Accessible Adaptations

Providing a Welcoming Home My goal is to demonstrate how to make adaptations to your present home, to accommodate your loved one's special limits in mobility. Ideas here have been gathered from a devoted group of families who are learning as abilities change. As all of us age, our needs will change. It makes sense to plan ahead for these changes. If a family member or friend is injured or becomes disabled through an illness or aging, accessibility will help all of us. I hope you can find some ideas here that will help you create a usable home for your family, whether or not they are disabled. Please click on the category that interests you, Kitchen, Bathroom, Ramps etc, to find full descriptions and photos of the work done. Be sure to check out the added suggestions by other parents and our Links page. They will be updated as I learn more This is a site in progress. If you have made adaptations that you think should be included in the web site, please email me about them and provide photos that I may include here. My goal is to show that adaptations need not be institutional in appearance. They also need not be prohibitively expensive. Although we were given a $30K estimate for renovating our daughter's bathroom, we kept looking and managed to do the entire job for closer to $3K. Please get multiple estimates and be creative in your problem solving.

Kitchen Ideas When looking at kitchen access, you need to consider if the person will be doing the cooking and clean up or just accessing snacks or meals, already prepared. Roll under counters and sinks may be necessary for a person doing their own meal prep. Lowering a section of counter top works for an eating location or a spot for helping or doing homework near the action. Rather than a raised breakfast bar, consider a lowered area for the family to share.  The photo below shows a corner desk area in a kitchen, designed as a computer space for two but usable as a food prep area or dining space. Large deep drawers provide easily accessible storage for a variety of items. Lazy Susans in corner cabinets can increase the ability to reach everything stored there. Drawers usually work better than shelves, because things cannot fall off the back or sides of the drawers. Deep drawers beside the dishwasher hold plates, glassware and flatware for easy emptying, allowing helping in the kitchen. To the left, near the stove, another set of large drawers hold pots, pans and casserole dishes. Ikea has some great ideas for the internal parts of cabinets. They have pull out pantry cabinets and under counter shelves, shown below. . These pull out shelves allow access to items at the very rear of the cabinet and one push on the outer surfaces, closes the entire cabinet, easily. Another Kitchen This kitchen has multiple height counters, lower at the work counter, stove and sink areas. Higher at the dishwasher. This allows multiple users to be comfortable. There is roll under access at the work counter and under the sink. A drop in stove, set lower than average height allows better, safer access to the oven from a wheelchair.                               Bathroom Design This custom vanity was built using specialty hinges which allow the doors to open normally and then slide into the cabinet, to not obstruct the access to the drawers. In addition, the floor of the cabinet area is removable. The horizontal board under the doors could have been cut out and would allow rolling under the sink. The pipes were set back to allow clearance for knees. The mirrored wall allowed visibility while standing or seated. The counter to the side allowed room for make up or hair dryer, etc. The faucet is a single lever control and a pull our hose. It made hair washing easier.  Until needed, most of these features were not obvious. The bathroom also had pocket doors and grab bars near the shower. Blocking was built in at the time the room was built, so if grab bars were needed, they could be added and have the required support in the walls.  This bathroom uses the sloped back vanity design, with drawers to the side and lots of counter top space. Grab bars are spaced around the toilet to help transfers and accessing the shower which is to the right in this photo. The bench was built in, from tile, which I understand has been very cold and a little slippery. It bears considering using materials that are more friendly to the user. The shower has a vertical bar holding a hand held shower attachment and multiple grab bars. This bathroom took an existing shower space, leveled it to the bathroom floor and removed sliding glass doors. A partial wall was added to give a place for a grab bar by the toilet, as well as a wall to put the hand held shower and rod on inside the shower. The vanity has a sink that overhangs, and baskets for added storage to the left. The toilet is the "comfort height" with a round bowl to save space. There is a grab bar above the toilet paper dispenser that is mounted to the right side of the vanity.  Inside the shower there is a folding teak bench that makes it easy to slide over to reach the water control that was not able to be relocated, and the hand held shower head. Corner shelves provide storage for shampoo and a foot rest for shaving. Add caption The bathroom below used a similar approach to the one just above. A standard shower stall existed, with the floor below grade. A short wall was added to one edge of the shower space, the floor was brought up to the level of the bathroom floor and sloped to the drain. Grab bars were installed, a folding bench and hand held shower all make for functional space within easy reach of the user.  The new wall is about 30 inches wide and allows a good open section for entry to the shower. This design has actually allowed for no shower curtain to be needed, if the user is a little careful with the spray direction of the hand held device. Another grab bar was added at the water source end to assist in positioning on the bench. The bathroom below had double vanities. One was removed to allow roll under access. The door to the toilet area was removed and the entrance was widened to allow wheelchair access. At the very left you see the entrance into the shower area. This bathroom uses the wet room approach, being sure that any surface that gets wet will drain to the low point where the drain is. There are not walls around this shower, which allows easy access by the person showering and any assistant who might be helping. For the sink areas, counter tops provide plenty of space for personal items and allow rolling under, while drawers provide an abundance of storage. Below are some really clever adaptations one family came up with to address a reach issue. By turning a standard bathroom basin sideways, the water faucet is much easier to access. You would want to be careful to pipe the drain as far to the rear as possible, so knees aren't hitting the pipe, if a wheel chair is involved.   Below you can see the wall grab bars, but again they were not quite what this young person needed, so the family located attached toilet frame bars on Amazon for less than $40.00. They also located a "family toilet seat" which has two diameters for the inner opening, which adds a greater feeling of security for kids and those with tiny bottoms. See the LINKS section for where you can find this type of product. The shower stall has several grab bars allow options for positioning inside the shower.  A hand held shower head on a rod, facing into the shower helps keep the water where it belongs. Remember when building a shower that water will go from a higher level to a lower one. Whenever possible, the drain of the shower should be the lowest point in the room. Ramps Most of us have seen the metal or wooden zigzag ramps that are installed when a family with a disability needs wheelchair access. If you are careful selecting a house and creative, you can hide the ramp so no one realizes what it is. No step entries should be commonplace. Not only do people with disabilities appreciate them, so do delivery people and friends with strollers. Keeping in mind the guidelines for 1 foot of length for each 1inch of rise, we were able to design a slope, with a turn and rest area, and camoflage it with a raised bed garden. This is the original entry, with three steps up to the front door. This was taken soon after the ramp was poured and the gardens started.There is no longer any step needed to enter the house. This was the way it looked last summer. The walkway is hardly visible. Our previous house had 12 feet from the porch to the corner of the house, where the driveway began. It was possible to build a ramp from Trex type decking material and create a landing of patio blocks for entering the car. (The drive was gravel) The ramp was hidden behind a couple of strategically placed sections of picket fence and a garden. From the street, it was not apparent that the house had a ramp. This ramp to the patio has a flat surface at the door end to allow turning to enter the house. A piano hinge and clamshell molding provide for a smooth transition to the concrete patio.   Suggestions by parents Reprinted with permission. Remember that each person's disability affects them differently. These are good guidelines, but you may have to tweak them a bit to get the best benefit for your situation. Suggestions: -Use pocket doors to maximize floorspace in the bathroom. Make sure you use really strong hardware, solid doors, and reinforce the pocket side of the door opening (great diagrams in Journal of Fine Homebuilding) -Allow enough open space in the center for a wheelchair to spin or make a y turn, ideally 60" in diameter -Look up guidelines on the ADA website for distances and heights, we used 18" from centerline of toilet to the wall (15" is minimum), with the other side open to the door space. Sophia is right handed, so that is the side we placed the grab bar and toilet paper holder on -Place the tp holder under the grab bar so it won't be used for any other purposes -The grab bar next to the toilet should be the longest you can find to enable pulling up, lowering down, leaning forward, etc...(try to open your jeans with one hand while standing on one leg, then attempt to lower yourself onto the seat to get an idea of what it might be like for our kids) -You need a minimum of 36" in front of the toilet, so you can place it facing the open shower for even more room -Only buy the taller toilets (called comfort height in California) or the wall mounted ones you can place as high as you want -Make sure the seat has metal bolts with a bar in between for stability -Make all doorways 36" wide -Put blocking in the walls at grab bar height along the entire walls of the bathroom for future flexibility. Don't try to guess where you might need them -You can never have enough towel bars -in the shower, around the sink, on the sides of the toilet...(these should all be grab bars because that is how they will be used) -Install a sturdy pedestal sink, bolted to the floor and to the wall as well (more blocking to remember)  -If you have a ton of room you could install a vanity sink with two columns of drawers (never use cabinets with doors) spaced a minimum of 36" apart for ample room for a wheelchair to manuever under. There are sinks available now which have the trap to the side or towards the rear of the bowl to allow more room under the counter -If you can afford it buy a handsfree faucet (they only had ugly ones when we were looking, but now i see all sorts of beautiful ones) -Install ceiling lights in the shower area, in the main area, on each side of the vanity mirror (above creates bad shadows) -There are large tiltable mirrors that can be a big asset for different height folks -One of the best things we did was install hydronic floor heating in the entire house. In the bathroom it is even more of an asset. Make sure you map out the coils so you don't bolt or screw anything into a pipe -Treat the entire floor of the bathroom as a showerpan to minimize future leaks -Create a large roll in shower space with no curbs and with a built in bench (we used wooden 1x1 slats for drainage and comfort at 24" height to make it easier to stand and sit. If the shower is large enough- ours is 4'x6' with a 2' wing wall enclosing the bench-and you slope the floor properly and the drain does not clog, the water will stay where it should. The shower curtain has to be pulled of course! If you have an even wider bathroom you can extend the wing wall minimize water spread -Install a long shower pole which allows the handheld shower to slide to any desired height instead of a fixed showerhead. This makes it easy for anyone from a two year old to a basketball star to get their parts clean -Plan for two windows if possible, one should be operable. Sunlight improves the mood and airquality. If you are careful with placement there should be no privacy issues either. We have one high up facing North for no glare light, and the other is a very narrow and tall one facing the garden for a view and fresh air. It is on the second floor so you can't see in unless you climb a hill and get binoculars! -Finally-one of the lights in the bathroom (actually a good idea for hall ways too) should be of the 'occupancy sensor' type. This will give you points in your energy calculations for the building department and is a huge plus for those urgent last minute trips Some things to consider: Wall hung or pedestal sinks are apt to be pulled on, if your family member is still standing at times. Their mounting system needs to be really sturdy and usually is not. Also you lose all storage that a vanity would provide. You also lose the counter surface that many need to organize their daily care routine. A built in bench, from tile or molded fiberglass will take up floor space and cannot be removed, should the time come that you need a roll in shower chair. A folding bench seat from wood or padded can be flat against the side of the shower, out of the way, for future needs.  A hand held shower can be in addition to an overhead shower, with a diverter used to decide which is active, or allow both to be active for that spa experience. Pocket doors save valuable floor space, but the wall they slide into can't have any electrical or plumbing in it, which can limit where you can use this option. Links to other accessibility information When visiting these sites, look around under several headings. There is a wealth of information on each. This first one was developed by one of the parents in our group and has an unbelievable amount of information and ideas for everyone to learn from! http://www.mda.org/publications/quest/extra/PDFs/MDA_Home_Mod_Presentation.pdf http://www.accessible-bathrooms.com/ http://www.penatesdesign.com/bath-remodeling/single-gallery/3903102 http://www.comfortdesignsbathware.com/ http://www.acessinc.com/AccessibleShowerShowroom_0001_000.wmv http://www.acessinc.com/handicap_bathrooms.htm http://barrierfree.org/  http://blog.amsvans.com/wounded-warrior-home-project-builds-accessible-homes-for-injured-veterans/ These are pretty attractive grab accessories: http://barrierfree.org/product/list.aspx?categoryid=37 Attractive grab bars  http://www.moen.com/bathroom/safety/_/N-67x An article about redoing a really small bathroom for a wheelchair user. http://www.accessibleconstruction.com/articles/special-living2.html The site has a lot of information and even a section on pre-owned items for sale. I particularly liked the lego like ramp for acces to a shower with a lip at the entry. http://www.accessibleconstruction.com/services/bathrooms/40.html Very interesting mechanical adaptations for kitchens. http://www.accessible-kitchens.com/  Family Toilet seats, with inserts to make the opening smaller      http://www.onestepahead.com/catalog/product.jsp?productId=6766     http://www.activeforever.com/p-2031-maddak-family-toilet-seat.aspx Learn more about Friedreich's Ataxia, click this link. To donate to Friedreich's Ataxia Research Alliance, click here. We greatly appreciate your interest!