Having MS is a life changing experience, which means you most likely will have to adapt to new enviornments, including your home.
Designing Your Environment
When you moved into your home, you arranged your things to meet your needs. After a few years, you probably rearranged or redesigned because your needs changed.
Most homes and the things in them are designed for standard-size humans with standard physical and mental abilities. But not everyone is standard. New parents “baby-proof” the house and buy baby furniture. If a horse moved in, the modifications you’d need would be different.
Whether the MS with which you live is a baby or a horse, your first thought when it moved in was probably not to remodel or redecorate. But making changes to your home is part of the game of adapting.
Fatigue affects everybody, but especially people with MS. Look at all the things you have in your home, one by one. Ask yourself to answer honestly. Do you need it? Do you really want it? If “yes”, keep it.Energy Conservation and Work Simplification
Otherwise, pack it away, give it away, sell it, or throw it away. The uncluttered look is a definite plus for cutting down your workload. It also makes it easier to find what you’re looking for if you have a visual impairment.
Next, think through your activities at home. Ask who, what, where, when, why, and how about everything you do. Who can help with what specific jobs? What jobs can you eliminate? Or simplify? Would you be more comfortable doing the job somewhere else? Can you make the location more pleasant? Plan in terms of work centers where you can sit for each of your activities, with everything you need handy. Ask for input from everyone in the family. This process can and should take time.
Almost any equipment or installation required by a disability can be tax deductible, within IRS rules and guidelines. There may be other resources you can tap as well. See “Resources” below. But not all changes, as you will note, are costly.
Determine how many levels of living space there are inside and outside your home. Identify any potential access problems. Mobility aids need a certain amount of open space to maneuver. Canes, crutches, and walkers need ample turning space. Wheelchairs and scooters have a considerably wider turning radius, which varies with the design. (Consider this factor when selecting an aid. The turning radius is usually specified in the product literature.) Improving access fights fatigue, even if you do not use an aid.
If you decide that access to a storage shed, an attic, basement, or even your second floor is not important or feasible, make sure there is nothing stored in those locations to which you need access.
The easy-reach zone, for most wheelchair users, begins about 15″ or 16″ from the floor and ends about 51″ or 52″ from the floor. Standing, the zone begins at knee level and ends a few inches higher than your height, not your outstretched arms. Next, consider accessibility to high and low storage spaces, furniture, work spaces, and controls. You will need to measure heights.
- Put the things you use most often within your easy-reach zone. In each work or storage area (kitchen, bathroom, garage, study center), measure out that zone and figure out how to use it as completely as possible, leaving those areas outside your easy reach zone for storage of things you almost never need. Your storage adaptations may include hanging baskets, rolling storage carts, peg boards, hooks, and more.
- People with limited balance or vision tend to avoid open spaces, preferring to keep in contact with walls and furniture. Check walls for low-hanging mirrors or pictures. Make sure furniture is stable.
- Furniture helps define simple or complicated paths of travel through an area. It can be an obstacle or provide assistance. Plan improved furniture locations on graph paper first. Be sure to allow easy access to light switches, electric outlets, windows, window coverings, and controls such as thermostats.
- Place the bed away from the walls; bed making is much easier. You’ll need four-and-a-half feet on one side for access by most wheelchairs.
- Handrails need not look institutional. Some are designed to be almost invisible, giving the impression of a chair rail or wall design feature.
- If the door cannot be modified, a crank device can be added to a folding manual wheelchair which can briefly narrow the width of the chair. All outside doors should be 36″ wide. All inside doors should be at least 32″, including bathroom and closet doors. Most doors can be widened a couple of inches by replacing standard hinges with offset hinges. Some doors can simply be removed. The door frame can also be removed to provide more width. Some doors can be replaced with curtains if privacy is an issue. A sliding door or a pocket door, which slides into the wall, may be an option. Folding doors are another alternative if there is no room for a door to swing open, but they narrow the doorway by several inches.
- Install grab bars in the bathroom, bedroom, and anywhere else they would be helpful to you. Placement is critical for safety and usefulness. You will need to consult an experienced rehabilitation or occupational therapist. In many locales, wall-mounted grab bars must be installed by a licensed plumber. Grab bars are available in colors. They don’t have to be ugly to work.
- Beds, chairs, and toilet seats are easier to rise from if they are high. There are several ways to elevate a toilet seat. The 3-in-1 commode can be used as a bedside commode, a shower chair, or placed over the toilet as an elevated toilet seat. Other options include a variety of permanent or portable elevated seats, with or without arms or backs and of different heights.
Avoid low chairs, especially if the seats slant back and down. If you transfer to and from a wheelchair, try to have all your other seats at the same level, so you can slide easily from one to the other using a sliding board. This is easier than standing up, turning, and sitting again.
- Hi-lo hospital beds are a big investment but have important advantages. Some are available that don’t look like institutional furniture.
These beds can be raised to change the bedclothes, or to permit a person to “stand down” from the bed when rising. The bed can be lowered to reduce the risk of injury from falls during occupancy, to allow access to nightstands, or to make for smooth transfers. When selecting a bed, be sure to check maximum and minimum heights and ease of operation.
- Kitchen countertops usually need to be lowered for wheelchair users. This major carpentry job should be carefully planned. Even if you don’t use a wheelchair, consider installing at least one low section, so you can sit while doing kitchen work. Remove the doors and perhaps the cabinets under the sink in the kitchen. Leaving the cabinet base in place can provide a footrest if you use a scooter with a swivel seat. Cover exposed pipes with insulating material to prevent bumps and burns. If you remodel, consider a wall-mounted sink.
- Raising a desk or table can improve sitting posture and provide a surface on which to stabilize your arms to improve your coordination and reduce tremor. It is often necessary to raise tables and desks to allow access to a wheelchair or scooter. Desks, tables, chairs, and beds can be raised by adding wheels. This improves their mobility but greatly decreases their stability, depending on the wheels and the braking system. Decide which trade-off is best for you.
- Desks, tables, chairs, and beds can also be raised by putting them on blocks. Blocks are commercially available. If you construct your own, be sure the legs sit well down into the top of the block, at least one-third of its depth, so they can’t slip. Blocks can be made of wood or from coffee cans partially filled with concrete and painted to match the decor. Adaptive equipment suppliers and catalogs carry leg extenders which fit some tables and chairs.
- High doorsills, the edges of carpets or rugs, and other changes in the floor covering can impede access. Doorsills can often be removed. Special little ramps are available in catalogs for unavoidably high doorsills.
- The thicker the carpet, the more difficult it is to pick up heavy feet or propel a wheeled mobility device. Smooth non-skid floors are always best for anyone with mobility problems. All rugs and mats should be firmly secured to the floor with double-sided carpet tape, non-slip backing or matting, and/or metal or other edging. Any worn rugs, mats, or carpet should be removed.
- For bathtub access, remove tub doors and replace them with shower curtains. Stairs can be circumvented by ramps, electric stairchairs, or elevators. Ramps and outdoor grades should not rise more than one inch per foot, for safety. Ramps should be 30″ to 40″ wide. Stairs and long ramps need sturdy handrails on both sides.
- Permanent or portable transfer lifts can pick you up, move you, and put you down almost anywhere. Mounted on ceilings, walls or wheels, they provide access to the pool or tub, to your vehicles, or from bed to chair. Some can be operated independently.
- Make gardens accessible and less fatiguing to care for by building narrow raised beds along sidewalks and driveways. Look for books on container gardening methods.
|Read on: Brochure: At Home with MS – Adapting Your Environment – National Multiple Sclerosis Society|