Goose accessibility thread...

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Gooserider

Gooserider

Mod Emeritus
Nov 20, 2006
6,737
Northeastern MA (near Lowell)
Lots of folks have been sending me offers of help and support since my accident, and I don't know how much I can express my appreciation as I start down the long road to recovery... This will probably lead to lots of threads in different places about different aspects of my issues, but I figure I ought to start one here in DIY to deal with the purely mechanical aspects of trying to make the house accessible to me in my current condition.

Essentially I'm currently wheelchair confined, and paralyzed from the waist down - NOBODY knows what the future holds in the way of recovery - some folks connect back up, others don't, to varying degrees, and with varying speeds, and nobody knows just how or why... At any rate, my rehab is based on the "worst case" assumption that I won't get any better, and I've been told to assume that in terms of any accessibility planning, etc...

It currently looks like I will probably be in rehab for another 4-6 weeks while my other injuries heal, and I learn the many skills needed to live in a wheelchair - but the insurance will only pay for a limited length of time before I'm kicked out to either go home or to a "skilled nursing facility" (aka Nursing home) depending on whether or not the house is ready for me to move in. It is VERY much preferred for me to go home...

So what will it take to go home? Our current house is very pretty, but it is a difficult house at best to work on, and it will be very difficult to make it "fully" accessible - lots of different levels, and reasons why I'd like to get access to most of them. It also needs a lot of repairs to things like siding and outside porches which aren't relevant to access questions. OTOH, it won't be terribly difficult to make it "minimally accessible" enough to get me home. This is what I think my immediate objective should be, with a longer term plan of deciding whether to fix this house, or trying to sell it and get a different house (i.e. a raised ranch with a walk-in basement) that would make a better "starting point" for accessibility work.

From what I've learned so far, there are two main issues that need to be addressed - redoing the bathroom and a ramp or lift to get me in and out of the house...

The kitchen and some of the other rooms might eventually need more attention, (especially depending on if we keep the house or not) but they will do for now.

Once I get my Linux box, I will be able to post what floor plans I have done on the house so far, and get Mary-Anne to take lots of pictures so you can see what we have to deal with, in the meantime folks will have to deal with my verbal descriptions...

The house was built approx 1980, and as far as I know all the fixtures, etc. are original, and mostly look it... The main floor bathroom is relatively small, but is reasonably well laid out (I think) All the fixtures are avacado green :sick: and their only virtue is that the toilet is a "real" 5 gallon reliable flusher. The bathtub is alongside the toilet, and is a fiberglass one-piece unit that has the tub and shower walls all in one unit, surrounded by badly deteriorated sheetrock (not sure if it is molded or just mildewed with lots of peeling paint, etc) the sink is in a cabinet that is recessed into an alcove in the wall... We did have the floor of the bathroom redone a few years ago with a nice tile that I would like to keep (and we have a fair bit of extra tiles)

As I understand the "rules" for accessible design, the minimum that we would need to do to make the bathroom accessible would be to replace the sink with an open front style that I can roll my chair under. However even though the house has 2.5 baths, this floor is the only one I could access so further renovation after I got home would leave me w/o a usable bath for the duration, so it makes sense to me that doing a total bathroom makeover before I got home might be a better approach...

This would mean replacing the current tub w/ one of the more modern "curbless roll-in" showers which would also deal with the rotten sheetrock, and possibly a more "friendly" toilet as well as fixing the sink.... Does this sound reasonable????

Will post more in my next on the ramp issue...

Gooserider
 
The other big challenge that I have to deal with is getting in and out of the house with some sort of ramp or lift, or combination of the two....

The full basement of the house is about 4' down into the ground, and about 4' above. There are several possible entrances, each posing their own challenges for accessibility.

There are two routes that we have been looking at as likely candidates for modification, the front door and the garage.

The garage is how we primarily accessed the house, the way I dragged in the wood supply, and so on. It would have the advantage of keeping the ramp out of the weather (including snow) and would give me access to the laundry room, but would mean an extra level change, and be a challenge in terms of making things fit.

The front door might be a challenge in terms of design, and poses obvious challenges for snow removal

will post more later - they are taking me away for an X-ray///

Gooserider
 
Eh, nice to see you back Goose. Glad you cheated the reaper. For the access ramp to the front door, a switchback design would probably be best if you have the space for it. A lift would be better. You want to limit the length of a run and need flat rest stops. They make special offset hinges so that the open door doesn't impinge on the opening.

A curb-less shower enclosure is probably the way to go but a lift could also be an option. As for the sink, you also need to consider the height, not just clearance underneath. They do make sinks with the sanitary drain set far enough away that the trap doesn't get in your way. Too bad you're so far away. I'm in the process of reno'ing my bathroom so I could apply all I learned from my mistakes.
 
Goose - Thanks for posting on layout and setup of your house.
When our good friend became confined to a wheelchair a few years back, they used the garage as the main entrance for the same purposes that you had related.
For the garage, they installed was a small lift, similar to that you would find on the rear of a moving truck, and this allowed my friend wheelchair access to from the garage into the kitchen area. A ramp was not in the cards in the garage due to space, and I am thinking your position might be the same. This small lift in the garage kept the normal flow of traffic to what they were used to, and allowed them protection during access during the wintertime months. Try to keep the route from the exit from the car into the house as short as possible.
They had to make some modifications to the entrance between the garage into the kitchen, but that wasn't terribly bad as they just opened up the current doorway and installed a larger door, etc.. If you currently use this way for access now, I'd try to keep it the same for you and Mary-Ann.
Will be nice when we can see a layout, and try to include any elevation changes, as it sounds like you have a few on your hands.
Baby steps, right ? :)
 
Hi Goose,

Nice to see you back and I'll bet you're glad to be back! Last summer we finally got around to replacing the porcelain enamelled, cast iron tub and the 18 yr. old "temporary" plastic surround that enabled us to get an occupancy permit when we built this joint. We could count the number of "baths" we took in that tub on about 2 fingers, lol. So, out it went! (with some sweating and swearing). We replaced it with a fibreglass shower floor (Kohler from Orange, about $600). While not curbless it is just terrific, should have done it ages ago. I'd wager curbless models for retrofits are available, too. We put up blue board (whatever the stuff is for tile in tub/shower surrounds) and my brother and I tiled it. Came out great.

I cared for my frail elderly mother for nearly 4 yrs. and I have some thoughts to offer on your bathroom:
1.) you have to be safe! Everything you do to that room should be done for your safety and comfort.
2.) fixtures have to work for you and make it EASY to for you to use them.
3.) think grab rails! you can never have too many. Go out on the web and plug in Mr. Grab bar or Mr. Grab rail (I can't remember the site right now). I bought several from that site. The founder is a physical therapist and there is a huge assortment of styles and grips. Great site.
4.) since you will be rehabbing the john, and removing the tub enclosure this is the time to put in the proper blocking to support the grab rails securely; this is critical. And you should only err on the side of too much blocking! While the renovation is under way take lots of pictures so you can refer back to them to "jog your memory" of where all that fabulous blocking is; great "back up" for written notes or blueprints!
5.) shower seat. A must have; we installed a fold down model in our new shower and it's great. Not cheap, but well worth the dough, remember the blocking! Our's is phenolic white/stainless and was about $250, if I remember accurately.
6.) Hand held shower head; if you can swing it it would be helpful to have a have the shower head located near the shower seat, so you can easily reach and dial in the temperature water you desire and you don't have to let gallons of water run down the drain when you don't want to. If the shower area is on an outside wall this may not be adviseable or easy to accomplish.
7.) Toilet; get a high one. They are worth every penny. We have a crappy Kohler that doesn't flush for a -hit, and an American Standard that is pretty effective at making the brown stuff go away. Look at Totos, too. A friend has one and says it damn near sucks the brown stuff out of him... . Lol.
 
Thanks for all the advice so far, it matches up quite well with what I've gotten from folks here... Hope to start getting pictures and floor plans this weekend... Craig's loaner is good, but I want to get my own machine up so that I can get my usual photo software running on it and so forth... It will also let me get my CAD software copied over and upload the floor plans I've made...

Not sure what else I can add to the info on the bathroom - but nothing anyone has mentioned sounds like it will be a problem. Only thing I can think of is the question of how hard it will be to keep the existing floor while getting enough slope for a curbless shower to drain properly, but I think that only needs an inch or two, so it should be possible, even if I have to add a bunch of extra sistering on the rafters under where the tub is now... One of the other suggestions I've seen is that it is best to use an extra large 3" drain in the floor as it allows faster draining and easier cleanup in the case of "accidents" (which can be a problem w/ spinal injuries) I think there is reasonably good access to the plumbing as well, nothing in outside walls.

For the ramp - more details... To go in through the garage, I have to go up about 4' to get from the garage floor to the laundry room. There are then about 3 steps (about 2') to get from the laundry room to the living room. The laundry room has a pretty high ceiling (9-10') so it might be possible to raise the floor of the laundry room, though that would have the minor challenge of dealing with the plumbing for the washer and outside hose bibs, plus the gas dryer, and making the window heights look right, and all that. However it would keep the entrance out of the weather, and deal with the question of how to handle things like snow removal (I'm thinking the best approach to that might be a lawn tractor w/ a snowblower attachment and some hand controls?)

If we did decide the front door would be a better approach, it would be easier in some ways and harder in others... The current setup has a set of concrete steps going up to a front porch at the same level as the laundry room, making a left turn and then up a couple more steps to the end of the porch, where you go to the right and in a 3-4' deep alcove to the front door. A ramp could come straight out of the alcove, and either take a turn as soon as it cleared the edge of the porch and go over the steps (there are some railings that would need to be removed) and run down the side of the house and garage, OR go out 5-10 feet from the house, turn and make the same sort of turn after clearing the staircase. Either option would have to deal with various landscaping issues, walks, and such, but would be doable, and was my first thought. (Tim was the one to suggest the garage...)

Will see what happens...

Gooserider
 
Goose,

At that same link provided above, check out the automatic door openers. Also, talk to someone and find out the minimum radius you need to turn your wheelchair around. You will need this in the bathroom - or at least the 'code enforcers' will probably check this before they let you come home - been there, done that.

Our son was in a wheelchair & then leg braces/forearm crutches for years - his biggest indoor problem was carpeting & rugs. Carpeting bogged down his wheelchair, rugs slipped out from under his crutches.

Wheelchairs: Have you checked out the wheelchairs the 'rise up' so you are almost at a standing height? Awesome technology there. I'm not positive, but maybe if you have this type of wheelchair those 'code enforcers' would not require as much home remodeling before you come home.

If you need a Hoyer lift for anything at home, check out the local nursing homes for a used model. I think they have to replace theirs every year or so for insurance purposes even though nothing is wrong with them. (Frankly, we have one here that I have even used for picking up large rounds for the splitter or to get rounds into our trailer - so they even have other uses after you heal!)

Financial: Check out disability social security. (My hubby is on this.) Sometimes it's hard to get, other times it's not so hard to get it - depends on your health issue. If you haven't already checked into this, do it now as it does take 6 months after qualified application to actually begin to receive benefits.

Think positive thoughts every day! :)

Shari
 
Goose - it's difficult even to imagine dealing with the issues you now face, and I praise you for your attitude in dealing with these in a very practical way. Ups and downs, literally and figuratively, likely will face you for quite awhile.

Also, a positive from your experience is a lesson for now very healthy adults who may never even consider a future disability. We all need to consider future disability, both in buying homes and in remodeling the homes we have.

My best wishes to you, and I'm glad so many Hearth.com forum participants stepped up to help you. Please don't be bashful, personally or through a proxy, to let us know if there is more that we can do.
 
Goose . . . I'm afraid I don't have much solid advice to offer . . . quite frankly when it comes to construction the wife is the brains of the outfit here . . . I just do the heavy lifting.

But what I wanted to say, or rather echo, was JEbatty's thread . . . you don't know how good it is to have you back . . . and how encouraging it is to know you're doing well and improving in both mind and body . . . I cannot imagine what you're going through now . . . but your perserverance is inspiring.
 
One thought - during the bath reconstruction, if the sheetrock is coming down, have a 2x6 or 2x8 nailed between EACH stud at the height that a standard grab rail would be mounted. Knowing that this "backing" is there will allow you to add/move/install a grab rail or multiple grab rails anywhere, any time at the proper height.
 
Goose and I have discussed redoing the bathroom,
and I am not completely convinced it would need to be
redone before he gets here.

How long would a bathroom be impossible to use
while it is being reconstructed?

If we just have to complete the ramp or lift
before he gets home, that maximizes his ability
to discuss and supervise whatever else we do.
But he cannot live without a bathroom for long.

What happens for people with residences which
have only one bathroom?

Mary-Anne
 
I know how much you want Goose. to be home. I felt the same way about Mum when she was incarcerated in that dreadful place that was supposed to prepare her for life back "at home". (They did virtually nothing to prepare her and wanted her to stay as long as possible because she was a Medicare patient!).

You HAVE TO HAVE AN EASILY ACCESSIBLE BATHROOM. Nothing will work until you have this most necessary room ready and waiting for the first visit by the guest of honor. I know you don't want to read this, but I know from whence I speak and I hope Shari will add her voice to mine on this topic. There are no short cuts on this count, Mary Anne. (though I wish there were).

Goose., you have been dealt a bum hand. But you now have to play that hand to the best of your ability. You have to have an easily accessible and useful bathroom, this is a basic necessity and sadly, there are no shortcuts. Your present condition dicatates certain needs and if they can't be easily met "at home" you will be better served following the regimen and working on new skills at the rehab. hospital. Patience. It will pay dividends long term... but you have to permit yourself to believe that.
 
It is not only that I want Goose home,
which I do. Of course.
It is also that we are discussing
whether to sell this house
and move. If that happens,
the less we spend
on this house, the more we can spend
on the new one.

I am unemployed.
Resources are limited.
Nobody in their right mind
would give an unemployed
person a mortgage in this market.

We have a shower above a bathtub.
If Goose can move himself onto a bath
chair in that tub, then that suffices.
Not optimally, but maybe well enough
if we're going to move soon.
If he cannot move himself in that way,
then the bathroom may be the least of
our problems. How would he get into
and out of a bed?
 
I am so sorry you two are facing this awful choice. I don't know what to offer as counsel.

But you need to have a fully accessible and functional bathroom before Goose. can come home. And hospitals can refuse to "release" a patient if they know they know the circumstances "at home" are inadequate for the pateient's needs.

Hoping others will chime in with their (huge) collective knowledge...

Hang tough, Mary Anne. I know there will be more in the offing!
 
Goose, you have no idea how great it is to have you posting again and know that you are on the road to recovery. It surely made my day just seeing you post.

You do have a tough and rough road ahead but nothing that cannot be solved. You also have many, many friends who are willing to help however they can. I'll not add anything to what has already been posted because there have been some very good posts. I also agree with Mary-Anne that some decisions should be made before too many dollars are thrown into the house. Whatever you do or however you go, think it out good BEFORE starting. We wish you well, my friend.
 
Goose, two things. Can medicare or insurance or something pay for a lift in your garage? If so, that may be the best bet. If you go the ramp route, you will need one linear foot of ramp for each inch of rise, plus landings. Four feet up to the door is 48 plus feet of ramp.
Second, if you need help moving plumbing, let me know. My brother is a master plumber in this state and I was his aprentice for many years. We can even pull a permit if need be. Also, if your renovations require metalwork, I will be glad to help. I make and install miles of railings.
 
The sink in the main floor bathroom is not accessible.
We will need to replace it with a sink that Goose
can fit his knees under, even if we eventually move.
I am not sure how much plumbing that will require.
If we replace the bathtub and shower,
that may also need plumbing work.
 
It's great to see you are back in action at the keyboard. We had some similar issues a few years back with my Father COPD and broke his foot and fell breaking his wrist. We found the hospital has some wonderfull people in a home rehab department and they came out to the house and looked at the situation in the bathroom . the house was a one story ranch with one 6" stair at the front door but all clear otherwise. The situation was different but maybe you can get some similar help with your bathroom they had all the requirements as well as the most cost effective solutions to get the bath modified and since it was a single bath house the mods had to be made before Dad could come home.
Good luck with your future .
Tony
 
I can see how this is a big challenge and requires some good thought. Some houses adapt easier than others for handicap retrofit.

Usually I start on a project like this with a simple spreadsheet or a handwritten table that defines the scope of the project. It lists the tasks, cost of each task, time it will take, then pros and the cons. It could be that retrofitting the house will be fairly reasonable if you can get donations of labor and materials. However, the bathroom retrofit will take a bit more work. If there is tiling involved, there has to be time added for thinset and grout drying. Or it could be that the bottom line just doesn't make sense if all the doorways are narrow and a new building is needed to store everything that is in the garage now. Try to take a very detached perspective in order to decide what is best for say the next 5 years.

If you do decide to renovate, what are your resources? Look at both your own finances and what the community can offer. In our local area several organizations and companies have one-day house renovation blitzes organized for those in need. I have worked on one called Christmas in April. We showed up early with a team of about 25 people. By end of day we had repainted the exterior of the house and 3 interior rooms. We renovated a bathroom, dig several minor repairs, laid carpet in the living room, fixed multiple wiring problems, cleaned up the yard, planted some nice new plants and hauled away a large truckload of old crap to the dump. It's pretty amazing what a well organized team can accomplish in a day.

If you do decide to stay in the current house, how much can you call on your community, church, or local friends for this kind of event? By when would you really be ready to start? How much will need to be moved out of the way before work can start? How much help can found for Mary-Anne to get things cleared out and prepared for a blitz?

I'm coming out east for a memorial service at the end of May. If it will help, I could spend a couple days helping and can bring hand tools. The better things are organized in advanced, the more that can be accomplished. Let me know what you think.

PS: In order to make an objective and informed decision, I would also meet with a good realtor to get a professional and realistic opinion of what what the options are. Ideally this would be a person you know and trust.
 
Excellent questions.
I cannot answer most of them
yet. Working on it.

There is tiling involved.

I am already working on
getting the house ready.
It is WAY cluttered,
and I am putting things in
boxes, with the idea of having
a chain of people pass boxes up
to some attic space which I do
not expect to be involved
in what needs retrofitting.

I am also putting lots of papers
into recycle containers.

As to whether we stay or move,
in the short run, we stay.
One cannot buy a house that fast.
Unless Arthur needs ongoing care,
we stay.

That means we must solve
the problem of getting into the house
and the problem of the bathroom.
Whether the doors are wide enough
will need to be measured.
We can remove inside doors to make the
opening wider temporarily.

Goose is expected to be ready to come
home in May, maybe early May.
This date can change.

In the longer run, maybe months,
maybe longer,
we will need to decide about staying
or moving, and then your spreadsheet
idea is the best idea.
At that time Goose will be home.

I will be calling the case manager this
week, to ask about getting Goose onto
Medicaid, and to ask if some mobility
expert should visit our home to give advice.
 
LOL, when the garage entrance was mentioned as a possibility, I thought of my garage. It would take several days to clear out all the crap I have in there. Hoping to make a dent into that mess some time this summer.

It sounds like a good first step will be measuring the doorways that Goose will need to navigate. The standard wheelchair is about 26" wide. To allow for hand clearance it would be best to have at least 3" clearance on each side or a minimum 32" doorway. Doors can be removed from the interior temporarily, but not for the exterior entrance. Fortunately most primary entrance doors are 32-36" wide. If you can post pictures of the two entrance possibilities from inside and outside that would help visualize the possibilities and challenges that each presents.
 
MY All
I am the friend that was with Goose the day of the accident and the one who lifted the log off of him. I am also in part organizing the retrofit of their home. One of the Ideas I am thinking of is to try to build everything inside there home so that Goose has the most access to the house. I still need to take some measurements to figure that if we can fit a ramp into the garage and still have some workable space, also if there will be enough room in the Laundry room to put a ramp into the main level. As for the bathroom I know I do not have the skill set to that myself but I still know what needs to be done. I am thinking that if we can get enough people to help in one day we could split us up into teams to tackle each space separately and get as much done at one time. We are currently burning time on this so later this month we could set the date for the work day.

Tim Harrigan
 
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