Some home adaptations are essential for enabling a family to care for their child and keep him or her safe, while others expand the child’s independence, so he or she can get out of bed, use the toilet, move between floors, grab a snack, and get out the door without assistance.
On this page, we have organized home adaptations into three broad categories:
- Ramps/Entry – Access to the home itself is the most immediate concern for a family with a child who uses a wheelchair or other ambulatory device.
- Bathrooms – The size and design of bathrooms often present the greatest challenge within the home.
- Other rooms – Hallways, bedrooms, kitchens, garages, and other living spaces each present their own set of challenges.
Families that will be caring for a child who uses a wheelchair should consider their options: Can they carry their child? Can they carry the chair? What kind of chair will they use? Does their home have room for a ramp? How might these things change over the next several years?
|Ramp to front of home||
Size - Not only must a bathroom must be large enough for a wheelchair to enter and maneuver, but it must allow enough space for a parent or other adult to be in the room to assist the child.
Sinks - Ideally, the bathroom sink will be built without cabinets underneath it, so that the child can wheel up to the sink to wash their own hands. 2010 ADA standards state that the sink surface should be 31 inches maximum above the floor with 24 inches of knee clearance for sinks used primarily by children 6 to 12 years. (From ADA.gov)
As children grow, lifting them in and out of a shower chair becomes increasingly difficult, or even impossible. One solution to this problem is a roll-in shower, which has no barrier or rise between the level of the bathroom floor and the shower floor itself, allowing a manual chair to be wheeled right into the shower.
Another solution, and a newer product, is a tub with a drawer-like cutaway in the side. The drawer pulls open so a chair can easily roll in. The drawer is then closed, sealing the tub for bathing.
No matter which options a family chooses, handrails and grab bars should be mounted throughout the bathroom to aid in mobility and safety.
One challenge for parents as their child grows is the difficulty of lifting him or her from the bed to the wheelchair, and vice-versa. One solution is a lift–a mechanized sling attached to the ceiling above the bed. The caregiver (or the child, if he or she has sufficient strength and coordination) places the sling beneath the child. The sling then lifts the child slightly and moves him or her over to the chair and back again when needed.
Some children, such as those using ventilation or other specialized medical equipment, require virtually round-the-clock monitoring. Families who have confronted this challenge suggest putting the child’s bed in an open area near other conveniences: the kitchen, a bathroom, and perhaps a living room and television.
Therapy Rooms - Many children are instructed to engage in various kinds of physical therapy, and sometimes require bulky equipment to stimulate breathing (for example). Some families are able to dedicate a room as a “therapy room;” a space that allows a child room to move, and to use and store equipment.
Interior Mobility, Stairways, and Furniture Placement - For young or more headstrong children, it is important to be cautious with stairs so that a child in a chair doesn’t accidently wheel down them. Parents interviewed recommend placing sturdy gates at the tops of all stairs.
Families able to build a custom home can take additional steps to improve interior mobility. They may choose an open floor plan, making it easier for a chair to maneuver. A home that is built entirely – or at least mostly – on one level is ideal, although this is significantly more costly than a multi-level home. Alternatively, a family can consider having an elevator installed so that their child can maneuver easily between floors.
Furniture should be carefully arranged, or even removed, to allow easy passage for a wheelchair.
- Added lighting will increase safety, particularly in areas such as stairways.
- Push/pull lever faucets are helpful for children with limited hand strength or dexterity.
- Side-by-side refrigerators are more accessible for children in wheelchairs than vertically arranged ones.
- Leverset entry and interior door hardware are easier to use than regular doorknobs.
- Wide swing hinges allow use of the entire doorway.
- Reinforcement of wall substructures will better support grab bars.
Families with lower incomes may struggle to make even minor changes. They may need to rely on the benevolence of organizations that help families with disabled children. The demand for the services of such groups often exceeds their capacity. (See the bottom of this page for contact information for several such groups.)
Families who have been through the process of building a custom home recommend seeking a builder with relevant experience—someone who is flexible and understands the particular challenges of designing and building a home for a child with special health care needs. Families often need to modify their plan and ask for additional changes throughout the construction process.
It is difficult to put precise numbers on these changes. However, one family that built a home specially designed for a child in a wheelchair said it cost them approximately $40,000 more than building a standard home. This family chose to live in a more remote, suburban location because their dollars would stretch further there and allow them to live in the home they truly wanted.
ASSIST Utah Guidebook ( 2.6 MB)
The ASSIST Utah site has a very useful downloadable guidebook with information and guidelines on home modifications and new construction.
The ASSIST Utah site offers examples of home modifications and shows new homes that people using wheelchairs can visit.
2010 ADA Standards for Accessible Design
The Department of Justice published revised regulations for Titles II and III of the Americans with Disabilities Act of 1990 “ADA” in 2010. These revised, enforceable accessibility standards set minimum requirements for newly designed and constructed, or altered, state and local government facilities, public accommodations, and commercial facilities. These are the minimum standards for a building to be accessible to and usable by individuals with disabilities.
Easter Seals Easy Access Housing Program
Here you will find helpful educational brochures and an expert panel with additional resources and easy-to-implement tips for making an accessible home a reality.
Disability.gov - Accessibility & Universal Design
Here you will find links to many good websites with accessibility & universal design information.
Dedicated to independent living for persons of all ages and abilities, this site serves as an information clearinghouse on home modification to equip professionals and consumers with a comprehensive inventory of resources, including funding programs.
Provides resources and information geared toward people with disabilities and special design needs and those who care for them. (This is a commercial website; the Medical Home Portal does not promote or endorse commercial products or companies.)
The Home Wheelchair Ramp Project
Offers a manual for design and construction of wheelchair ramps, as well as specific information about modular ramps and long-tread low-riser steps that can improve safety and home accessibility.