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Chapter 20
Home Modifications: Making Your Home Accessible

 

Making your home accessible can mean many things. Your home may need only a few changes, such as a ramp to the entrance or grab bars in the bathroom. Then again, it may need even more involved modifications, such as wider doorways and hallways, lower windows, or an elevator or lift.

As part of your rehabilitation program, your therapists may make a home visit with you. At that time, measurements will be taken and accessibility issues will be discussed. This will help you plan any modifications you may need. If you live outside of your SCI center's area, your therapists will still help you by using floor plans of your home and giving you printed materials as a resource.

In making your home accessible, there are many specifications to make sure any changes are safe and can meet your needs. These changes often need to be adapted to your particular situation. Your occupational and physical therapists are good resources for this information.

Your social worker can help you look at the resources you may have for designing home modifications. You will also be able to explore possible funding for this project through governmental or other community services.

This chapter makes recommendations for heights, widths, distances, and other home specifications. Before you jump into anything, let us help you figure out exactly what meets your needs. There are blank spaces by the drawings for you to fill in the requirements of your own specific needs.

Please note that throughout the chapter, we will use the following abbreviations:

inch or inches = " like 9" for 9 inches
foot or feet = ’ like 2’ for 2 feet

 
HAVE THE WORLD AT YOUR FINGERTIPS

You bring home a bag of groceries. You cruise up your ramp and into the kitchen. Placing the bag on the counter, you turn around to put something in the fridge and... Oh, no! The bag dumps over and all your oranges and apples roll to the back of the counter. Can you reach them?

Perhaps the barrier is something as simple as having a bathroom in which you need to go out in order to just turn around, or a sink that hits you right in the armpits, drenching your clothes every time you do the dishes.

It becomes apparent that most ready-made buildings were not made ready for you! So, customize them. Plan ahead and in no time your house will really be your home.

The diagrams of wheelchair dimensions and levels can get you started in making sure work counters, tables, doors, etc., are accessible to you and your wheelchair. (See figure 20.1 and 20.2). Your therapist can help you in measuring your chair as well as figuring out turn spaces and your reach from your chair.

FIGURE 20.1. Turning Space Required

FIGURE 20.1. Turning Space Required

FIGURE 20.2. Wheelchair Dimensions

FIGURE 20.2. Wheelchair Dimensions

 
PLANNING FOR ACCESSIBILITY

 
Ramps for Your House

Sometimes it seems that all the world is a staircase. Many places are wheelchair accessible because they have ramps, but others are not. The one place you should be sure has ramps, though, is your own home.

Ramps are a safe way of replacing steeper sets of stairs. Listed below are some hints on what you should consider when building ramps.

  • Length: Safe ramp lengths should be one foot for each inch of rise. This means a slope of "one in twelve", 1:12, or an 8.33 percent incline. For example, if you have two 7" steps or a total 14" rise, you will need a 14’ long ramp.

Exceptions to this guideline are if you have very strong arms or are using an electric wheelchair. In either of these conditions, you may be able to use a steeper ramp. We will recommend that you use the 1:12 ratio, though. You’ll appreciate that when you bring home groceries or are carrying a baby in your lap!

  • Width: The recommended width for ramps is 36" to 48". A 48" width is usually very convenient if you use marine plywood, since it comes in sheets of 4’ by 8’.
  • Landings: Landings are necessary at the top and bottom of ramps as well as at any intermediate levels where a ramp changes direction or rises more than 3". Landings at all levels should be at least 5’ x 5’. (See figure 20.3) The top landing should be placed so as to extend 1’6" on the latch side of the door. This means that if you want to center the platform on a 3’0" opening, a wider, 6’0" platform would be needed. If the door opens in, the platform can be 3’ deep x 5’ wide. (See figure 20.3).
  • Railings and Edges: Railings are best placed on both sides of the ramp, approximately 32" high and securely fastened to the ramp. They can be made of 2" x 2" or 2" x 4" lumber, or 1 1/2" diameter pipe. The edges of the ramp should be at least 2’ high to prevent wheelchair casters from going over the edge.
  • Surfaces of Ramps: Ramps exposed to the outdoors can become extremely slippery and dangerous unless a proper nonslip surface is used. Adhesive nonslip strips, ribbed rubber matting, or a rough roofing material can be used. A broom-swept surface works well for a concrete ramp. A painted surface is not recommended as it can be very slippery when wet. However, paint mixed with sand (one pound of silica sand mixed thoroughly with one gallon of paint) or a non-skid deck paint both provide nonslippery surfaces. Surfaces should not be so rough as to make wheelchair travel difficult or unpleasant.
  • Materials for Ramps: For building a long-lasting ramp, use of treated lumber (such as plywood), concrete, or 2" x 4" slats placed crosswise is recommended. Ramps that are the means for emergency exits should be built of fire-retardant materials.

FIGURE 20.3. Ramps

FIGURE 20.3. Ramps

 
Walkways and Entrances

Walkways around your house are important to provide a solid, constant surface through rough terrain like your yard. That way, you will not have to worry about getting stuck, especially when the ground is soft due to rain or snow. That is, of course, if the walkways are built right!

Walkways should be a minimum of 42" wide to prevent slipping off the edge. To allow for wheelchair turning on corners or switchbacks, a 5’ width is needed.

Entrances should have a clear, unobstructed opening of at least 32" (36" preferred) with a level or beveled threshold no more than 1/2" higher than the floor.

 
Doorways and Hallways

 

Have you ever gone through a doorway and mashed your fingers on the edge of a box you were carrying or smashed your fingers on your wheel because you just barely had enough room? Not too much fun, is it? So give yourself a break and plan plenty of room for your doorways.

The minimum width of doors should be 3’0" (32" clear opening). Special attachments on your wheelchair may require even wider doors. Ask your therapists to help you determine your wheelchair width. (See figure 20.4).

Doorways into bathroom or other confined spaces should swing out. Large bathrooms providing ample maneuvering space will permit the door to swing in; however, in-swinging doors are a potential hazard if you should fall and block the door. Sliding doors, pocket doors, or "break away" hardware are other alternatives.

Doors can be one of the biggest obstacles in your daily life. In fact, there are several things about a door that you should be aware of in order to make your life easier.

FIGURE 20.4. Door Width

FIGURE 20.4. Door Width

 
 
  1. Any door must be capable of being opened in a single motion.
  2. Door latch handles are easier to grasp than round ones. Your therapist can make recommendations on various ways to adapt door handles, handles to cabinets, etc. (See figure 20.5).
  3. The best height for door handles is approximately 3’. Your therapist can help you evaluate your reach and determine what heights work best for you. (See figure 20.6).
  4. No matter how careful you try to be, the footrests of your wheelchair are going to scratch your doors from time to time. Kick plates on both sides of your doors are recommended to protect them from this kind of damage.
FIGURE 20.5.
Latch Handle
FIGURE 20.5. Latch Handle

FIGURE 20.6. Door Dimensions

FIGURE 20.6. Door Dimensions

 

Hallways at least 36" wide allow wheelchair access to rooms; however, if a doorway is too narrow, turning may still be difficult. Figure 20.7 illustrates the best hallway-doorway configurations to optimize your accessibility.

FIGURE 20.7. Hallways

Poor Access     Good Access     Excellent Access

 
Other Convenient Heights

Some modifications you may need can get lost among all the more major changes you are planning. Check out the heights and measurements given below to make sure you don’t miss them:

  • Counters, tables, and sinks: 27" to 33"
  • Electrical outlets: 18" to 48"
  • Light switch/thermostat: 36" to 42" from floor
  • Wall-mounted telephones: 32" to 40" recommended; maximum height of 48"
  • Closets:
    - Clothes hanger rod: maximum height of 48"
    - Shelves: maximum height of 54"
  • Windows: For viewing, a low still height is recommended (no higher than 30")

The heights of tables, beds, etc., can be easily raised using wooden blocks. Your therapists can help answer these questions for you.

 
Bathrooms

All bathroom fixtures and equipment must be thoroughly evaluated by you and your therapist. The height of toilet seats and the placement of grab bars are specific to you and to the type of bathroom you have.

Part of your rehabilitation process will be the evaluation of your bathroom facilities. If changes or adaptations are needed, your therapist can give you the specific details.

 
SAFETY CONSIDERATIONS

  1. If you have to come down a very steep ramp, you may want someone to back you down the ramp to prevent you from falling out of your wheelchair.
  2. Exposed hot water pipes, drain pipes, motors, and other sources of burns or abrasions should be adequately housed or insulated; preset hot water heaters to less than 120 degrees.
  3. Doors to any confined space with only one exit should swing out. In-swinging doors pose a potential danger should the wheelchair user fall and block the door.
  4. You may want to have two separate accessible emergency exits in case of emergency.
  5. You should consider an emergency warning signal, e.g., a system to alert neighbors, fire department, police, in case of an emergency.
  6. Install smoke detectors throughout your home (hallways, kitchen). If you have difficulty hearing, a system that alerts you with lights (or other means) would be a good idea.
  7. Fuse boxes or circuit breakers should be accessible.
  8. Provide adequate, even lighting throughout the house.
  9. It is helpful to have accessible telephones near the bed and a phone jack in the bathroom; consider carrying a cordless phone with you throughout your home.
  10. Have a fire extinguisher readily available and within reach.

 
RESOURCES

 
Publications

Accessible Home Design.

Kitchen Design for the Wheelchair User.

Purchase:

PVA Distribution Center
PO Box 753
Waldorf, MD 20604-0753
(888) 860-7244

Download: www.pva.org

 
Organizations

The Center for Universal Design
North Carolina State University
Box 8613
Raleigh, NC 27695-8613
(800) 647-6777
www.design.ncsu.edu/cud

The Ramp Project
Metropolitan Center for Independent Living
1600 University Avenue West
St. Paul, MN 55104
(651) 646-8342

Trace Research and Development Center
5901 Research Park Blvd.
Madison, WI 53719-1252
(608) 262-6966
trace.wisc.edu

 
Web Sites

www.easyaccesshomes.com
You’ll find information at Easy Access Homes on homes that are suited to the needs of your family--whether that means a home with main floor living for family members who have difficulty with stairs or a home with total wheelchair access throughout.

www.hometime.com
Hometime is an on-line source for home improvement, remodeling, and repair information. Here is where you’ll find project advice and products to help you with your project.

 
SCI Self-Care Guide Main Page
Chapter 1     SCI Anatomy & Physiology
Chapter 2     Skin Care
Chapter 3     Circulatory System
Chapter 4     Respiratory Care
Chapter 5     Range of Motion
Chapter 6     Bladder Management
Chapter 7     Bowel Management
Chapter 8     Nutrition
Chapter 9     Medications
Chapter 10   Nerves, Muscles, and Bones
Chapter 11   Autonomic Dysreflexia
Chapter 12   Pressure Sores
Chapter 13   Psychosocial Adjustment
Chapter 14   Sexual Health & Rehabilitation
Chapter 15   Community Resources
Chapter 16   Vocational Rehabilitation
Chapter 17   Recreation
Chapter 18   Driver’s Training
Chapter 19   Attendant Management
Chapter 20   red dotHome Modificationsred dot
Chapter 21   Approaching Discharge
Chapter 22   Pain after Spinal Cord Injury
Chapter 23   Substance Abuse and SCI
Chapter 24   Exercise
Chapter 25   Alternative Medicine
Chapter 26   Equipment
Chapter 27   Staying Healthy
Glossary


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