I was a boy growing up in Van Nuys, California during the 1950's and
60's, I remember waiting patiently by the curb so I could help my
mother, who was using crutches, get up on the sidewalk. She suffered
from Polio, an acute viral condition, which caused a paralysis in
her arms and legs. The world we lived in back then certainly wasn't
designed to meet her special needs, but a lot has changed since then
for people with needs such as my mother.
A lot has changed for me, too. I am now a board certified orthopedic
surgeon, but still live in the San Fernando Valley, and still help
those individuals challenged to complete simple tasks that most of
us take for granted.
Mom's perseverance was very inspiring growing up and it was a key
reason I chose the medical field. So, in the late nineties, as her
condition grew more profound, confined her to an electric wheelchair,
and severely limited her ability to function, I was able to build
her a home modified to meet her needs. My goal was to give my mother
a functional and classy living space that allowed her to live an independent
life with style and grace. Special needs do not need to make this
impossible to achieve.
A SPECIAL NEEDS HOME
In addition to researching what was available in terms of products
for people with special needs, I came up with a very helpful litmus
test that aided in most of the modifications. While walking the halls
of the design or hardware store, searching for a product or solution,
I'd simply think... "If my hands didn't function, would I be
able to operate this?"
It sounds simple and it is. Trying to decide which faucet to buy?
Try turning it on and off without your fingers. You'll soon find that
levers are much more effective than knobs. And once you have that
faucet at home and installed, you'll find that the little bit of investigation
you employed pays off in the long run. Your loved one doesn't have
to worry about what they're doing anymore. That's really what it boils
down to. We want to get their environment to the point where they
function with ease.
I'd like to walk you through some of the key observations that I've
made since I built my mother's house and began consulting with my
patients on how to modify or build their home. We'll take a close
look at specific rooms of the house, but first let's look at some
general guidelines that will help you every step of the way. Remember...
there is no reason your home should look like a hospital. All of these
renovations and modifications can be done with aesthetics in mind!
Feeling good about where you live is as important as any of the factors
I'm listing here.
• Good lighting.
For someone who is aging or in danger of falling due to a tricky environment,
good lighting is essential.
• Levers instead of knobs.
Try turning a knob without using your fingers.
• Plenty of space.
When designing any room or area, keep in mind that wheelchairs,
walkers and crutches require
room to maneuver. In general, the more open space the better.
• Ramps. There are
many ramps available pre-made or in kit form.
• Consult the ADA (American
Disability Association) website for helpful codes
and guidelines when constructing
ramps or other devices.
• Flat surfaces.
An even surface promotes easy navigation and decreases the risk of
due to a raised lip or
• Ease of accessibility.
Consider the height of the person... if they are in a wheelchair
they need to be able to
access items such as dishes, the roast in the oven, and the sink
to wash themselves.
• Handrails are
very useful in areas where people need to transition from sitting
or transfer from a wheelchair.
This is particularly relevant when considering the bathroom
where it is easy to slip.
Make sure this and other key locations are centrally located.
Now that we've covered some general tips, let's go through room by
room and cover off some important details to consider.
I'll start with the most important and challenging room to design
for a person with disabilities.
• Make sure it's large!
Maneuvering a wheelchair or other aides can be a nightmare
a cramped bathroom. Unfortunately,
most old bathrooms are very small and, in the end,
you may want to consider
just gutting yours and starting over!
• Ensure that the sink
is the proper height. For a wheelchair, one should be able
to sit with
their legs beneath the
sink and have full access to the sink. If the person is tall or has
back problems, you may
want to raise the sink so they don't have to bend over too far
to reach things.
• The shower should be
open with no lip or raised area between the floor of the
bathroom and the shower
• Flooring should be non-skid
tile with a grip to prevent slipping.
• Non-skid showers
and bathtub surfaces.
• The shower should have an adjustable
• Ensure that the shower
area is close to the toilet.
• I recommend having a phone
in the bathroom in case of emergencies.
AREA and HALLWAYS
The living room should be somewhere you feel comfortable and relaxed.
• Keep switches low.
For an individual with MS, polio, rheumatoid arthritis, or other
crippling conditions, they
may not be able to raise their arms very high. Setting a
switch up at waist level
or using lights with a touch sensitive switch should be
• Ensure there is plenty
of room to navigate. Space the furniture out.
• Rugs of any kind are
not good... just a little buckle in the rug or a lip can
• Ensure that there is an even
surface between every room in the house.
• If you do have shifts
in surface heights or any other potential tripping hazards,
make sure they are well
marked and highly visible.
• Electric cords can be very dangerous,
wireless is best. I can't tell you how many
telephone cord injuries
I've treated over the years.
• Make sure there are no
raised door stoops or bumps.
• Home security systems
also offer a medical emergency option and should be
The bedroom is, like the living room, a place to relax.
• Electric beds.
Beds that will lift or move to accommodate the needs of the
person have come a long
way. They no longer look like something from the
hospital... they look like
real beds. Find one that matches your style and enjoy.
• Lifts. A lift
is a portable hoist that can lift the person and move them. There
many options, including
tracking that affixes to your ceiling and allows you to
be hoisted throughout your
This has the potential to be the most dangerous room in the house.
Make sure to spend extra attention here!
• Plenty of space!
I say it again and again and it's true. No where more so than in
• Oven doors.
They should open on the side instead of towards you. If you are in
a wheelchair, it is uncomfortable
and dangerous to access the oven in a
conventional fashion. Ovens
come in a variety of shapes and sizes these days...
the ones built into cabinets
are particularly helpful.
• Cooking surfaces.
Avoid gas, or electric coil surfaces. A flat heated surface that
is easily accessible and
has easy to see warning lights when the surface is hot.
• Appliances should have
easy-to-press buttons. No knobs, handles or switches.
Touch sensitive buttons
are the most ideal.
Similar to the oven... the cabinet style with drawers is ideal as
are easiest to access.
• Cabinet doors that unfold
like an accordion are particularly helpful. Also choose
hinges that open with ease
and/or have a counterweight.
• Refrigerator. A
fridge with a freezer drawer that pulls out at the bottom is ideal.
These are a challenge in
general and I recommend testing them out on the
showroom floor. A difficult
refrigerator can be a serious headache.
To insure a safe, independent existence, it's crucial to
create the proper parking situation.
• Attached garage.
It's raining and you have to get from your car to your home. Pretty
obvious why a detached
garage could be an issue. The added security is a huge bonus.
• Ensure that there is an easy
transition from the parking area to the home. Use ramps or
other devices to ensure
that this process is simple.
• Electric garage door
• Motion sensor lighting
and lots of it.
• When entering the home, consider
using a key card or a code pad. Many people with
disabilities struggle with
keys and knobs. There are some amazing technologies out there
that deal with this problem.
I credit my mother with teaching me how to look at the world through
the eyes of someone with unique needs. Since I built her home, I've
passed on a lot of what I learned to my patients. Most modifications
are basic but make a huge difference. It's a difficult transition
dealing with the loss of mobility or functions and I like to help
these people live their lives without the worry of "how the heck
am I going to open that door?"