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Posted: September 30, 2008

Keeping Loved Ones Independent

It All Comes Down to Mom's Mobility in the Home

Editor’s Note: Our four-part series, Solutions for Keeping Loved Ones Independent, explores the safety issues facing our aging loved ones in their own homes and suggests solutions for improving safety and mobility at home. In this, our final installment, we examine the broader picture of mobility at home and provide ideas for taking a planned approach to creating an accessible home environment that will help our loved ones “age in place.”

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The single biggest factor in determining whether Mom or Dad will be able to continue living independently is whether they live in a home environment that enables elder mobility. As important as it is to install safety features, such as grab bars in the bathroom or fire extinguishers in the kitchen, these items are useless if a loved one using a walker or wheelchair can’t safely get down a thickly carpeted hallway, through a bathroom door that is too narrow or across a threshold that is too high.

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As caregivers, we may have an idea of how well all this works together, but unless we’re in Mom’s or Dad’s shoes and actually have to move as they move through their home, we can’t really appreciate what they must deal with – and know what to change.

So, let’s do just that – let’s take a tour of a typical home, imagining that we must move through it using a walker or a wheelchair (or actually using one!). What obstacles will we encounter? What can be done to eliminate them? We’ll answer those questions, and more, along the way.

Front Steps

Let’s begin outside, at the foot of the front steps. Now imagine that you rely on a walker or a wheelchair to get around. How on earth will you get up those stairs? With a walker, it’s a treacherous undertaking at best; with a wheelchair, it’s downright impossible!

One solution is a ramp with an anti-slip surface and strong handrails. There are guidelines for determining the appropriate size and slope of a ramp, and specialty vendors or contractors with experience in accessible home modifications can help you get it right. The ramp should have handrails that are at an appropriate height, firmly attached, with a surface that frail hands can easily grip.

The cost of ramps varies by material, size and width, with a 6-foot aluminum ramp ranging from between $250 to $500, depending on where you live. Check out www.americanaccess.net, www.accessibleenvironments.net or http://medramps.com for examples of products and pricing.

Another option is a vertical porch or stair lift, which provides mobility in places where the long slope of a ramp may not be feasible. This is a more expensive solution, with the cost of a pre-fabricated lift beginning around $3,000. You can view lift options for both indoor and outdoor use at www.vertical-platform-lifts.com and www.accessibleconstruction.com.

Doorways and Thresholds

So, let’s assume you’ve got a ramp or lift that elevates you to the front door. Now, a new challenge awaits -- will your wheelchair fit through the doorway? Will you be able to maneuver it up and over that raised threshold? Will you be able to turn the doorknob and hold the door open while maneuvering your walker or wheelchair through it?

An opening of 32 inches is the standard set by the Americans for Disabilities Act (ADA) for allowing adequate wheelchair passage through a doorway. But don’t panic! You may not need a construction project to enlarge a doorway that doesn’t measure up. First, try installing offset hinges that can add up to 1.5 inches of clearance – a major difference, in this case, for little cost and effort. Additionally, special hinges can be added that will hold the door open so you don’t have to struggle. (A wide variety of hinges are available at hardware stores.)

 

Thresholds can be made wheelchair-friendly with the addition of a tapered rise. Depending on size, threshold ramps cost between $60-$200 and can be purchased from the same suppliers that sell ramps. Replacing doorknobs with levered handles will make opening doors easier, as well.

Hallways and Floors

Congratulations! You’ve made it inside the house! Now let’s head down the hallway. But wait: is it wide enough for your wheelchair to pass? How will the wheelchair move over that plush wall-to-wall carpeting? Will your walker get tripped up on those pretty area rugs?

A hallway with a width of 36 inches will allow wheelchair passage, but a 48-inch width is preferred. If it’s a tight squeeze, remove any and all furniture or clutter that impedes passage. Adding wall and corner bumpers will help prevent wear and tear from mobility devices moving through a narrow hallway.

Throughout the home, smooth floor surfaces, including low-nap carpeting, vinyl, hardwood and non-skid tile are the best options for safety and mobility.

Kitchen and Bathroom

Hooray! You’ve made it down the hallway! Now let’s see how easy it is to maneuver in the kitchen or bathroom. The obstacles you’ll encounter in these two rooms are similar, as are the solutions for overcoming them.

Tight spaces like those found in bathrooms and kitchens are major impediments to mobility for those using a walker or wheelchair. Making a 180-degree turn in a wheelchair requires at least 48 inches of free space. In bathrooms and kitchens, built-in cabinetry reduce free space, so installing sinks and workstations without cabinetry below them is a solution that allows extra turning room as well as the ability to roll in closer to the sink or underneath a counter.

In the bathroom, strategically placed grab bars are a must. A sturdy shower or tub seat for bathing and handheld showerheads are easy solutions that make bathing more accessible. For the longer term, installing a wheel-in shower is a more costly solution, but one that makes bathing much easier. (See our article, Helping Mom and Dad Navigate the Bathroom, April 2008, for a full discussion of bathroom safety and accessibility.)

Where to Begin?

It’s not that easy to get around the average house with a walker or a wheelchair, is it? But you don’t have to dive into making changes all at once. Start with the simple ones, like installing offset door hinges, levered door handles and threshold ramps. Take on smaller renovation projects first, such as putting a pedestal sink in the bathroom, changing out the faucets, installing grab bars and creating open closet and cabinet storage in the kitchen. Over time, you can consider larger projects such as full bathroom and kitchen renovations, or the installation of ramps or vertical lifts.

Thinking about all these potential changes may seem overwhelming at first, but taking a proactive approach can make it more manageable. Not only that, but developing a plan early on will allow you to distribute the cost of renovations over time.

And, finally, for those of you who might have snickered at the idea of literally navigating your parent’s home as they would, trust me – it works, and works well, and gives you unmatched insight into what needs to be done and how best to prioritize the work.

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Melissa A. Goodwin is a freelance writer and photographer living in Santa Fe, New Mexico. She has years of experience working with volunteer caregiving programs that help seniors and family caregivers. She can be reached at meesarj@msn.com.

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