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Making Homes More “Visitable” for Wheelchair Users and Potential Hosts

      Wheelchair users and the people in their social networks want to enjoy each other's company. However, many homes have barriers (eg, entrance steps, narrow interior paths) that limit their visitability in a wheelchair. Visitability refers to an effort to change home construction practices so that new homes, whether or not designated for residents who have mobility impairments, offer 3 specific accessibility features: 1) at least 1 zero-step entrance on an accessible route leading from a driveway or public sidewalk; 2) all interior doors providing at least 81cm (31.75in) of unobstructed passage space; and 3) at least a half bathroom on the main floor (http://concretechange.org/visitability/visitability-defined/). These barriers can cause both wheelchair users and potential hosts to forego sharing special events or just spending quality time together, which is mutually important for all relations.
      People who use wheelchairs and other mobility devices report that discussions about home access can be difficult. Potential hosts may feel bad about the lack of access or interpret the mention of accessibility as criticism of their home; wheelchair users may fear that initiating such discussions will create conflict. These perceptions may prevent productive problem-solving regarding home barriers that could make visiting possible.

      How to have a productive discussion regarding home barriers

      • Recognize that this as an increasingly common problem: many people want to learn how to make their homes more accessible, and wheelchair users want to visit them.
      • Accept that no one is to blame: in most communities, there are few accessible homes that can readily accommodate wheelchair users.
      • Focus on the actual barriers, not the perceptions. If both parties recognize the importance of the relationship and devote energy to figuring out how to remediate barriers, more homes could be made visitable.
      • Address the issue openly and factually, relaying any possible solutions:
        • “I would love to accept your invitation, but let’s discuss what barriers we might need to address to make that happen.”
        • “We want you to come to the party; let's talk about how we can accommodate you.”
        • “My brother's home has steps, and here is how I get in there in my wheelchair…”
        • “There are 6 steps up to our front door, so how about if we have dinner in our recreation room in the daylight basement…there is a path around the house to the door with no steps.
        • “If I visit for only a few hours, I will not need to use a bathroom.
        • “We think if we relocate the loveseat, you can easily get into our living room.”

      How to assess the wheelchair user's needs

      The wheelchair user should be able to describe access needs for specific settings. Knowing wheelchair dimensions, combined weight of the person and chair, and deciding in advance whether she/he is willing to be lifted up steps will be useful. Other helpful information includes parking needs (eg, space to put a van lift down) and bathroom needs (or not needing a bathroom for a short visit).

      How to assess home barriers

      Areas for assessment include door widths and steps at entrances; interior paths, including doorways; sharp turns required to reach a specific area; space for a wheelchair user to sit (eg, in a living room or at a dining table); and access to a bathroom. Other areas might include parking and the path to an entrance. Measuring the width of entrances and indoor paths and sharing mobile phone photos of potentially problematic features can help to strategize regarding barrier removal.

      How to remove home barriers

      • Do not assume that what works for one wheelchair user will work for others. People, their equipment, and their needs differ. This especially applies to willingness to be lifted up a step or access to a bathroom.
      • Steps at entrances are often the deal breaker. If a main entrance has steps, consider whether a rear or side entrance might be more accessible. Temporary or permanent ramps are likely the best solution for steps. However, if there are many steps or if the residence is an upper floor apartment or multilevel home, relocating the event may be the only option. Another home, an outdoor setting, or a public location may be alternatives. Inclusion is more important than location.
      • Typical wheelchairs require 81.3cm of clear space (door jamb to edge of open door) to pass through. Because most exterior doors are 91.4 cm wide, narrower interior doors may be more problematic. Replacing door hinges (with displacement hinges that displace the door from the doorway opening, gaining about an inch) is a possible solution.
      • Interior paths of homes should be measured and assessed for furniture or other moveable obstacles. An accessible path should be 91.4cm wide; however, 81.3cm is the minimum. Consider where a wheelchair user can be comfortably located in a gathering space (living room, dining room, kitchen, etc). Assess the space around any sharp turns because most wheelchairs require additional space to turn. Creating access is more important than having perfectly placed furniture.
      • Bathroom needs are unique to the individual wheelchair user. If a narrow doorway or placement of fixtures prevent entrance, barrier removal may be impossible. Because this is a personal issue, the wheelchair user should take the lead on disclosing needs and suggesting solutions. Possibilities include limiting the visit duration, leaving the home to use facilities nearby, temporarily replacing the bathroom door with a curtain, or using a portable commode located in a bedroom.
      Online resources are subsequently noted that can assist in removing barriers to make a home more visitable. The most important step is a frank discussion between the wheelchair user and host. Addressing home barriers to facilitate visiting can be beneficial for all involved.

      Resources

      Ramps for homes

      The Manual Wheelchair Training Guide

      • Information on negotiating stairs with assistance is available in The Manual Wheelchair Training Guide (Axelson P, Chesney DY, Minkel J, Perr A. The manual wheelchair training guide. Santa Cruz: Pax Pr; 1998).

      Adaptive access

      Christopher and Dana Reeve Foundation Paralysis Resource Center

      Disclaimer

      This information is not meant to replace the advice from a medical professional. You should consult your health care provider regarding specific medical concerns and treatments.

      Authorship

      Making Homes More “Visitable” for Wheelchair Users and Potential Hosts was developed by Dorothy E. Nary, PhD, and funded by the National Institute on Disability and Rehabilitation Research/United States Department of Education (grant no. H133F110017 ). This information/education page may be reproduced for noncommercial use for health care professionals to share with patients and their caregivers. Any other reproduction is subject to approval by the publisher.