Multiple Sclerosis Centers of Excellence
There's No Place Like My Home
Sam Adams, OTR/L and Jacqueline Hall, MS, OTR/L, ATP
Most Americans nearing retirement say they plan to live in their homes for as long as possible. Yet, fewer than 5% of people in the US live in homes that support moderate mobility difficulties and fewer than 1% live in homes that are wheelchair accessible. Similarly, most people with MS want to live at home but have not made plans to ensure home accessibility. Mobility challenges for many with MS include fatigue, vision changes, weakness, and poor balance.
Making changes to your home before you experience mobility challenges can help with your safety, your fatigue, and staying independent. Modifying your home may feel overwhelming at first, but there are some steps to follow that can keep things manageable. You can ask your physician if they think you would be a good candidate for a home evaluation from a rehabilitation specialist. A rehabilitation specialist, such as an occupational or physical therapist, can help you select and plan home changes.
Evaluate Yourself and Your Home
First, plan for the home evaluation by gathering information about yourself and your home. A table like below, where each room or area is listed, along with difficult activities followed by why a specific task makes you feel unsafe, can help organize this information.
Make a Plan
In a multi-level home, list rooms for each level. Remember entrances, steps/stairways, parking, and your yard. What is causing you trouble? Is it the layout? Are there too many things in the room? Are your rooms well lit? Are you needing more outlets for lighting or charging? Can you reach things you need?
Once you have identified what is difficult in your home, decide which rooms or areas involve safety. Your safety should be the most important focus, followed by things that most affect what challenges you, like fatigue. There are many simple changes that can result in increased accessibility. A major remodel or moving to a different home may also be an option, though both require more resources -information, as well as funding.
Follow the “5 Rs” When Considering Modifying Your Home For Safety and Accessibility:
Eliminate the unneeded – clothing you don’t wear; extra dishes in the kitchen; expired items in the ‘fridge or bathroom. Overfilled storage areas require more effort and time to locate items.
Save energy by moving heavier items to places easily reached. Clear pathways to reduce trip hazards and ensure access to light switches, door handles, and the bathroom at night.
In a multi-level home, consider rearranging rooms to spend most time on the most accessible level. Can you convert a main floor office to a bedroom, a dining room to a multi-purpose room with computer access, or move someone else’s bedroom to the upper level?
Make home modifications before you actually need them to maximize safety and your peace of mind. Remodeling may include adding ramps, widening doorways, adding safety equipment, or using technology to operate your environment hands-free or with voice activated devices.
If these modifications are too much to manage, you may consider moving somewhere that has helpful features already in place. Certain single-family home styles (e.g., ranch/rambler) may be more accessible with open floorplans and single-story living. Some apartment buildings offer units that were designed with accessibility in mind.
When You Need More Support
Managing changes to your home requires time and energy. You may choose to do these updates yourself, or with a rehabilitation specialist’s or remodeling professional’s help. A “Certified Aging in Place Specialist,” interior designer, or a general contractor may be helpful additions to your team.
Terms and Specialists to Know as You Navigate Supportive Resources:
Certified Aging in Place Specialist (CAPS) are professionals, often home remodelers or healthcare professionals, who offer home modification services to seniors or adults looking to age in place.
The federal Fair Housing Act Act requires that some units in multi-family projects feature some accessible design features, such as an accessible entrance, widened doors, and reinforced walls for grab-bar installation.
Accessory Dwelling Units (ADUs) are living units on the same lot as a single-family residence that are often detached from the main residence. They have their own kitchen, sleeping area, and bathroom, and can be designed to maximize accessibility. This may be an option for those who are interested in living on a family member’s property.