Home is supposed to be our safe space, a relaxing retreat from an unforgiving world. But for people living with a disability, home can sometimes feel more like an obstacle course — its steep steps, narrow doorways, stubborn windows, and hard-to-reach switches a constant source of challenge and frustration.
Fortunately, between new advances in home technology and a bit of forward thinking on the part of designers and architects, more people with disabilities are able to go about their daily lives at home with an impressive measure of independence. Small, thoughtful changes to a home can make it far more usable for nearly anyone, while even those with very limited mobility can now control their environments — turning off lights and appliances, opening doors, closing windows — with automated, integrated systems operated by vocal commands or even eye movements.
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“People think of ramps and grab bars, and that’s just the tip of the iceberg,” said Deborah Pierce, author of “The Accessible Home” and founding partner of Pierce Lamb Architects in Newton.
Pierce grew to appreciate the need for accessible design in the 1990s, when she was assessing public buildings for compliance with the nascent Americans with Disabilities Act (ADA). “For me it was just a job until I met a man who had a spinal cord injury, and had occasion to walk through my daughter’s school with him,” Pierce said. She realized the building presented enormous and unnecessary obstacles to him at every turn, often in subtle ways. “It was a big a-ha moment for me to see how a person in a wheelchair experiences the environment differently from me. The ADA suddenly became real, rather than just another code to comply with.”
There are nearly 800,000 people with disabilities living in Massachusetts, about 12 percent of the state. Add to that the temporarily disabled — perhaps from a car accident, work injury, or a bad wipeout on the ski slopes — plus the aging baby boomer population, and there’s a good chance you or a family member will face at least some difficulty with everyday activities at one point in your life. That’s why, Pierce said, it can make sense for everyone to design his or her home with accessibility in mind from the start.
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“The things that make a home better for disabilities often make them better for a wide range of other uses, for children and for families and for people who may have health conditions that affect how they see, hear, or understand,” Pierce said.
That’s the guiding principle behind universal or inclusive design, the idea that products and buildings should be made both aesthetically attractive and inherently usable to as wide an audience as possible, regardless of age or ability. An example would be lever-style door handles, a simple alternative to doorknobs that can be used by a far greater number of people, or the ergonomic kitchenware designed by Oxo.
Some smart-home technology also fits this bill: App-enabled and voice-activated thermostats, lighting, and appliances promise to make the home more automated and efficient, but they can also empower people with disabilities to maintain more independence over their environment if designed thoughtfully (with textured buttons and large, visually contrasting displays for the visually impaired, for example).
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Valerie Fletcher, executive director of the Institute for Human Centered Design in Boston, said technology isn’t central to every residential project they do — but it has its advantages. “We designed a home for a lawyer with ALS in Wayland, and it was a full-tilt integration of physical and smart-home technology,” Fletcher said. The new-construction home, intended to be a case study for others with ALS, will allow the owner to remain as independent as possible, even as the disease progresses. “He can control lights, heating and cooling, windows, doors, and music with his hands, his voice, or through eye-tracking if that becomes his method of communication.”
The home uses PEAC, an automation system by Promixis Automation Solutions and Assistive Technologies that can be networked to control just about anything that has an on-off switch using a regular tablet or smartphone as the interface — which in turn can be outfitted to respond to eye movements or sip-and-puff sensors for people with limited mobility. The PEAC server is housed on site, and hardware like door openers and automatic window shades are connected to it by Ethernet cables, so the system can still operate during an Internet or Wi-Fi outage. The house is also outfitted with radiant heat in the driveway to reduce buildup of ice and snow, a small residential elevator that allows the client to use the entire house, and powered pocket doors by DORMA that can be operated with a movement of the hand or shoulder.
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Pierce said another exciting smart-home technology being used in South Korea but not yet available in the United States is ubiquitous computing — where microchips embedded in everyday objects, like building materials, allow them to “talk” to one another. “For example, microchips in the floor register impact if you take a fall and call 9-1-1,” Pierce said.
However, technology isn’t the only answer. “The most effective universal-design solutions are decidedly low-tech,” said Pierce, such as ramps, wider doors, and comfort-height counters. Many of her clients with disabilities are wary of high-tech solutions, she said, because they can fail due to mechanical or electrical problems. “Imagine if your garage doors don’t work, and that’s the only way to get in and out of the house with a wheelchair; it’s a major problem, not just an inconvenience,” Pierce said. “The stakes are higher when you have a disability. Having something that can’t break is essential.”
One example of a simple, low-tech solution — for the bathroom, which can be treacherous terrain — is to create a walk-in shower. “It’s so easy to accommodate people with a range of mobility disabilities, including many folks who don’t need a wheelchair but will have difficulty stepping into a tub,” said Bill Henning, director of the Boston Center for Independent Living.
While a bathroom renovation doesn’t come cheap, new products are making it easier and less expensive to convert a bathtub to a curbless shower. “Schluter is a German company that makes backer materials for tile, and they’ve developed a system that doesn’t require you to rip up the floor structure in order to have a curbless shower,” Pierce said. The company’s sloped subfloor panels can be installed on top of the joist, she said, potentially saving thousands of dollars in structural work in a typical bathroom. “That’s really an exciting innovation to me.”
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Pierce and Fletcher both recommended the Toto Washlet, a bidet-style toilet popular in Japan that sprays warm water and blows warm air. “For anyone who has dexterity or upper-body limitations, being able to maintain personal hygiene is a matter of comfort as well as dignity,” Pierce said.
In the kitchen, Pierce recommends adjustable-height counters, single-lever faucets, shallow sinks, a wall oven with separate stovetop (with no cabinets underneath) to facilitate seated cooking, a single-drawer dishwasher, and a side-by-side refrigerator/freezer. “It’s easy to make an accessible kitchen now — or easier than it was 10 years ago when appliances like this weren’t readily available,” she said.
The home’s entrance is another crucial area. “We’ve got real weather issues in New England, so the entrance sequence is very important,” Pierce said. Protection from the elements is essential, as is good lighting. “A really accessible home has a ramped approach at the exterior, but the ramp should be well integrated into the design of the house so it doesn’t broadcast to the world that a person who’s vulnerable lives there,” she added.
Renovating your home’s bathrooms, kitchens, and entryways may sound expensive and impractical — and Pierce said deciding whether to move or remodel is a common dilemma. Either way, it can be expensive. “These modifications can be costly, a problem that worsens if the homeowner is unemployed due to illness or injury,” she said. Insurance may cover medically required upgrades, Pierce said, so check your policy and keep clear records of your expenses, as some of them might be tax deductible.
Pierce recommends making inclusive design part of any renovation project, since simple accessibility choices become almost cost-neutral during construction — just another design decision. “A 36-inch opening between rooms really isn’t more expensive than a 30-inch opening if installed from the start. But widening the space later can mean re-framing the wall, patching and refinishing the floors in two rooms, and moving electrical wires and switches,” Pierce said.
While public buildings like malls and libraries are accessible, most building codes governing private residences don’t yet have accessibility requirements, Pierce said. But that’s changing as some places rethink their zoning rules to serve aging baby boomers. Communities like Atlanta and Bolingbrook, Ill., for example, now require certain newly built homes to be “visitable” for people with disabilities. “That’s a zero-step entrance, a 32-inch-wide minimum passage through the house, and a bathroom on the main floor — so that even if I’m not in a wheelchair, but I have a relative or friend who is, they can visit me,” Pierce said.
Perhaps the real innovation isn’t any new, connected gadget, but rather a growing understanding of the possibilities of inclusive design. “People with disabilities want what anyone wants for their home — to live in it as independently as possible, in comfort and safety,” said Henning. “It simply may take more planning and tweaks to how things are built, designed, and furnished, but it’s not rocket science.”
Jon Gorey is a freelance writer in Quincy. Send comments to jongorey@gmail.com. Follow him on Twitter at @jongorey.