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Multiple Sclerosis Centers of Excellence


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There's No Place Like My Home

Jacqueline Hall, MS, OTR/L, ATP

Most Americans close to retirement say they plan to live in their homes for as long as possible, despite less than half having accessible living areas to allow for changes in mobility. Similarly, most people with MS want to live at home, but have also not made plans to make it easier to get around their home. The primary mobility challenges many individuals with MS develop with the disease are fatigue, changes in vision, and less strength and balance for walking. Studies show that 20 years after diagnosis, 30-50% of individuals with MS will need to use a wheelchair.

Making changes in your home before you have less mobility can help with your safety, managing your fatigue, and keeping your independence. Modifying your home can feel like an overwhelming project but, there are some steps to follow that can make this much easier. If you have information about your home environment and needs, a rehabilitation specialist, such as an occupational or physical therapist, can help you with your planning.

Evaluate Yourself and Your Home

If an occupational therapist completes an evaluation in your home, they will measure rooms and doorways for wheelchair accessibility and look for safety concerns – tripping hazards, lighting, emergency access, etc. They will also evaluate your ability to complete activities of daily living and help determine what is limiting your independence. You can plan for this home evaluation, as well as your next clinic appointment, by gathering information.

Make a table that lists each room in your home and write down what difficulties you are having with completing activities of daily living in that room. For example:

table with needs

Make a Plan

If your home has more than one level, list rooms separately for each level. Remember to include entrances, steps/stairways, parking, and your yard. In each of the rooms you are having trouble, also write down why you think you are having difficulties. Is it the layout of furniture? Are there too many things in the room? Is there good enough lighting?

Once you have figured out where you are having difficulties in your home, decide what is most important to work on first. Your safety should be the most important focus, followed by things that affect your symptoms the most, e.g., fatigue. There are many simple changes you can make to make your home more accessible. A major remodel should be the last option.

Follow the “4 R’s” to modify your home for safety and accessibility:

Reduce: Eliminate duplicates – clothing you don’t use or need; extra dishes, utensils, and pans in the kitchen; unused or expired medications in the cabinet. Overfilled storage areas require more work, energy, and time to find what you need and too many items often overflow into living spaces and walkways creating safety hazards.

Reorganize: Save energy by moving heavier items to lower shelves. Create pathways for safe walker or wheelchair use. Clear areas near light switches for easier reach.

Relocate: In a multi-level home, consider whether you can rearrange rooms so you spend most of your day on the most accessible level of your home. Can you convert a main floor office to a bedroom, use a dining room as a multi-purpose room by putting your computer there, or move a family member or attendant bedroom to the upper level?

Remodel: Make home modifications before you actually need them to reduce safety concerns and your stress level. Remodeling may include adding ramps to entries, widening doorways, changing furniture heights, adding safety equipment to your bathroom, or using technology to operate your home with hands-free or voice activated devices.