ability. Ideally, standard mortised lock and knob sets should be replaced with lever-style handles. In those instances where knob and lock replacement is not possible, several manufacturers offer lever handles that fit over the existing knob.

Kitchens

It can be difficult for people in wheelchairs to use standard counters because of the cabinets below. Under counter base cabinets can be removed to provide access to the sink or work area. A pull out or drop leaf shelf can be added for working space. Sliding shelves can be installed in lower cabinets. Electric receptacles, garbage disposal and exhaust fan switches can be moved to the front of the counter or cabinet.

Sinks can be installed to allow wheel chair access. Cabinets can be removed from below the sink. This will expose the plumbing pipes requiring covering with insulation or boxed in to prevent contact with sharp edges and burns by hot water pipes. Sinks may be located at a height of 36". If space is provided underneath, pipes should be covered with piping insulation in case the user has no sensation in their legs.

In most cases, a single-lever handle that controls both water temperature and flow rate is recommended. Installation of a hand-held spray and a tall “gooseneck" spigot is also recommended to make it easier to rinse deep pots and fill tall pitchers.

A side-by-side refrigerator is best for the mobility impaired and wheelchair users.

Built in ovens at counter height is reachable for wheelchair users and the elderly. Cooktops should be placed at 30" is convenient for wheelchair users and others. No space should be allowed underneath because of the danger of hot spills.

Extra counter space should be provided in pull-out work surfaces. These also enable a wheelchair to be placed beneath the surface. Tables with legs are more stable than pedestal legs, if users require leaning on the table in order to stand up.

Tile flooring with an abrasive face that will prevent slipping is a must in surface material selection. Joints between tiles must be kept small to prevent tripping.

If you opt for carpeting, remember to use low pile, low-level loop, or industrial type flooring that provides surer footing.

Basic work sequences can be accommodated in several different counter arrangements including U-shaped, L-shaped, and galley (straight-line) kitchens. Kitchens with island counters are a variation of one of the three basic arrangements. Of these counter arrangements, the U-shaped kitchen may be the most efficient for wheelchair users because countertop surfaces are more continuous.

Kitchen design should minimize workflow disruptions and simplify kitchen tasks. The kitchen arrangement should locate appropriate counter space next to each work center. Convenient counter space is important for wheelchair users who must set items aside each time they reposition themselves. As a general rule, counter arrangements should provide the following features:

* Refrigerator located next to a 1'6" (minimum) countertop.
* Sink and dishwasher with a 2'0" (minimum) countertop on both sides of the sink basin.
* Stove or oven/cooktop with a 2'0" (minimum) countertop on both sides of the appliance unit.

For wheelchair users, countertops should be as continuous as possible so that dishes or containers can be slid between workstations. This arrangement is preferable because it is difficult for wheelchair users to move items between unconnected counters. In some arrangements, a worktable can provide additional counter space. Tables can be repositioned to suit specific activities and stored when they are not needed.

Kneespace below cooktops enables wheelchair users to more closely approach and orient themselves to the cooking surface. Kneespace requirements are similar to those provided under the kitchen sink. For cooktops and stoves, an electric unit with a smooth ceramic surface allows cooking containers to be easily slid on and off burners in order to minimize spills.

Cooktop operating controls should be either front- or side-mounted. Rear controls create a dangerous condition where individuals must reach across burners to operate the cooktop. Control knobs and switches should be configured to allow one-hand operation and should not require tight grasping, inching, or twisting of the wrist.

Wall ovens are more convenient for wheelchair users than conventional ovens, but spill protection must be provided. For conventional ovens, the lowered oven door provides spill protection as heated dishes are removed. For most wheelchair users a side-hinged oven door is easier to operate, but it does not offer the same protection. Where side-hinged wall ovens are installed, a pullout lapboard can be installed beneath the unit for spill protection.

For more information, download the free guide to accessible kitchens

Closets

Most walk-in closet doors are only 24" wide. The door can be widened, shelves and rods lowered or adjustable shelving installed.

Frequently closets can be made accessible simply by lowering the hanging rods. When the existing rod is an integral part of the closet, a second one may be installed below it. Another option is the use of modular storage systems which include hanging rods, shelves, and drawers that can be configured to the specific requirements of the user. Powered units which raise and lower and/or rotate shelves and racks also are available.

Laundry

As with other areas, this involves providing sufficiently wide doorways, space for maneuvering, and suitable appliances. Most often, front-loading washers and dryers with easily operated, front-mounted controls provide the necessary access.

Entryways

For walkways, no obstructions or gratings should occur. A width of 4’ provides space for a wheelchair and a pedestrian to pass and also allows for a 90 degree turn of a wheelchair. However, a width of 5’ provides space for the passage of two wheelchairs and a 180 degree turn of a wheelchair.

Wheelchair ramps should be developed at a grade no steeper than a 1:12 ratio. Curbs should also be provided so that a wheelchair cannot accidentally run off the ramp or crutches or canes cannot slip off. There should also be at least 5’ of straight clearance at the bottom of the ramp. Ramps can be aesthetically incorporated into the overall design. Carpeting of the ramp also prevents slipping.

Ramps are practical alternatives if the height difference between the entry floor and yard is 18" or less. As the height difference increases, however, ramps must be lengthened to maintain a proper slope (less than 1:12). Long circuitous ramps are problematic for many wheelchair users because of the strength and stamina necessary to ascend the ramp. Construction costs for long ramps can also be significant.

Entrances should be on-grade with a slip-resistant surface and awning of some type. Also, a drop-off area should be visible from the front door. Door thresholds should be no higher than 1/2 " and tapered for easy passage by a wheelchair's small front wheels. Entrances should not include steps between the home's interior and the outside porch or stoop.

For entrances where the height difference between the yard and entry floor is substantial, an outdoor lift can be installed. Lifts can be integrated into the home's design and covered with a roof structure that protects both the occupant and the mechanism from inclement weather. Lifts can be expensive, but these costs should be compared with the marginal accessibility provided by long ramps. A combination of different alternatives can be effective. A bridge, for example, can be ramped up to reach a wood porch. Entrances can also be grouped to decrease cost. Perimeter decks, for example, can connect multiple accessible entrances from a single ramp, bridge, or platform lift.

Although there's times when a wood ramp is the only alternative, we recommend aluminum wheelchair ramps or concrete as the preferred material. Concrete, when installed properly will last many years, requiring no maintenance and can be finished with a rough texture. Wood requires constant maintenance and lasts only a few years when exposed to outdoor elements. Wood can be a real hazard, it's slippery when wet. Although slip resistance can be improved by painting the surface with a sand additive or applying those stick on grit strips, neither method will last long, requiring repeated applications. Outdoor carpet has been used, but it traps moisture and promotes rot, even when using treated wood. One solution is to apply rolled asphalt roofing to the ramp surface.

Safe travel from one room to another, or from one level to another, is also facilitated by the use of tactile warnings. Tactile warning strips may be used to mark abrupt changes in floor level, the edges of steps, and the transition from one area to another. For those with low vision, similar results may be achieved using contrasting colors or tape markers on surfaces to indicate changes. In addition, door thresholds should be flush with the floor or fitted with small beveled ramps to eliminate tripping hazards.

Dining Rooms

Dining tables should have a 4’ width for two wheelchairs or a 4'6" width for four. Tables with legs are more stable than pedestal legs, if users require leaning on the table in order to stand up.

Home Offices

Desks with lowered portions that retract when not in use provide a writing surface of wheelchair users.

To accomodate a scooter or wheelchair, a desk needs to be a special height (20 inches). In addition, worksurface is 20 inches deep--shallower than a traditional desk that averages 29 to 32 inches deep, becaus arm reach is not as extensive when you sit in a wheelchair or scooter.

Multifloor accessibility

There are three common alternatives to provide access between floor levels. These are residential elevators, stair lifts, and inclined platform lifts. Each option has advantages and disadvantages.

Straight staircases with resting places on the landing should be provided for those with mobility differences and who tire easily.

A stair lift can be installed on a narrow stairway and the track can be configured for installation in most stairwells. The collapsed chair is typically stored at the bottom of the run until it is called for use. Stair lifts are relatively inexpensive alternatives for retrofit into existing homes.

Residential elevators can provide wheelchair access to a second floor or basement or to both levels with a total vertical rise up to 50’ . Residential elevators are either cable operated or hydraulically powered and travel on a single side-mounted rail. Hydraulic models are typically more expensive, but provide smoother and slightly faster operation. Residential units vary in weight capacity, cab size, and cab configuration. Most manufacturers offer cabs that are large enough (36" x 48") and have sufficient load capacity (500 to 750 lbs.) to accommodate wheelchairs and motorized scooters.

Homeowners can specify entry doors on any of three cab walls. Elevator manufacturers also offer cabs equipped with multiple entry doors. With two entry doors, access can be provided from different directions on different floors. This arrangement greatly increases the design flexibility and reduces maneuvering for wheelchair users. Cabs with two doors, for example, allow wheelchair users to pull straight in on one floor and then exit straight ahead (rather than back out) on another floor.

If a wheelchair user is planning to construct a new house or an addition to an existing home, it can be relatively inexpensive to make provisions for future elevator installation. This approach postpones the elevator purchase and reduces future inconvenience if an installation later becomes desirable or affordable.

Bedrooms

A comfortable sleeping system with storage within reach is necessary for people with disabilities who spend more time in bed.

Living Rooms

People with mobility and visual issues need clear open spaces so that they can navigate around a room easily. You can open up your floor spaces simply by moving your furniture out of the walking areas so that you can move about without bumping into coffee tables or decorations. You can divide a large open area into several groupings for “special use” areas.

Carpet wearablility and institutional versus residential appearance must be taken into consideration when selecting. Also, mobility of a wheelchair on certain types of carpet is a consideration. Make sure that the living area flooring is non-slip and level. Thick carpeting and area rugs that are not tacked down are a hazard and an accidental tripping waiting to happen.

If you are replacing flooring consider matte finishes in wood, tile, stone or cork to reduce glare.

Lighter color schemes should be applied in rooms with large or many windows as to prevent the "dazzle" often caused with drastic differences in light levels, and for people to recognize objects near the window.

Well-textured patters should be used on wall coverings. Slick, shiny surfaces offer no friction for stability and may cause glare that can be visually confusing.

Lighting and environmental controls

Lighting and environmental controls play a large role in making a home accessible to people with low vision and other disabilities. Lighting should be bright and at consistent levels throughout the home, but care should be taken to eliminate as much glare and reflection as possible.

Lighting systems that sense people in a room, automatically turning lights on when someone enters a room and turning lights off when the room is unoccupied, are an option in lighting control.

Light switches with large controls are easy to use and often come with dimmer capabilities to adjust the amount of light needed for task surfaces. Avoid halogen lighting as it can cause retina damage.

Light switches can be relocated and made available from a wheelchair height.

Recessed lighting under stairs should be provided to prevent accidents.

Thermostats should have raised, easy to read numbers. Controls with audible clicks are also helpful.

Computerized environmental control systems are also available, allowing lights, televisions, stereos, heating and cooling systems, security systems, etc. to be controlled from a computer keyboard, remote control units, switches, or via voice command.

Security

Security is another consideration. Push-button locks which disengage when the door is opened from the inside are among the easiest to use for people with disabilities, but may not provide adequate security. Some options include slide bolts, remote control locks, electronic keypad security systems, and in some instances, push-button padlocks.

Download the The Do-able Renewable Home to identify and explain the design concepts, products, and resources that can help make an existing home more comfortable for the elderly and people with disabilities - courtesy of AARP.

Free eBook on 100 ways to make your home more accessible

The Accessible Home is for anyone concerned with making a home convenient and accessible for someone with a physical challenge of any kind. It is written for the homeowner who has begun to recognize the effects of aging. It is also for the reader concerned with the quality of life of aging parents, who would like to give them the emotional and financial dignity of remaining at home rather than moving to an assisted living situation. The book will also be of interest to readers wanting to make a home more convenient for young children or grandchildren. It's a book for almost everyone. It includes nearly two dozen complete how-to projects, but also is an indispensable home design planning guide for readers who are more likely to hire contractors for the work of modifying for building a handicapped accessible home.

Creating the handicapped accessible home is based on the principles of Universal Design-the practice of planning new buildings or updating existing structures so they are conveniently usable by all people-from small children to physically impaired elderly people. These are not homes designed exclusively for handicapped individuals, but for all residents. The book includes not only the expected construction projects - building an entry ramp for wheelchair access, installing curbless showers and grab bars in bathrooms, the installation of intercom systems and assisted-listening units, installing hands-free controls for switches and electrical fixtures, making computers and other electronics more user-friendly.

This book examines all areas of the home design. Outdoors: motion-sensor security lights; wheelchair ramps; raised gardening beds; keyless locking systems; barrier-free entrances. Bathroom: anti-scald faucets and showers; entry-platform tubs; shower seats; grab bars; pocket doors. Kitchen: low-level work surfaces; accessible appliances; easy-open cabinets and storage accessories. General living areas: handrails; wide, non-slip steps and floor surfaces; easy-operating electrical switches and outlets; hands-free door handles. Each major section of the book includes a product guide listing helpful accessories, building material, and devices to enhance a home's accessibility.

Grants for Disability Accommodation in the Home

If you have concerns regarding the affordability of home modifications, you will be relieved to know that there are many ways to receive grants for home modifications to cover part or even all of your expenses. There are many organizations at national and state levels dedicated to providing financial support to citizens living with disabilities.

In order to be awarded grant money, you will need to demonstrate how you will use the funds, and why you should receive these benefits over other grant contenders. Different organizations will have different requests on what to include in your personal application. Typically with disability-related grants, you will be asked to fill out a form rather than develop a proposal on your own. Most grantors simply request that you share your unique story, as well as what you hope to accomplish should you receive the grant. Don’t be afraid to be personal and honest – these grants were created to make a difference in recipients’ lives and wellbeing, so the reasons you feel you are deserving of them are important.

Home Accommodation Cost Guide for People with Physical Disabilities

Financial Assistance for Accessibility Home Repairs and Modifications

Home Accessibility Costs

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