When 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.

BUILDING 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.

GENERAL TIPS


     • 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 falling
        due to a raised lip or entryway.
     • 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 to standing,
        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.

THE BATHROOM
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 in
        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 itself.
     • Flooring should be non-skid tile with a grip to prevent slipping.
     • Non-skid showers and bathtub surfaces.
     • The shower should have an adjustable handspout.
     • Ensure that the shower area is close to the toilet.
     • I recommend having a phone in the bathroom in case of emergencies.

                

LIVING 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
        considered.
     • 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 cause
        tripping.
     • 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
        considered.

BEDROOM
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 are
        many options, including tracking that affixes to your ceiling and allows you to
        be hoisted throughout your home.

KITCHEN
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
        the kitchen.
     • 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.
     • Dishwashers. Similar to the oven... the cabinet style with drawers is ideal as they
        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.
                

PARKING
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 openers.
     • 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?"