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General modifications

• Doors
  • Doorways must be 34-36 inches wide. If extra space is needed, offset hinges allow for an extra 2 inches.
  • Door levers are instead of door knob. Make sure lever curls toward the door for safety purposes.
• Hallways
  • Hallways must be 36 inches wide, but 48 inches is recommended if there are decorations in hall.
• Entrances
  • There must be at least two accessible entrances into the house so that, in the event a primary entryway is blocked due to fire, there is an alternative exit route.
  • Ramps must rise 1 inch for every 1 foot of length (1 inch rise/1 foot run).
    1. Ramp should be a non-slip surface.
    2. Do it yourself non-slip option: Silicon carbide/carborundum strips or outdoor paint and sand. Make sure entire ramp is covered.
  • Guardrails must be 32 inches high and have a nonslip surface.
• Utility outlets
  • Cables should not be less then 12 inches from the floor.
  • Light and other switches should not be higher than 48 inches.

Note: Tile and wood flooring are preferable over carpet.

Bathrooms

• Flooring
  • Use of smaller tiles can create a non-slip surface.
    • Grout between tiles creates a non-slip surface.
• Shower
  • Towel rods should not be more then 54 inches from the floor for easy use.
  • Roll-in showers should be 30 inches wide and 60 inches long.
  • Slope of floor should be slanted to properly drain water.
  • Non-slip grab bars should be installed on a piece of plywood before applying it to the wall.
  • A shower chair is necessary — it should be free-standing or mounted to the wall, or in the form of a shower commode chair.
  • A hand-held shower head may enhance accessibility.
  • Do not use towel rods as grab bars, as they do not provide the support needed and can't handle the weight. Towel rods become dislodged easily, and using these as grab bars can result in serious injury.
• Sink
  • There must be space under the sink to allow room for a wheelchair to roll underneath.
  • There must be at least 60 inches of obstruction free floor space in front of sink.
  • Plumbing must be appropriately covered (to prevent burns from hot pipes, etc.).
  • To enhance accessibility, faucets should have levers and/or electronic sensors that do not require someone to twist the wrist or grasp onto a knob.,
• Toilets
  • Standard toilets can be modified with a raised seat or spacer installed beneath the base.
    • Toilet seat risers and spacers can be found at most DME providers.
  • Install safety rails on both sides of the toilet.
  • Bidets can be attached to standard toilet seats (various models).

    

Kitchen

• Ensure that 60 inches of floor space exists between work counters.
• Island-style kitchen allows for open feel and greater accessibility.
• Counter height should be 34 inches.
• Install pullout counters and cutting boards as needed.
• Ensure adequate space under the sink and oven to allow enough room for a wheelchair.
• Staggered burners on stove top allows for safer access.
• Create a 6-inch kick space along the bottom of floor cabinets.

  

Bedrooms

• Using a hospital bed allows for easier transfers in/out of bed for you and your caregiver because the height is adjustable to meet the specific needs of the bed user, as well as the person completing the transfer.
• Make sure there is enough space under the bed to allow for an easy transfer (at minimum there should be enough space for the caregiver’s feet; more space is needed to allow for a patient lift to be rolled under the bed).
   

Funding

• Explore funding through private insurance companies (for durable medical equipment items such as hospital beds, raised commodes, patient lifts, etc.) or a Medicaid waiver for home modifications.
• Check with a tax adviser to determine whether any necessary home modifications are tax deductible.
• Seek alternative funding through local and national government agencies.
• Contact your local independent living center to learn about any grants for home modifications that may be available at the local and state levels.
• State loan programs vary from state to state, but they are dedicated to assisting with access to assistive technology devices that promote independence for individuals with disabilities. Be sure to check with the following:
  • State Department of Housing
  • State Housing Finance Agency
  • State Housing Development Authority
  • State Department of Rehabilitation
  • State Office of Health and Human Services
  • State Treasurer’s Office
  • State Department of Vocational Rehabilitation
  • State Technology Assistance programs

For more information about home modifications and potential funding sources within your local area, please contact your local MDA Health Care Service Coordinator.

Note: Be sure to use contractors for all home modifications who are knowledgeable about ADA regulations.