ALS Home Modifications

A barrier-free environment in the home is essential to successful independent living for individuals who are physically disabled. It can also increase the ease for the primary caregiver. People who are diagnosed with ALS or other motor neuron diseases know that over a period of time, as increased weakness develops, simple day-to-day activities and self-care can become challenging. Architectural barriers are defined as architectural features in the home that make moving around the environment difficult or even impossible. Examples may include stairs, narrow doorways, low toilets, and sliding glass doors on the tub. This article is intended to provide the reader with some practical suggestions to consider when making changes to their home environment.

To begin with, look at the exterior of your home.

• Do you have stairs to climb in order to enter your front door? If so, how many and how high is each step? Is it possible to have a ramp built?
  
• Some general needs regarding ramps may include:
• Minimum width should be at least 36 inches.
• The ideal ratio of slope to rise is 1:12--that is, for every inch of vertical rise, 12 inches of ramp are required.
• Ramps should have level landings at the top and bottom of each run.
• If you build a ramp, consider the space necessary to open the door (usually a 24-inch area is needed).
• If ramping is not an option, is there another entry that could be utilized?

Next, make a list of problem areas. Go room by room to keep yourself organized. Try to prioritize the problem areas. Although a standard door width should be 32 inches for easier wheelchair access, there are several solutions to narrow door problems:

• Existing hinges may be replaced with "swing clear" hinges. They may increase the clear opening of a door by 1.5 to 2 inches.
• Doorstops may be removed, adding an additional 3/4-inch to the clear opening. By removing existing doors, an additional 1.5 to 2 inches may be gained.
  
• Sometimes, depending on the type of wheelchair you have, by removing the push rims you can narrow your chair by up to 2 inches.

Common barriers inability to enter the bathroom (bathroom doors are notorious for their narrow width) and difficulty maneuvering in the bathroom. These barriers may impede the ability to perform your basic self-care activities such as grooming, bathing, and toileting. Possible suggestions include:

• Building an additional "roll-in" bathroom somewhere else in the home
• Removing the existing bathtub to create a roll-in shower stall
• Using a tub transfer bench with your existing tub to eliminate the need for standing while bathing
• Placing grab bars to increase safety
• Placing a commode over the existing toilet to increase the height, which makes sit-to-stand and transfers less difficult