1. Home Modifications The Road to Independence

2. Universal Design n Opening every door. It enables everyone not just people with disabilities to navigate, manipulate and appreciate ones environment. n Example: Non-Slip Flooring is safer for all sorts of feet. n UD makes products, communications and the built environment aesthetically pleasing but also more usable by more people - at little or no extra cost.

3. ADA and Home Modifications n ADA Guidelines do not have to be followed to the letter, but they are a good reference. n When evaluating a client you should look at the whole picture. Client’s daily routine (work –vs.- home all day). - Home Modifications - ADL within the home - Vehicle Modifications - Seating and Mobility - Jobsite Accommodation n All of these should be addressed and evaluated when looking at the “whole picture” of enhancing the independence of a person with a disability.

4. Accessibility n Our purpose is to provide easy and safe access: –Access in and out of the vehicle and into the home –Accessibility within the home environment –Accessibility should provide the greatest degree of independence

5. ADA Ramp Guidelines for Ramps and Landings n 1:12 ratio n 3’ minimum for one way traffic n 4’ -Allows one wheelchair and one walking person to pass n 5’ -Allows two wheelchairs to pass n 5’ X 5’ at top of ramp, a change in direction (switchback ramp) and and at the end of the ramp Ramp Width and Landings

6. Handrails n Handrails are needed if: –Rise greater than 6 inches or –Run greater than 6 feet n Should be on both sides of the ramp n Continuous n If not continuous, must extent 1 foot (safety)

7. Problem and Solution

8. What’s wrong with this picture?

11. Pros and Cons of Ramps n Pros: - Provide gentle incline when accessing and exiting the home –Provides independence and safe access for a wheelchair user n Cons: - Are large and aesthetically obtrusive –Long - For walker may want to use large steps instead of ramp not an accessible solution for some –Requires maintenance

12. Before Example

13. After Example

14. There is another option - Lift

15. Pros and Cons of Lifts n Pros: –Require less space –require less maintenance –Less travel distance –Possibly receive quicker than wooden ramp n Cons: –Depend on electrical power have manual override, but requires assistance- May require battery back up which adds to the cost

16. Before Example

17. After Example

18. Ramp Vs. Lift n Low maintenance n Cost n Sometimes quick and easier access

20. Portable Modular Ramps EZ-ACCESS 1704 B Street N.W. Building E Suite 110 Auburn, Washington 98001 Toll free: 1.800.451.1903 Fax: 1.253.939.7125 Toll free fax: 1.800.630.2350 E-mail: customerservice@ezaccess.com customerservice@ezaccess.com

21. Doorways n ADA Guidelines Require 32” passageway but we attempt to get 36” passageway n Bathroom Doors are smaller (24”) n Not enough wheelchair clearance from hallway to bedroom and bathroom etc… n Swing Away Hinges is an option/removing door jams

22. n If Client can access tub –Tub transfer bench, tub lift –Hand held shower –Grab Bars –Lo tub with cut out and seat Access to Tub

23. The Slider Shower/Tub Chair n Walk In Bath Tubs www.ranetubs.com 21"

24. Roll in showers/Roll in shower chairs: Custom Tile Prefabricated

25. Roll in Shower Chairs

26. What’s wrong with this picture? Client information: - 22 year old female with MS and Lupus - Has lost vision completely - Unable to do any transfers independently - Cannot get wheelchair into bathroom - Currently get bed baths from mother

27. After Example

28. Before Modification Example

29. After Modification Example

30. After Modification Examples

31. Access to Toilet n Client uses wheelchair –wants toilet height at w/c seat height n Client does not use wheelchair –usually want high toilet –standard toilet - 15 inches –ADA guidelines - 18 inches

32. Access to Sink n Lever Handles n For Wheelchair users - free knee space with insulate pipes underneath n Mirror should be at eye level n Electrical outlets should be ground fault insulated

33. Before Example

34. After Modification Example

35. Before Example

36. After Example

37. Miscellaneous Modifications

43. Additional ADL Aids SuperPole Stair lift Outdoor stair lift

44. Final Thoughts Achieving a client’s ability to be as independent as possible is our goal. Always look at the whole picture of a person’s life from home, work, social and religious environments. The road to independence is a revolving door and one that will need nurturing throughout a person’s life.

45. Resources n www.access-board.gov n ADA Hotline –1-800-949-4232 n www.homemods.org n www.dynamic-living.com n www.independentliving.com n www.disabilitymall.com