Home Modifications

 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. Or it may need more involved modifications, such as wider doorways and hallways, a new bathroom, or an elevator or lift.
 

For more informantion see Yes, You Can! – A Guide to Self Care for Persons with Spinal Cord Injuries, Page 87, 4th Edition, Paralyzed Veterans of America, Chapter 8, Nutrition

Additional Points About Home Modifications: Making Your Home Accessible(supplement material)

 

 

Accessibility of one’s home is dependent upon individual needs. As few homes are built to allow wheelchair access, this chapter outlines some of the adaptations which may be required to make a home accessible.

 

The following general information should be considered when building a new house or doing modifications to an existing house to make it wheelchair accessible. Before you make any changes, talk to your occupational therapist!

 

1. Take into account the re-sale value of the house when building or making renovations.

 

2. Choose a flat lot, preferably located near public transportation, shopping areas, and other amenities.

 

3. Choose building materials for long life and low maintenance. 

 

4. Choose an open plan to avoid hallways. The fewer corners the better.

 

5. Make sure the house plans fit the building code and conform to local bylaws. Check the building codes of the area and have the plans approved.

 

6. There should be a fire exit from the bedroom.

 

7. Install wiring for an intercom system, call light, environmental controls and electric doors when building.

 

8. Have extra plugs on separate circuits installed behind the head of the bed for lights, environmental controls, electric bed, and air mattress.

 

9.  Light switches and thermostats (with lever or push button control) should be mounted lower than normal, approximately 36 to 40" (92 to 102 cm) from the floor. Plugs should be higher, approximately 20" (51 cm) from the floor. Some light switches could operate table lamps that are plugged into the wall.

 

10. Install a larger than normal (50 gallons) hot water tank that has a temperature limiter.

 

11. When building a new house, plan for extra storage areas for various pieces of equipment, e.g. commode chair, extra wheelchair.

 

12. There is no standard wheelchair height as wheelchairs are different, particularly manual versus electric. Therefore, counters should fit individual needs.

 

13. Flooring should be hardwood or linoleum. Low pile carpeting can be used but is more difficult to propel on than hardwood floors.

 

14. Lever handles are easier to manage than doorknobs.

 

15. “Swing clear hinges” or “offset” hinges on doors can give an extra inch to a narrow doorway. The hinges can be purchased at local hardware stores or some medical vendors.

 

16. Sliding glass doors should be flush with the floor. For drainage, the drain pipe will have to be recessed and can be covered by an open grill.

 

 

 

Points to consider:

 

• The outside approach to house (main entrance) should be enclosed to keep it dry and free from ice and drifting snow. All pathways should be well lit.

 

• The paved area outside the entrance should be smooth and hard, i.e., concrete, asphalt. It should slope gently away from entrance to drain water.

 

• There should be two useable entrances provided in case of emergency.

 

• Avoid storm doors as they are difficult to open. They should be used only if a breezeway or porch cannot be provided. Depending on prevailing winds, a breezeway between garage and house may become a wind tunnel.

 

• The outside door(s) should be able to be opened and locked with one hand.   Electronic lock/openers are available. A grab bar on the door frame, beside the lock, may be useful for support. A horizontal handle is useful for pulling the door shut.

 

• Entrance should include no steps or thresholds. In extreme climates, it may be necessary to have a 1/4" weather strip.

 

• A non-slip floor surface inside the entrance is recommended to allow for drying and cleaning of the wheelchair.

 

• The vestibule should lead directly to the interior of house with no turns.

 

• A bench or table inside and outside the door may be useful to place objects on while reaching for the lock and door lever or when removing coats and cleaning wheels.

 

Minimum paved area outside entrance:

5 x 5 ft (152.4 x 152.4 cm)

 

Minimum width of entry doors:

2 ft 10 in (86.4 cm)

 

Ideal width of entry doors:

3 ft (90 cm)

 

Minimum turning area inside entrance doorway:

5 x 5 ft (152.4 x 152.4 cm)

 

Area required for clear swing of door:

2 x 5 ft (60.9 x 152.4 cm)

 

Unobstructed space adjacent to pull side of door:

2 ft (60 cm)

 

Unobstructed space adjacent to push side of door:

1 ft (30 cm)

 

 

 

 

Measurements:

Apartment blocks - minimum width for two wheelchairs to pass:

5 ft (152.4 cm)

 

Home hallways - minimum turning area with manoeuvring of wheelchair:

4 ft 8 in (142.3 cm) optimal

 

Corridor to door turn - minimum total of door and corridor widths:

5 ft 8 in (172.7 cm) optimal

 

 

 

 

Points to consider:

 

• Cost factor - ramp vs. elevator.

 

• The amount of ramp necessary based on the vertical use (the height of the entrance) may be impractical. For example, a five-foot vertical use from the ground to the entrance would require approximately 60 feet of ramp plus ten feet of level area at the entrance and a midway rest stop.

 

• Consider the appearance of the home and the resale value.

 

• Consider the building codes and bylaws before putting in a ramp or elevator.

 

• Consider how many levels within the home need to be accessible.

 

• Ramps need to have a non-slip surface such as course aggregate, concrete, rubber matting, or non-slip paint.

 

• Ramps should be protected from rain and snow with a roof. Embedded electric coils will keep the surface ice free.

 

 

The length of the ramp depends on the vertical rise - accepted average is 1:12 ft (for every foot of vertical rise, 12 feet of ramp is necessary).

 

Minimum width of ramp: 

36 in (92 cm)

 

Height of safety railings:

32 to 36 in (81.3 to 92 cm)

 

Curb height - wheel & crutch stops

4 in (10.2 cm)

 

Illustrations: 8 diagrams – see Alberta Home Modifications (Chpt 20) document pages 20-3, 20-4 and 20-5 for labelled ramp illustrations.

 

 

 

Points to consider:

 

• Should be located close to the entrance with the steps and curbs ramped and entrance doorsills ramped.

 

• Position parking stalls so a person does not have to wheel behind parked cars.

 

• If parking lot space is restricted, parking should be located close to walks, driveways or at the end of rows of standard spaces.

 

• A sign/symbol is necessary to identify designated space.

 

• The parking stall should be on level ground.

 

 

Minimum width of a parking stall for wheelchair unloading:

2 ft (365.5 cm)

 

 

 

Points to consider: 

 

• Parking stalls should be located close to elevator with level or ramped surface (1:12 slope for ramp).

 

Clearance required for van (with top):

10 ft (304.8 cm)

 

Preferred width of parking stall for wheelchair unloading:

12 ft (365.6 cm)

 

Minimum width of parking stall for wheelchair unloading:

10 ft (304.8 cm)

 

Button for elevators (height):

36 to 56 in (91.4 to 142.3 cm)

 

 

Minimum area for loading pad that can be connected to driveway:

5 ft (152.4 cm) square

 

 

 

Points to consider:

 

• Should have a direct route from vehicle to door.

 

• Enough space on house side of garage to allow vehicle door to open fully.

 

• If appropriate, a winterized garage is most suitable, e.g., a heated garage to eliminate chores of cleaning ice and snow from vehicle.

 

• Entrance of carport/garage - must consider individual height of vehicle.

NOTE: Measure height of van plus height of add-on for van.

 

• Electrically operated garage door are preferred; controllable from wheelchair parked at side of vehicle in garage and from outside the garage that’s accessible to seated driver by touch or radio control.

 

• A two-way light switch allows the garage light to be controlled from inside the house and in the garage (mounted at accessible height), or there are automatic light system.

 

 

Minimum width of parking space:

12 ft (365.6 cm)

 

Recommended entrance height for a standard van:

8 ft (243.8 cm)

 

 

 

 

Points to consider:

 

• Is the bedroom a multi-use area, e.g., sleeping, study area, computer, entertainment centre? Consider what equipment needs to be in the room, e.g. the size of your bed - hospital, double, queen; patient lifter; wheelchairs, commode chair; overbed table; entertainment centre; computer; book shelves.

 

• Is the bathroom located nearby?

 

 

Doorway opening (minimum) to pass through with wheelchair:

30 in (76.3 cm) minimum

36 in (90 cm) ideal

 

Minimum turning area:

4 ft 8 in (142.24 cm) diameter with manoeuvring

 

Standard bed height (commercial):

between 15 in-22 in (38-55 cm)

 

Average bed height required for wheelchair user:

19 in (47 cm)

 

Area required beside bed for wheelchair access or circulation:

3 ft (91.4 cm)

 

Turning area on one side of bed:

5 x 5 ft (152.4 x 152.4 cm)

 

Maximum height for clothes closet railing:

5 ft (150 cm)

 

Minimum height for clothes closet railing:

4 ft (121.9 cm)

 

Shelf above clothes closet railing (maximum height):

5 ft 3 in (160 cm)

 

 

 

 

General considerations:

 

The bathroom frequently requires renovations to make it wheelchair accessible.  The possibility of building a new bathroom specifically for the use of the individual should also be considered. Because methods and equipment vary depending on the needs of an individual, planners should consult with an occupational therapist to ensure that the proposed changes meet the needs of the client and caregiver.

 

It is useful to pre-plan the bathroom by taping the outline of fixtures on the floor so a client can try out wheeling (in the room - between fixtures) before construction plans are finalized. If planning a new bathroom or addition it is easier to install new plumbing near existing plumbing preferably against a common wall. If toilet plumbing is to be installed in a basement a plumber should be consulted regarding location of the bathroom and height to allow sufficient drainage.

 

Corridor to door turn:

5 ft 8 in (172.7 cm) minimum, combined widths of doorway and corridor - can be a bit less with manoeuvring and “jumping,” i.e., door width 30 in and hallway 38 in = 5 ft 8 in.

 

Door width:

30 in (76.2 cm) minimum clear opening

 

Door Latch side clearance:

2 in (5 cm) minimum

 

Turning area:

4 ft 8 in (142.2 cm) minimum, 5 ft (152.4 cm) ideal

 

Room needed beside the toilet for sideways transfer:

33-35 in (81.3-88.9 cm)

7 in (17.8 cm) without assistance

21 in (53.3 cm) with somebody standing on opposite side to give assistance

 

Commode wheelchair space required:

Minimum of 7 in (17.8 cm) either side

 

Room needed on either side of toilet:

19-21.5 in (48.3-54.3 cm)

 

Maximum toilet seat height:

15 in (38 cm)

 

Medicine cabinet height:

36-40 in (91.5-101.5 cm) off floor

 

Wheelchair sink:  knee clearance (depends on height of chair):

27 in (68.6 cm)

 

Counter top height:

33 in (83.8 cm)

 

Desirable clear width:

30-36 in (76.2-92.5 cm)

 

Depth for feet under the counter depending on length of leg and foot - with desk arms:

24-27 in (61-68.5 cm)

 

Wheel-in shower:

3 x 5 ft (91.5 x 152.4 cm) minimum

5 x 5 ft (152.4 x 152.4 cm) or larger to allow full turn and attendant 

 

Drainage slope for wheel-in shower:

2 in (5 cm) drop to drain or .25:1 slope

 

Average distance between studs for grab bars:

16 in (40.6 cm) 

 

Tub shower with bath bench

• Average tub width

inside measurement 24 in (61 cm)

outside measurement 30 in (76 cm)

• Average tub height

inside measurement 14 in (35.5 cm)

outside measurement 16 in (40.5 cm)

 

 

 

Bathroom doors are often the narrowest in the house. They can be widened by enlarging the whole doorway, putting in a sliding/pocket door, or by using offset hinges. If the corridor outside is narrow, then the door must be wider. As a safety factor, bathroom doors should swing outward. Then, if a person falls near the door, you can still get into the bathroom.

 

 

 

Toilet:

 

A standard height toilet (15 in) is preferred to a fixed raised seat. This way, a shower/commode chair can be wheeled over the regular height allowing for space between the commode seat and toilet bowl to facilitate reach for bowel and hygiene management. If a commode is used, the tank must be high or narrow enough to allow the wheels to go back to align the commode opening with the toilet bowl. There should be room enough for a straight approach over the toilet. Space may be required beside the toilet for a caregiver. A raised toilet seat allows for side/45 angle or front-on transfers.  Shelves within reach of the toilet are an asset to store supplies and equipment needed to carry out the routine.

 

Regular bath tubs can be used by persons who are independent or need minor assistance with their transfers using three methods:

1. Transferring to the bottom of the tub.

2. Transferring onto a shower bench.

3. Transferring onto a hydraulic bath lift to lower themselves into the tub.

 

Persons requiring major assistance use a bathtub by:

1. being transferred onto a hydraulic bath lift.

2. using a patient lifter to lower them into the tub, or

3. using a wheel-in shower as an alternative.

 

To use a floor patient lifter, the tub has to be raised off the floor 6 inches to allow the lift to go underneath. There is a commercially available lift that can lock beside the bathtub by insetting plates into the floor and allows the beam to swing over the tub to lower a person or consult your occupational therapist to assess for an overhead Tracklift system.

Hand held showers with a hose 6 feet or longer are ideal for showering and washing hair in the bath tub.  Controls, with a scald guard feature, are best located on the wall side of the tub near the middle for easier access from a shower seat or lift.

 

If you require assistance with your personal care, you need to eliminate many transfers due to limited endurance, strength and skin management concerns, or are independent, a wheel-in shower is recommended. Ideally, wheel-in showers are level with the floor with a gentle slope to a corner or centre drain. Alternatively, you can put a storm drain around the outside of the area. In some instances, a lip cannot be avoided so the sill needs to be ramped.  
 

Pre-fabricated wheel-in shower stalls are commercially available. These fit into a bath tub space but may be more expensive than tiling the area. Controls should be located on the sidewall, featuring a long hand-held shower and a scald guard feature. Single mixing valves are the easiest to manage.  Provision of a shelf or shower caddy within reach will hold bottles.  A grab bar may be necessary for you to stabilize yourself when leaning forward.

 

Counters and the sink should be open underneath to provide easy access for grooming and oral hygiene tasks. Drawers can be hung under the counter provided they do not impinge on the turning circle. Two sinks are preferable so that one can be used to wash bladder apparatus. Hooks or a rail above the sink facilitate easy reach. A shower spray at the sink is useful for washing hair and rinsing bladder equipment. All pipes should be insulated under the sink to avoid burns. The mirror should come down to counter top level as opposed to mounting it on a tilt. A tilted mirror distorts the image.

Illustrations: 4 bathroom designs – see Page 20-9 of Alberta document

 

 

 

 

Points to consider:

 

• Who will use the kitchen the most, i.e., a person in a wheelchair or a person that can walk? If there are various users, then it may be made partially accessible, e.g., under sink and stove, level surface between counter and sink.  Pull-out board or a removable board placed on an open drawer increase accessible space for wheelchair users.

• What functions will the kitchen serve, e.g., meal preparation, baking centre, food processing, social area, eating area?

• Counter heights and reaching heights are determined by the sitting height of the person in a wheelchair and this is variable depending on the type of wheelchair.

 

Counter height

floor to counter top

33-34 in (83.8-86.3 cm)

 

floor to underside of counter

27-28 in (68.5-71.1 cm)

 

Counter depth

24-26 in (61-66 cm)

 

Cupboards

overhead above counter

14 in (35.5 cm)

 

Wall oven

height from floor

28 in (71.1 cm)

 

Turning radius (free floor space)

5 ft (1 m 52.4 cm)

 

Toe space under counters

8.5 in high x 6 in deep

(21.6 cm x 15.3 cm)

 

 

 

Overhead cupboards: Reach to cupboards is aided by “lazy susans,” and/or pull-out or pull-down shelves.  Half shelves under the overhead cupboards are useful for storing small items, e.g., mugs, spices.

 

Undercounter cupboards: Accessibility to stored items is increased by “lazy susans,” pull-out shelves.

 

Drawers:  Stacks of drawers on casters stored under the counter allow their removal so person in wheelchair can increase clearance under counter.

 

Pantry:  This increases storage space.

 

Wall oven - side opening; pullout board in front of or beside oven gives a surface on which to place dishes.

 

Microwave - push-button control, lever opening, level floor in interior of microwave.

 

Stove top - front or side controls, staggered burners.  Extractor fan should have a switch mounted on the counter.

 

Refrigerators - apartment size; single door must open 180 degrees for access.

 

Outlets - electrical outlets placed on the counter or in front of counter are easily accessible (but must be safe if there are small children around).  Outlets at the back are important for permanently placed appliances, e.g., toaster, so the cords are out of the way.

 

Sink - 6-inch depth, access under the sink should be open or have cupboard doors with no base. A rear drain, insulated drain pipe and one-lever tap are recommended.  A sprayer is handy for filling kettles/pots so heavy pans don’t need to be lifted out of the sink.

 

Other work saving devices - spill buster (mini vacuum), food processor, a cordless mixer.

 

Safety equipment – Have rubber apron so hot liquid spills will run off you instead of being absorbed, fire extinguisher.