Introduction

General household chores can be very difficult if you have a physical disability that limits your mobility. Having devices in your home can make independent daily living easier for you. In this section, you'll find ideas on everything ranging from physical accessibility (ramps, lifting devices, etc.) to practical day-to-day tips for household cleaning and so on.

As in other sections of this booklet, the ideas are simply suggestions. Take a critical look at these recommendations and make decisions or modifications to suit your needs.

Grab bars make the most of your strength by giving you extra support when you need it, like climbing into and out of the bathtub or your bed, using the toilet, standing for long periods or negotiating a flight of stairs. A grab bar can help keep your balance and give you stability while moving, standing or sitting.

A grab bar looks like a towel rack, but that's where the similarity ends. A grab bar is designed to be strong enough to support your weight and more. Flanges on the ends of the bar have sturdy screws for installation, preferably into wall studs. There is room between the bar and the wall for you to get a good grip and the diameter of the bar will feel solid in your hand. Made of plastic or rust-resistant metal, it often has a rough surface to prevent slipping. Many shapes and sizes are available for different uses: most are wall mounted, but some attach to the edge of your bathtub. There is also a "grab pole", with or without handles, which attaches to the floor and ceiling. Other grab bars attach to the bed.

Grab Bar Basics...

A vertical grab bar: is used to pull yourself up, usually from a seated or lying position.

A horizontal grab bar: is used to push or pull yourself up, usually from a seated position.

An angled grab bar: can be used in a combination of these movements. Since the grab bar will be supporting your weight and taking the brunt of the force you exert, it must be securely mounted on the wall, preferably to at least one of the wall studs located inside.

Wall studs are usually located 40.5cm (16") apart. To find them, use a stud sensor or start at a corner of the room and tap the wall 35 - 45cm (14" - 18") from the corner. A stud will sound solid, while the empty space will make a hollow sound. Mark the location of the studs. The mounting screws should be long enough to go through the wallboard (usually 1cm or 1/2") as well as any tile covering, and still leave a good 1 - 2cm (1/2") for support in the stud.

Try the following method...

1. C Cut a piece of 1cm (1/2") plywood for each mounting flange at least 5cm (2") larger than the flange. Sand and paint if desired.

2. Drill four holes in each piece of plywood, slightly smaller than the diameter of the screws you will be using, and four matching holes in the wallboard or plaster large enough to take plastic fillers for the screws. Insert plastic fillers into the holes in the plaster.

3. Glue and screw the plywood pieces to the wall with 2 - 4cm (1" - 11/2") screws and waterproof glue if the area is likely to get wet.

4. When the glue has set, mount the grab bar onto the plywood pieces.

Where to put a Grab Bar...

A grab bar should make the most of your maximum strength: install it at the height where your body and arms are at the best angle for your first push or pull. It might take a few tries to find this height; usually it is between mid-thigh and chest level. If you have a strong side, take advantage of it. An occupational therapist can help with these decisions.

Using a Grab Bar...

To raise and lower yourself with a grab bar, you should know something about your physical abilities. When you are seated, or in the process of sitting or rising, your leg muscles are at the weakest point of mechanical advantage. A grab bar lets you use your upper body to compensate for this weakness.

Which set of upper body muscles is your strongest? Try out various heights and angles by using someone's arm to simulate the grab bar until you find your point of maximum strength. You'll also need shoulder movement and some strength in your hands and wrists for a good grip. A grab bar should be long enough to carry the movement to its conclusion: if you run out of support before you're fully standing, you could lose the momentum and fall back, or fall forward from too much force.

If you are uncertain about some of the grab bar basics, consult with an occupational therapist from your local hospital or home care office.

Grab bars are used most often in the bathroom, for strength and stabilization when moving around the tub or shower, toilet, vanity or washbasin. They are also handy in the bedroom, by the bed, closet and dresser or your favorite chair. Install one in a hallway; where you take off your winter clothes; or along a staircase. In the kitchen, a grab bar or pole in a central location can help you move from one appliance to another, to the sink or to the table. If you conserve energy by working seated, a grab bar will make getting in and out of a chair easier.

Buying a Grab Bar...

Grab bars can be purchased at plumbing supply outlets, hardware stores and at medical/surgical supply stores. This last source would be your best bet if you want informed help to decide which grab bar would be best for your needs.

Grab bars are typically made from metal or plastic tubing, from 2-4cm (1" to 11/2") in diameter. The surface of the bar can be smooth or textured (ridged, brushed or knurled). Some metal bars are coated with plastic or vinyl. If you need a non-slip surface (particularly near the tub), choose a grab bar that has a rough texture. Many grab bars now come in decorator colours to match your colour scheme.

Some of the shapes and sizes with the larger and more specialized models costing the most. If you can't find the right one, some companies will make up a custom design, also for a higher price. Alternatively, see if you can mount one or more standard grab bars together as a component of pieces or in sequence to give you the support you need.

Poles...

Instead of the standard grab bar, some people like to use a pole like the one illustrated here. It acts like a vertical grab bar for support and balance, but doesn't need to be installed on a wall.

A pole in the bathroom can be used for tub, toilet, vanity and transfer to a wheelchair and would also be useful installed in the kitchen.

Bed Rails...

A bed rail is a grab bar which attaches to a bed. It is useful for someone who may have difficulty pulling up to sitting in bed. It's also helpful for someone who finds it difficult to get in and out of bed.

Plumbing Fixtures

If you have decided to renovate your home to make it more accessible or simply want a few changes to make everyday activities easier, consider what improvements can be made by installing well designed plumbing fixtures in the kitchen and bathroom, the most used parts of a house. For example, a faucet with a single arm control will solve many coordination and strength problems, or a shallow kitchen sink might make it easier for a person in a wheelchair to roll under the counter to wash dishes.

The price of plumbing fixtures varies, depending on the design, materials and whether the article is imported. If you know what you want, however, a little hunting in plumbing supply outlets will usually turn up a design that is easy to operate and will look attractive in your home at a reasonable cost. This pamphlet will outline what features you may wish to look for when choosing a new plumbing fixture.

Where to Find It...

Check the Yellow Pages for a plumbers' supply outlet that has a showroom. It's always better if you can see and try out the article in a mock-up situation. Explore hardware stores, building supply outlets and department stores. Read the literature available at these locations, which describes products that might not be on display but can be ordered. Talk to your contractor or ask your friends where they found their fixtures.

Sinks...

The height of the sink in both the kitchen and the bathroom should be low enough for you to be able to reach in and use it (can you reach the drain?) and also high enough for your knees to clear if you use a wheelchair and want to roll under it.

On the other hand, if you have trouble bending over from a standing position, you should install the sink at a higher level so you can work comfortably without stooping. In this case, the bottom of the sink should be a few centimetres (2 in.) higher than the distance from the floor to your wrist (when you are standing). Use the front edge of the counter to rest your elbows; a folded towel or a piece of foam rubber padding will make this comfortable when you're at the sink for long periods.

If your sink is too deep to use comfortable, try setting a plastic wash tub on two pieces of wood to raise the level of the working area. This could save you the cost of replacing your sink.

Shallow sinks (13 cm or 5 1/4 in. deep instead of the standard 18 cm or 7 in.) are available in single and double stainless steel kitchen models. The drain is at the back for better clearance underneath. You could install the single unit sideways for better access to the taps. The usual minimum height for wheelchair clearance is 69 cm (27 in.), but be sure this is adequate for your needs, and that the counter around the sink is at an accessible height.

Insulate the underside of the sink and hot water and drain pipes with styrofoam or wood to prevent burns to knees and thighs if you use a wheelchair.

Bathroom sinks (basins or lavatories) come in many shapes, sizes and colours, and can even be made to order where cultured marble products are manufactured. If you use a wheelchair, consider a shallow model with a rear drain (insulate that drain pipe!) which is either wall-mounted or installed in an open, accessible counter. An "institutional" model is available, as are small units which can be used from the side if the bathroom is too narrow to allow front access to the basin. Prices vary widely with the model chosen.

Taps...

Most round-headed taps are difficult to use if you have coordination or strength problems in your wrists and hands. An easy solution is to replace them with lever handles. The range of designs here is huge, from simple lever taps through institutional blade handles to ultra modern designer sets. Avoid taps that require a twisting motion. Lever handles are easier to operate by pushing and pulling motions and need no grip strength.

Easiest of all to operate arc single arm control faucets, which combine hot and cold and flow pressure in one movement. They are also easy to install. You'll find designs for both kitchen and bathroom use.

A simple aid can make a twist tap into a lever tap. The tap turner fits almost any tap: it's made by Maddak and can be found or ordered at a medical/surgical supply store.

You could also try making your own tap turner or lever handles to fit the fixtures you have: a small piece of wooden dowelling attached with wire is all that's needed.

It's unlikely that you'll want to replace a bathtub, but if you are having problems you might find it easier to bathe using a bath seat. Safety treads on the bottom of the tub can prevent slipping. Don't take unnecessary risks!

A hand-held shower can make your bathing routine much easier. Many models are available, some made of rubber to fit over the tub tap, and some requiring installation. Make sure the model you choose has a long enough hose and a handle that you can hold onto without too much strength, that you can manipulate it even with soapy, wet hands and that the controls are easy to operate. A portable shelf across your tub can hold your bathing articles and can be made in the home work-shop to fit your tub.

A tub insert has the effect of raising the level of the tub and can be used for bathing a child or small adult with less bending over. Transfer in and out of the tub is also easier.

As with tub controls and faucets, you'll want shower controls that operate easily with push and pull movements rather than twisting. A hand-held shower is useful if you shower from your wheelchair or a shower chair, but install it and the controls at a height you can reach from a seated position. Sudden surges in the hot or cold water supply can cause wild fluctuations in your shower temperature. If you are concerned about this possibility, your plumber can provide a pressure balancing mechanism.

The key to efficient and accessible storage is organization. The ideas and products in this section will help you make better use of your existing storage space to avoid excessive reaching, bending, lifting and walking.

Most of the products described here are widely available in hardware or department stores. Be sure to take along the measurements of the space you are dealing with when you shop. Sometimes a research trip to a specialty store (some deal exclusively in products for improving storage) or to the appropriate section of a department store is a good way to get ideas on products and their uses; then visualize how you would use them in your own home.

It's possible to spend a lot of money on products to upgrade your storage facilities, but it's not necessary. Often a few simple shelves, a lazy susan or a shoe rack can make a big difference.

Kitchen...

More usable storage is required in the kitchen than in any other room in the house. Although most kitchens seem to have a lot of storage space, much of it is too high or too awkward for many people to reach easily, especially for someone who uses a wheelchair or who has a physical disability. So make the most of the storage space that is already accessible.

Stacking shelves or bins can stand alone against a wall, in a corner or under a counter; they are also useful in a cupboard. They come in plastic, wood, metal or sturdy wire (some are plastic coated). They range in size from a single plastic bin or shelf to a 5-tier shelving unit. Rollout shelves If you are prepared to renovate your kitchen to provide more accessible storage space, here are some ideas: if you use a wheelchair, a kitchen counter should be high enough to allow your knees to roll under, but low enough that elbows can rest while working; use the space under counters for temporary storage in wheeled carts. Pull them out of the way when the counter is needed; pull-out shelving allows access from both sides; comer cupboards can be used better by installing revolving or swing-out shelves.

Storage of food in your refrigerator or freezer can be improved by using plastic containers (for leftovers, meat & fish, fruits & vegetables) that are square or rectangular and can be stacked. Use "see-through" plastic or label clearly to prevent spoilage. Many of these products are dishwasher and microwave oven safe and feature good seals with easy to remove lids. They are widely available at hardware, department and grocery stores. Another simple solution for storage of leftovers is a freezer storage bag. Found at any grocery store, a freezer storage bag has a "zipper" closure that is very simple to close and open for someone who may have difficulty with fine motor movement in their hands. The bag is also clear and has a spot for you to label what is inside.

 The average bathroom has enough storage space for most people, but if you need more, or if you have removed the vanity to make the sink wheelchair accessible, here are some ideas:

 Use the wall above the toilet to install shelving, a cupboard unit, or towel racks or hooks.

 Make sure you can reach objects at this height, or use a reaching aid.

 If you use the tub and not the shower, take advantage of the wall space around the tub for shelves or bars.

 A vertical towel bar takes up little room in a small bathroom.

Hanging racks can be useful in the shower for soap and shampoo. They attach to the wall, shower fixture or soap dish. Another idea is a shelf that fits across the tub to hold soaps, scrub brushes or a magazine while you bathe. Make one yourself, or buy it at a bath specialty shop or some medical/surgical supply stores.

Several manufacturers have come out with organizers which fit into standard closets to increase their efficiency. They are available at most department and hardware stores and come in a wide range of sizes.

Look around for modular units - sets of shelves or cupboards which can be pieced together - to modify just part of your closet. Stacking shelves and bins can be used for clothing and linen storage. Closet adaptation like this could be a good project for the home hobbyist.

wheelchair.

· Wider or bi-fold doors will give you access to more closet space.

· Use large, flat blanket boxes to store rarely used items under the bed.

· An extra wardrobe, dresser or trunk will hold a lot. Interesting pieces are available at flea markets and auctions.

· Install a shelving unit on a wall or use one as a room divider.

 Hangers which hold several skirts or pairs of slacks save space on your clothes rack.

 Shoe racks or hanging pockets will help organize your footwear and use less space.

 Stackable containers on top shelves can hold lightweight objects.

 Adjustable shelves in a linen closet can be moved so you can use every bit of valuable space.

Utility Rooms... Adapt the ideas already mentioned to organize and use the accessible storage space in your basement, laundry area, or garage.

Utility shelving - not always beautiful but inexpensive and very functional - is widely available in wood or metal and can be used for many storage needs.

If flooding or dampness is a problem, keep everything off the floor (most shelving units have a 4" - 6" ledge). A dehumidifier might be a good investment if it means being able to turn wasted space in the basement into usable storage.

Many hand-held tools lend themselves to storage on a peg board, and shovels, rakes, etc. can be hung on wall hooks. Wheeled carts can be useful for storing and moving heavy objects.

Store laundry detergents, etc., on shelves close to the washer and dryer, and have an accessible surface nearby to sort and fold clothes.

Keep fertilizers dry and stored safely away from children's reach, along with other gardening chemicals. If the storage space is low enough to be wheelchair accessible, it may mean using a lock and key. Store garden tools out of traffic areas during winter.

"The abundant life does not come to those who have had a lot of obstacles removed from their path by others. It develops from within and is rooted in strong mental and moral fibre." William Mather Lewis

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