Home is where the heart is, but for people with disabilities or limited function it can also be a daily obstacle if it is not properly designed or modified for a person's needs. With 54 million Americans living with disabilities and aging Baby Boomers representing 20% of the US population, the building and the health care industries have recognized the need for universal home accessibility.

The National Association of Home Builders (NAHB), in collaboration with the NAHB Research Center, NAHB 50+ Housing Council, and the AARP, have created a special breed of professionals called Certified Aging-in-Place Specialists (CAPS) to satisfy this growing need. They are remodelers, general contractors, architects, designers, and health care consultants. These individuals have been trained with the necessary technical, business management, and customer service skills needed to properly assess a home's longevity and form plans to make it more livable by catering to people with disabilities and general aging issues.

According to research conducted by Focalyst, New York—a leading source of data, analysis, and advice about Baby Boomers and consumers age 50 and older—a majority of adults wish to remain in their current homes during their maturing years. In addition, 65% of these people plan on remodeling their homes in the near future. Thus, CAPS professionals can help to ensure a home's safety and utility for years to come.

A threshold ramp allows for easier transition for most individuals.

More and more Americans are finding their homes are not designed for people with current or future limitations. The understanding of how one can benefit from home modifications comes from a true understanding of a person's disabilities. There are more than 1,100 CAPS professionals in the United States, according to the NAHB's Web site. However, only 35 of them are also health care professionals. Occupational and physical therapists with a CAPS qualification have a more comprehensive knowledge of what a client's needs might be because of their understanding of the physical requirements of a person with disabilities. They also can plan for the progression of a physical condition as well as the physical impact of the normal aging process.

If a home is not modified for a person's needs, small problems can add up and demand big budgets. Thankfully, CAPS professionals can provide financial advice about where money is best spent and for what purposes. Their mission is to provide quality solutions to everyday problems for a variety of budgets.

The valuable advice of CAPS professionals can act as a safeguard for the future. Whether a grandparent moves in, a child breaks a bone, or a friend with a disability visits for a weekend, having an accommodating home is a valuable asset for family and guests. A recent renovation involved a middle-aged man with multiple sclerosis who wanted to remain in his home as long as possible. His renovation converted an unused bedroom on the first floor into a master suite and bath with its own barrier-free entrance. He has spent half his life in his home and now looks forward to growing old within its walls.

The safety of one's own home is of utmost importance. Yet, the home's aesthetics commonly overshadow its accessibility when considering a remodeling project or new construction. CAPS professionals are trained to find a balance between the two. There are infinite options for attractive and practical home modifications.

Many who are having these home modifications are currently facing physical barriers. It is easier for these individuals to understand the importance, convenience, and independence that a barrier-free and universally designed living space provides. Universal design, when done correctly, is not just for the disabled—it is to make life easier for everyone. It should always be a person's choice to move out of his or her home; that choice should never have to be made for them as the result of environmental barriers.

Getting In, Out, and Around

Several renovations can be made to a home that can guard against unnecessary injury and provide an easier and happier life. Areas that are most often modified are a home's hallways. Hallways are often widened to at least 36 inches, but CAPS professionals have found the larger the space the better, especially within high traffic areas.

Ideally, everyone's home should have a nonstep entrance. Just one small step can be a huge obstacle for someone in a wheelchair, someone with poor vision, or a mother trying to push a baby stroller in and out of her home. For exterior entrances, the threshold should not exceed 3¼4 inches and must be beveled with a slope of no greater then 1:2. Again, this would be easy if building a new home. For the majority of people who are trying to remodel and retrofit, there is the option of installing a ramping system. If the land allows, a variety of landscaping options can create a gentle slope and a nonstep entrance without the look of a ramp. Also consider a home's entrance, walkways, and driveway. Walkways should have a minimum width of 36 inches, and there should be covered access to the home in case of inclement weather. Entrances to a home should also have doorways with a minimum width of 32 inches to accommodate a standard wheelchair.

Individuals in wheelchairs can better access shower areas that feature a curbless entrance.

Once inside the home, interior entranceways should have a threshold no greater then 1¼4 inch if not beveled; and if beveled, they should not exceed 1¼2 inch at any point. However, no threshold is ideal. If there is a flight of stairs to a second floor, either stair glide systems or wheelchair platform lifts can be considered. For new construction, consideration should be given to designing two closets right on top of each other to cater to the potential installation of a residential elevator system. These also can be added to the exterior of a home, but they are more costly.

The Simple Things in Life

Simple projects can have a big impact on the longevity of a home. Light switches and electrical outlets should be moved so they are easily reached from a wheelchair and usable by a person without disabilities. This means they should be located 48 inches from the floor for a front approach and a maximum of 54 inches for a side approach. In addition, hardware should be lever or D-ring style to allow for someone with arthritis, decreased strength, or lack of motor control to open cabinets and doors. The lighting in and out of the home should also be considered. Special consideration should be given to adding lights under kitchen cabinets, in bathrooms, and in hallways for night lighting. Consider creating a contrast in light, as lighting is a huge issue for people with failing vision.

Another simple home modification is adding a package shelf by the entrance door for mail deliveries and a place to rest groceries, making it an easier transition into the home. Also look into using universal design hinges called swing-free or recessed hinges, which can add an additional 1 inch to 1.5 inches to a doorway. Other beneficial investments are French-style doors, which allow easy access by opening one or both doors.

Another major item to consider is the floor material. The floors should have good traction to prevent falls, but should also be wheelchair friendly. This means flooring should be both nonskid and nonslip, which can be nonwaxed wood flooring, linoleum flooring, or a simple Berber rug. It also helps to avoid a distracting or loud pattern, because such can cause difficulties for aging individuals with vision deficits.

Danger Zones

The bathrooms and the kitchen are the two most important areas to look at when either buying or looking to modify a home. They also happen to be the most troublesome when dealing with limited function or mobility. However, several modifications can address these various issues.

The bathroom needs to be large enough for wheelchair access. This ideally means a 5- x 5-foot space to allow for ample wheelchair mobility. This amount of space is typically challenging for many retrofit designs, which means that bathroom remodeling may require expanding into other rooms. In addition, CAPS professionals encounter many problems within bathrooms that require people to step up and into a shower or bath. Ideally, the best solution is to fit a barrier-free shower with, again, a 5- x 5-foot turning radius. This allows easy access via a shower wheelchair and also allows space for a caregiver's assistance, if needed. Smaller shower stalls and baths are also accessible as long as they can still accommodate a standard shower chair.

Likewise, there are many solutions for those who prefer baths as opposed to showers. Many bathtubs can be fitted with lift-transfer systems, which are operated by the individual or a caregiver. The bathroom sink should also be accessible and provide adequate clearance underneath for a wheelchair. This can be a wall-mounted sink, pedestal sink, or vanity with push-back cabinet fronts. Another easy, yet practical, provision for a bathroom is to make sure the toilet is tall enough to allow for easy transfer but also usable with a rollover commode chair for the future. The final word of advice is to enforce the bathroom walls with proper solid backing to allow for the installation of grab bars throughout the space.

A kitchen's modification revolves around accessibility. Basic considerations include the height of the cabinets and counters, the placement of appliances, and the space allotted underneath or around certain appliances. Due to the growing need to provide customers with adaptable products, companies now offer adjustable shelves and counters that lower with the push of a button. Also, when designing a remodel or new construction, homeowners ideally should allow about 48 inches of clearance in front of an appliance for wheelchair maneuverability. Like in the bathroom, the sink should have ample space underneath so that a person in a wheelchair can complete tasks comfortably. The same extends to the eating areas like the dining room table or island. An island is a particularly convenient space when incorporating a two-tiered design. Having more than one tier allows for one to be at an average sitting height and another tier to be at wheelchair height. This makes everyone comfortable when preparing or enjoying a meal.

Standard measurements are provided by the American National Standards Institute and the Americans with Disabilities Act; however, everyone has different capabilities. CAPS professionals provide a personal and customized modification plan that goes beyond implementing standard disability measures. Instead, CAPS offers a plan that will best serve your home, your lifestyle, and your safety.

When thinking about remodeling or building a home, consider a life within it for years to come. Adaptive solutions for the future do not need to look institutionalized, as there are endless attractive alternatives to ensure the longevity of a home with a custom feel. Understanding and building on the present and future should be the foundation of any person's home design.

Samantha Bogert, OT, CAPS, is an occupational therapist at Good Shepherd Rehabilitation Network, based in Allentown, Pa. She works as a CAPS professional within Good Shepherd's Designs for Life Home Modification Program. For more information, contact .