Here’s a “heads-up” room-by-room guide to six key areas of the house where there are usually issues related to accessibility and/or safety:
1) Getting inside
Problem: Steps are difficult to climb.
Solution: Rebuild or replace steps if too narrow or too steep, add nonslip surfaces, repair broken or loose steps, build a ramp to create an alternate route, and add sturdy handrails on both sides (should extend beyond the first and last step).
Problem: Ramp is unsafe or slippery.
Solution: Install handrails on both sides, extend porch to provide weather protection, reduce the slope of the ramp, add level platforms for landing spots at the top and bottom of ramp, add edge protection to keep wheelchair, crutches, cane, or walker from slipping off edge.
Problem: Counters are too high to be able to work comfortably from a seated position.
Solution: Use pull-out cutting board as lowered work surface, place board across top of open drawer, use lap tray for food preparation area, pull kitchen table/card table near existing kitchen to create seated work area, remove base cabinet(s) and install lower counter or table for seated work area; lower upper cabinet(s) above work area to create reachable storage, install power elevating cabinets and counters.
Problem: Sink faucets are hard to reach from a wheelchair.
Solution: Replace separate hot and cold faucets with single-lever control, add extension arm to single-lever faucet, remove floor of sink cabinet and centre doorstop to create knee access (attach doorstop to back side of door to keep cabinet appearance), and insulate pipes to prevent burns.
Problem: Can’t reach items stored in refrigerator or freezer.
Solution: Use lazy Susan to make items accessible, use a reacher, purchase a side-by-side refrigeration/freezer for easier access, select a refrigerator that has a water and ice dispenser in the door, purchase a small refrigerator for supplementary storage next to the seated work area, ask someone else to transfer items from a chest freezer to the freezer section of refrigerator once a week.
Problem: The existing kitchen is too large for the wheelchair user.
Solution: Create a “mini-kitchen” that allows the wheelchair user to reach everything from one spot; include microwave oven, portable appliances, and essential supplies and utensils; store small items on countertop shelf unit or rolling cart.
3) Living Areas
Problem: Windows and window coverings are hard to open and operate.
Solution: Clear floor space in front of window so controls are easier to reach, install auxiliary handle on bottom sash of double-hung windows, replace double-hung windows with casement-style windows, select mini-blinds with long wand, install power-operated windows and draperies.
Problem: Your elder has trouble getting out of a chair or sofa.
Solution: Place a pneumatic seat lifter in chair and use a chair that has sturdy arms; raise chair or sofa on wood blocks.
Problem: Good furniture, walls, and woodwork get damaged by the wheelchair.
Solution: Move fragile or valuable furniture to protected location, staple carpet remnants around doorframes, make “sleeves” from carpet remnants to protect chair legs, select durable furniture, use corner guards, carpet (wainscoting) and plexiglass sheets to protect walls, add rubber bumpers to footplates.
Problem: The bedroom on the upper floor is not accessible.
Solution: Relocate sleeping area to an accessible floor, place the bed in one end of large room and use bookcases or screens to create privacy “walls”; use a daybed in the living room to create a sofa by day and a bed by night; install a stairlift to another floor (requires a transfer to and from the lift); install a chairlift to another floor (lifts both wheelchair and person); install residential elevator; elevator shaft can be located outside house by converting a window to an access door.
Problem: You are worried about the potential for slips and falls in the bathroom especially during independent bathing or showering.
Solution: Install grab bars near the tub and shower (be sure grab bars are securely fastened into wall studs), replace existing shower head with a hand-held shower to bathe while seated, purchase bath bench that straddles tub (two legs inside, two legs outside), use hydraulic seat or boom lift to transfer in and out of tub, install transfer shower with built-in seat, install roll-in shower (requires transfer to shower chair), build combination shower/toilet compartment so toilet can be used as shower seat.
Problem: Your parent or friend can’t use stairs to reach laundry in basement.
Solution: Move existing equipment to accessible floor, and if space is tight, replace existing equipment with stacked washer dryer.
Problem: Can’t reach laundry controls.
Solution: Use “reacher” to operate controls, purchase laundry equipment that has touch controls or front controls, purchase front-loading washer and dryer.
Caroline Tapp-McDougall is a healthcare journalist and author of The Complete Guide for Family Caregivers.