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Building a house to accommodate pain and disability

  • Everything I do, all day, every day, hurts. The more I do things that are painful, the more the pain snowballs. We're going to build a house that we hope will help reduce the accumulation of pain, and maybe even let me recover a little. Help me make sure I'm covering all the bases in house design accommodations. I want to make this as fully accommodating as possible. Have I missed anything? (I've tried to read ADA accommodation regulations, incidentally, and I can not believe how insanely detailed they are without actually saying anything useful.) I have injuries, neurological weirdness, joint pain, nerve pain, muscle pain, numbness. I can't walk straight and I pass out a lot. (I fortunately get a touch of warning just before a syncope episode--blacking out--so I can usually make it to somewhere safe to fall.) Bending over hurts my back AND may make me pass out. I can't extend my arms or lift them above my head for long. Most of the time I'm independently mobile (if wobbly). Infrequently, I can't walk independently and either need assistance or a wheelchair. I'm currently in a house that was custom built for a couple of short people; we didn't realize how much of an effect that would have when we bought it. We've done what we can in small ways to make things easier on me, but to make this house really what I need we'd have to gut it down to the walls and start over. I'll shortly have the opportunity to custom build a house for ME (and my spouse, who has indicated that he doesn't care much about the way a house looks as long as it works out for me, and contains a few things he really wants). I'm 5'10" and he's 2" taller, so custom heights, etc for me should work well enough for him. Construction companies are willing to work with me to make the house right, but since this isn't a typical disability--not that any are "typical," I think--they're letting me specify what I want in terms of accommodations. This is the single largest undertaking of my life, and it's so important. If we can get it right, maybe we can reduce the amount of pain I am in all of the time. Every single thing I do hurts; just standing hurts, but then if I, say, go to chop a vegetable, I have to bend in a sort of hunch for a while. That makes the pain worse, and the extra pain causes extra fatigue, and I feel terrible for hours, sometimes days. Everything I do. All day long. It all hurts. The pain all accumulates. So I really, really want to get this right. We need to minimize obstacles/walls I'll bump into, keep me from having to bend over, sit, reach above my head, or lift heavy things--unnecessarily, or for extended periods of time, or at all where possible. This is what I have so far: General-- * Single story, full wheelchair access: from parking, through exterior doors, to throughout interior of house. Not just for the infrequent instances when I'm in a wheelchair, but also to reduce tripping, bumping into walls, and otherwise having the house interfere with my locomotion. * No high thresholds, smooth low-grade ramping up to and over any necessary changes in height. * Smooth flooring throughout: no carpet, no changes in height or high thresholds at changes in flooring type. * 36" minimum all doors, wider if possible. Wide passthroughs (42" if possible), minimal hallways if any, room for safe maneuvering of wheelchair or unsteady person. * Perhaps double pocket doors typically left open to any room we might want to close off occasionally (MBR, "den," etc). * Room in master bedroom and bathroom to maneuver wheelchair if needed. * Round corners on anything that does stick out, like the edges of a kitchen island. One fully handicapped accessible bathroom: make it easier to sit and stand, make it less likely I'll pass out in the shower-- * Lots of room to maneuver * Extra tall toilets * Extra tall vanity (40-44") * Large sinks with tall faucets * Grab bars at toilet and in shower * Roll-in shower (requires floor sloped for drainage) with fixed-height showerhead in convenient place for standing shower * Shower seat (about 24"x16") with adjustable showerhead centered behind * Curved shower curtain bar to make shower area as large as possible, and so that when shower curtain is pulled back, shower area is extra maneuvering room. * No shelves that stick out--particularly in the shower, but also throughout the bathroom itself. (IE, no soap dish) * Anything that does stick out (edge of vanity counter, etc) rounded off. * A garden tub would be nice, if I can safely get in and out. * Grab bars *everywhere*. Kitchen accessibility requirements: keep me from having to hunch, bend down, reach up for longer than absolutely necessary-- * Lots of room to maneuver * Extra tall counters (40-44"), sink, faucet (possibly in an island, leaving counters under wall cabinets at normal height) * Large sink * Investigate countertop dishwasher (drawer dishwasher) * Side-by-side refrigerator * Large pantry * Roll out shelving (drawers) for below counter storage * Hanging storage: from ceiling, from walls , to keep most everything at chest/shoulder height so I minimize reaching down or up Misc-- * Owner parking (ie, garage) opens directly to kitchen: smooth transition (no bumps, no high thresholds), for wheelchair or for hauling in groceries etc in wheeled cart. * Easy to use interior, exterior and garage doors, car-height and people-sized (you only have to have one sticky or heavy-without-good-framing or hard-to-open door, when you're like me, to feel like you need to specify this). * Electric outlets and light switches at easy-to-reach standing height (about 48", I think) ~ ~ ~ I do not know if, at some point in the future, I'll spend more time in a wheelchair than I do now. I *think* the right thing to do is to build the house for me at standing height, because sitting is the single hardest thing I do regularly. I currently spend as much time as possible either standing or lying down. So, aside from "building everything at this height means that I won't be able to reach it if I'm eventually wheelchair-bound", am I missing anything, major or minor? Side note: we have lever door handles in this house, and I *hate* them. The mechanism seems fragile; different parts wear out and the handle gets to where it's harder to use than a round doorknob. Are there other alternatives? If we have mostly pocket doors inside, that's one thing, but there are still exterior doors. On that note, is there anything that can make a sliding glass door easy to open, and remain easy to open?

  • Answer:

    I think you should put a little more thought into future wheelchair use as that will also be hard to change later. For example, lower light switches and perhaps instead of custom height cabinets consider standard height units on a raised base that could be removed and the base cabinets lowered in the future. Also make your garage extra wide so that there is room to fit a wheelchair around the vehicles. If you will have a basement consider leaving space or even rough in framing a space for a personal elevator. If the house is designed with this in mind future installation is much easier and cheaper. It seems possible that given your level of pain you may one day want/need live in care. Perhaps when designing the guest room space consider making it more of an "in law" suite perhaps with its own external door. Good luck with this huge project!

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I heard an interview once with an architect who's job was to design ADA friendly houses. I don't remember much, but from what I do remember, you definitely want to hire someone to help you with this. There are hundreds of things which you are likely not to think of, but an expert will have dealt with before. Even if it's just a short consultation, I think this is the best money you'll ever spend on this house.

markblasco

It depends on your budget, and it makes for a more complicated house in terms of maintenance, but it may be worth thinking about remote controls as a supplement, both for lighting (as this makes the lighting height independent), and for the external doors. Electric glass sliding doors are both easy to open and stay where you want them. If at all possible, and it may be difficult, I would try out a range of options, ideally in other houses, or in an accessibility lab. What seems easy on paper, and based on your current experience of less helpful otions, may not feel as good when you try it out - this is really the standard "measure twice, cut once" advice but it's especially important for non-standard arrangements where the fact that the standard way doesn't work for you may create an unjustified halo around a different way - which might not prove better in practice. This is another good reason for going to a consultant as they may have access to other adapted properties or mock ups that you can try out. Good luck with getting something that works for you.

Gilgongo

Consider radiant heating: A friend with chronic joint pain has resorted to spending most of his time in the portion of his house that has radiant heating in the floor, because his joints feel so much better when he's there. Even with the air temperature the same, radiant heat is noticeably more comfortable for chronically sore joints.

Corvid

I used to live in a house that was custom-built for someone who used a wheelchair. Some features that house offered that haven't yet been mentioned include:oversized windows that went down almost to the floor;barn doors on bathrooms and closets which slid on overhead tracksoverly wide garage, presumably to help with getting in/out of wheelchair-accomodating van;remote control drapesraised garden beds and wheelchair friendly paths around the yard, to deck area, etc.super wide hallways, as well as doors.motion-sensor faucetsin addition to lightswitches, other placement accommodations included higher electrical outlets, lower temperature controls, etc. for easy reaching from a chairHave fun!

carmicha

Be careful with the pocket doors. We had some in our house about 15 years ago and they became quite difficult to wrestle out of their pockets over time; you really had to pull to get them moving. Hopefully they make more user friendly ones these days but I wanted to point this out in case you've not experienced this before. Good luck with your house design!

DingoMutt

You sound like a very courageous and strong person - good luck with your new house. My grandmother had similar problems for the last decade of her life, and eventually she moved to a custom-made apartment with all the same specifications as yours. In many ways, this was a great improvement for her, I hope it will become that for you, too. In retrospect, several things didn't work perfectly. Like you, my grandmother hated sitting in chairs, and insisted on standing while cooking. After a while, she found it more comfortable to use a sort of standing-chair, but for that, she needed a little extra knee-space. Maybe the ideal solution would be for the work-counter, with sink and cooking range, to be adjustable in height and open underneath? And then have another counter with drawers and dishwasher (also drawers) under it. This other counter could be used for everyday easy-access stuff, like your favorite cup and saucer, the bread box, etc. My gran stopped using over the counter shelves the minute she figured she didn't have to anymore, and used her island for everything she needed frequently. Seconding the room for in-house help. We had planned such a room, but ended up using it for extra storage, to keep the main rooms as free of clutter as possible. And we missed having space for a nurse - or for me - when we needed it. The main access to the apartment was through an elevator with sliding doors. It looked a bit unsual with the steel doors in a home, but everyone seemed to find it cool - like in a James Bond movie. I wish we had had some sort of elegant railing in the hallway between the living area and the bedroom, like ballet-rails or something. What we did have was sturdy furniture in the middle of each room, so there was always something to hold on. Remember to have something nice to look at from where you lie down. Maybe a "vertical garden" views of nature have been proved to be more soothing than walls or tv-screens.

mumimor

Just want to second: consider the hardness of the materials you're using. The currently fashionable "high end" materials like granite, marble, tile, etc -- all of them are very hard. You don't want to fall on them or drop things onto them. Put in the most bouncy resilient materials you can, even if they are "cheaper" or your builder suggests that fancier materials will help resale -- investigate this, but just at a guess, maybe cork for floors; consider what underflooring there is to add more cushion; laminate rather than granite for counters, etc. Work with a designer or architect to design for both seated and standing use - eg in the kitchen, one section of counter at a good height for seated use, and with a gap underneath where you can roll your knees, and another section of counter at a good height for standing use. Can also build in wall/undercounter spaces for rolling carts/islands, which you could bring out for chopping and then put away when you're not using them. And yes, if you're going to build on more than one level, you can design it so there are spaces (eg closets) stacked over each other that would allow you to put in an elevator if you wanted to in the future.

LobsterMitten

To solve the shower/moisture problem-use http://www.schluterkerdiboard.com/ to line your whole bathroom. It is an awesome product and schluter Kerdi makes a whole line of products for http://www.youtube.com/watch?v=LXCt8kaFSIs (the technical term you are looking for). The stuff is expensive but it works and is quick and easy to install. And it solves the moisture problem if your whole bathroom is waterproof. You don't really want a ADA specialist (I work with ADA compliance issues daily) you want an aging in place (or universal design) specialist. It is a big and growing field and will help you tremendously. Like you said the ADA is really technical, tedious and unhelpful and was really targeted at public works agencies, not private construction. There is a type of http://www.eclisse.co.uk/Disability-And-Eclisse/No-Threshold with no http://www.sky-frame.ch/e/reference-projects/villas/sliding-windows-at-soh-in-winterthur-307-p3.html. But it isn't going to be cheap. On preview i see Orangedisk beat me to the universal design link.

bartonlong

Seconding radiant slab heating. It can work under some kinds of wood or wood-like flooring. In stead of sliding doors you could use French doors.

mareli

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