What are some potential modifications that can make my home more accessible for me and visitors?
Grab bars – Installing grab bars in the bathroom is a simple way to improve safety by preventing falls. Each bar will generally cost between $15 and $30, and they are available from any home improvement store. Ask to make sure they are ADA-compliant. Do not trust suction-cup grab bars for support. Grab bars should be professionally installed to ensure proper placement, but you may choose to put them in yourself.Portable ramps – For wheelchair or scooter users, sometimes a simple portable ramp is all you need to get over that step or two in your way. Also called suitcase ramps, the prices range between $60 and $500, depending on how much clearance you need. Since they fold up and store nicely, they do not have to be in the way when they are not needed.
Toilet seat extender (to 17”) – Unfortunately standard toilet sizes can be set too low to allow easy sitting and standing up again. Rather than buying a whole new toilet, an extender can be purchased to raise the seat to 17”, a much safer and more comfortable fit. A simple model will cost $30, but you can pay up to $100 for a model with built-in grab bars.
Non-slip shower mat or treatment kit – One-third of all falls among the elderly are a result of environmental hazards in the home, and the wet floor of a shower or bathtub is a prime culprit. A simple non-slip shower mat can be purchased at any home improvement store for around $10. This is an absolute safety minimum. Alternatively, spray treatment kits are sold for a little more that permanently coat the floor of the tub with a non-slip surface.
Shower chairs – A nice chair in the shower can be an essential for those with reduced mobility. Make sure the floor is non-skid first, or the legs of the chair will not be stable. A secure chair will cost between $30 and $50, and many offer adjustable heights.
Easy lever handles – Levers with wide, easy grips are preferable over knobs for all doors or cabinets. Difficult handles can trap those with limited hand strength or cut off access throughout the home. ADA has specific handle guidelines and many manufacturers advertise ADA compliance. Alternatively, easy push buttons or motion sensors can serve the same purpose.
Handheld shower fixtures – Allowing the showerhead to detach from its source can dramatically increase the usability of the shower for persons with limited mobility. A handheld showerhead replacement will cost between $10 and $20 and is available at any home improvement store. As long as you make sure your new head fits your existing shower arm, it may not be too difficult to do the replacement yourself.
Night lights – Simple plug-in night lights give you enough vision to navigate in the dark. They are widely available with many custom features, such as motion sensors or timers.
Moving items to accessible places – Take an inventory of everything you own, perhaps while doing a major house cleaning, and categorize your items into: “Use regularly,” “Use once a month,” and “Use once a year.” Make sure everything in the “Use regularly” category is in an easy-to-reach place on a lower shelf. They should not be behind heavy objects or in drawers or cabinets that are difficult to open. This is especially true for items that may be necessary in emergency situations. For items that are higher up, a grabber tool can be purchased to extend reach.
Tub Cuts – The walls of standard tubs can be too high to step or roll a wheelchair into. A tub cut is a one-time modification that cuts a hole in the tub to allow easy access. The alteration can be done by a professional in several hours, saving you from having to purchase an entirely new bathroom fixture.
Moving plugs, lights, and thermostats – Sometimes outlets, light switches, and thermostats are located in places that are out of reach or require too much bending. Rather than moving to them on a regular basis, just have them moved to you. In most cases, moving an outlet is a simple wiring task for an electrician. Consult the assistance section of this website for guidance on finding an electrician to meet this need. If you’re handy with household repairs, you could try doing this yourself.
Built-in ramps – Whether using a wheelchair or a scooter, many homes have steps or inclines that can be insurmountable on wheels. The number of ramp configurations is as numerous as the number of unique personal needs and physical proportions of the home. For simple cases, it may be possible to install a prefabricated ramp, but in most cases customized design and construction will be necessary. Sometimes a graded earth berm will work just as well as a ramp for outside purposes. See here for help finding a contractor with experience building wheelchair ramps.
Raised-seat toilet (to 17”) – If you want to replace your toilet anyway, why not purchase a more comfortable and accessible one? ADA recommends 17” high toilets for commercial establishments, and this size will work nicely for home too. Prices for these toilets are comparable to the standard 14” models. Sometimes they will be described as “comfort height” (as opposed to “elongated,” which refers to the width of the bowl).
Roll-in shower – Roll-in showers are full stalls that are wheelchair accessible - most importantly with a flush transition between the floor of the bathroom and the floor of the stall. A gentle slope toward the drain is necessary to contain water as much as possible, but it is also important to make sure that the entire bathroom floor is waterproof. A shower size of at least 3’6” by 5’ should fit most wheelchairs. These are not easy to install properly, but the Center for Universal Design offers a useful installation guide to help you understand what it involves.
There are a couple other options. The tub can be removed entirely and the entire bathroom made into a “wet area” with drainage in the center. Also, a portable no-step showering system can be purchased for around $1,000 and set up in any room of the house.
Widened doorways (to 32”) – Although typical bathroom doors are designed for a 24” width, wheelchairs need at least 32” of clearance between door frames. Depending on the location, additional width up to 36” may be necessary to allow sufficient turning radius. In cases where only an extra inch or two is needed, a swing away door hinge can meet the need at minimal cost. In most cases, two experienced carpenters should be able to widen a doorway, move a light switch, and repair flooring in eight hours. If utilities in the wall create an obstacle, more work may be needed.
Appropriate counter height – There are very specific counter heights to meet the needs of those in wheelchairs. Kitchen and bathroom counters should allow knee space for sitting while being low enough for easy reach. The countertop should be between 28” and 32” high (24” of knee space is necessary for comfortable sitting or wheelchair access). Shallow sinks (5" to 6 1/2") are available to allow enough room for knee space under the sink. Most sink manufacturers sell shallow models at comparable costs. Drains need to be located in the rear with protective insulation to prevent burns.
Carpeting in lieu of rugs – If somebody does fall, make sure there is something to cushion the impact. Carpeting needs may vary depending on the person, but fixed carpets are preferred over throw rugs to avoid slippage. More plush carpets can help soften the blow of a fall, but they may also introduce a tripping hazard and create an impediment for wheelchairs or walkers. Find carpeting that suits your particular situation and seek out a way to try using a carpet before committing to install it.
Increased floor space – Having to navigate and turn a wheelchair around a room typically requires more open floor space. They may be a way to free up space by removing unnecessary furniture or relocating items to places where they will not be an obstruction. If more space is needed, a major home modification could involve adding extra rooms or removing walls to expand space.
Home alert system – In cases where immediate medical assistance is needed, there should be a way for the homeowner to alert emergency services for help under very distressed conditions. Several medical alert systems are available to provide 24 hour emergency medical response service at the push of a button. The button is either worn as a pendant or in an easily accessible location. Most providers rent their equipment and services on a monthly or annual basis. Some options are Phillips Lifeline Home, Lifeguardian, or Lifestation.
Visual smoke detectors – Visual smoke detectors function as regular detectors do, except an alarm emits strobe lights in addition to sound. The device is intended for the deaf or hearing impaired. Each detector can either be hard-wired into the wall by an electrician or plugged in to an outlet. At a minimum, one visual smoke detector ought to be positioned in the bedroom to wake a person from sleep.
Units in compliance with state and federal regulations typically cost between $120 and $200. Landlords in Virginia are legally obligated to provide visual smoke alarms to qualifying tenants upon request for no additional payment. If you are a renter who meets conditions for hearing impairment, do not hesitate to let your landlord know of your needs.
Tilting/magnifying mirrors – Often the little things that get used every day determine whether the home “fits” you personally. Misplaced and fixed mirrors can grow into a constant annoyance. Built-in mirrors in the bathroom or bedroom ought to be located in a place customized to the individual user. Tilting and magnifying mirrors offer a higher degree of flexibility, allowing less mobile users to adapt the mirror to their own needs rather than moving their body into the mirror. Magnifying mirrors vary widely in price and are available at many home stores or specialty beauty supply retailers.
Anti-scald device – Exposure to 130-degree water for 28 seconds will lead to first degree burns. People with limited mobility or reaction times are especially vulnerable to burns in the shower and using the kitchen sink. Building codes in the Charlottesville region require anti-scald devices for all new plumbing installation, but older houses may not be equipped with these features.
The first line of defense is to adjust the home hot water heater to never exceed 120 degrees. Then a plumber can install either a thermostatically-controlled or a pressure-controlled device. The pressure-controlled devices are cheaper, but somewhat less reliable.
Motion-sensing faucets – Touch-free faucets for home use in both the kitchen and bathroom are getting less expensive and more widely available each year. They minimize the need to reach for and operate faucet controls, increasing access and reducing the risk of germ transmission. Most are battery-powered, but others are available with an AC adaptor.
They are typically marketed as “touch-free” faucets. A new faucet will cost between $200 and $500, or a motion-sensing adaptor can be purchased for under $100.
Elevators and chair lifts – When an upstairs bedroom is necessary or a ramp just can’t get over that incline, it may be time to invest in a powered alternative. Sometimes the incline is not that high, but there is not enough space to lay a ramp. Stair lifts, with a chair or wheelchair hook-up, can be installed along a standard staircase to an upper floor of the home. They typically cost between $2,000 and $5,000. Vertical lifts or home elevators can also be installed between floors. All of these are major home modifications, and a professional consultant can help an interested homeowner through the selection process.
Automatic entry door – Automatic entry devices, to unlatch a locked door, pause and close the door, can be installed on most existing doors very easily. They are typically used for the main entrance to the home, and are operated remotely with either a handheld button or a push pad on the wall or floor. Some models include a keyless entry system to enhance security and allow visitors or caregivers easy access. Prices vary widely from around $300 into the thousands.
Fully usable bathroom and kitchen – The number of design alterations that can make bathrooms and kitchens more accessible are too numerous to mention here. For more information, take a look at the Center for Universal Design home modification guidelines or the ADA guidelines for bathroom fixture placement.