When multiple sclerosis limits your mobility, your home can feel like an obstacle course. Fortunately, with some planning and creative thinking, most areas of the house can be readily adapted so you can function smoothly throughout the day.
"When modifying your home, the goal is to achieve maximal independence and safety," says Nancy Holland, EdD, vice president of clinical programs at The National Multiple Sclerosis Society. She says arranging things to accomplish daily tasks while expending the least amount of energy possible is the goal.
Having an occupational therapist assess your home may help, since she'll know about the latest gadgets and assistive devices and may point out new places to make helpful changes. And be sure to check with your state's vocational rehabilitation office; often they'll pay for things like ramps and other major modifications.
Here's a guide to get you started:
Toss the Throw Rugs
If you're using a cane, a walker, or a wheelchair, rugs can cause trips and falls, and they also can make moving around harder.
"I've engaged in a tug-of-war with patients over scatter rugs," says occupational therapist Nanci Wechsler. "Patients will say they've got grippy stuff under them, but even if they're secured, you can still trip or get a cane stuck under the edge."
Wechsler teaches at Midwestern University's College of Health Sciences in Glendale, Ariz.; she recommends hardwood or linoleum floors and low-nap wall-to-wall carpeting.
Ease Entrances and Exits
Outside doors should be 36 inches wide; inside doors at least 32 inches wide. Removing door frames can help widen doorways, as can replacing regular hinges with offset hinges. Removing floor sills allows wheelchairs and scooters to glide more easily.
Simple door knobs can also make life harder. If twisting door knobs is difficult, replace them with long levers.
"Always make sure you can get out of the house quickly in case of a fire, which means having a ramp that exits the porch," says Lori Letts, PhD, a professor at The School of Rehabilitation Science at McMaster University in Hamilton, Ontario.
Stairs can be outfitted with electric chairs, or, if there's room, a ramp can be installed. Ramps should be 30-40 inches wide and rise no more than one inch per foot. If you can navigate stairs on foot, install handrails on both sides, suggests Letts. "That way, you can lean on your strongest side whether you're going up or down."
Make Room to Maneuver
Walkers, scooters, and wheelchairs all require ample turning space; consider this when arranging furniture. Refer to your device's manual , which should specify its specific turning radius. Avoid having lots of side tables and other small pieces of furniture that clutter pathways.
Plug In and Turn On Without Hassle
Make outlets and light switches accessible with extension devices.
Install an intercom system to make room-to-room communication easier.
In the Bathroom
- "Showering is tiring, plus soap and water make it easy to slip," says Wechsler. To make it safer, install a steady seat or bench in the stall and use a hand-held shower nozzle. Roll-in showers exist for people in wheelchairs.
For showering, it's best to replace glass doors with a shower curtain and install grab bars. "But grab bars must be professionally installed," Wechsler tells WebMD. "They need to be screwed into wall studs to be safe." In addition, have an occupational therapist advise you on the best placement for them. Mechanized tub seats are available for people needing extra help getting in and out.
Sinks should have long, lever-type faucet handles. Insulate any pipes to avoid bumps and burns.
A standard toilet can be made more comfortable by installing a raised toilet seat with handles.
In the Kitchen
- Use a refrigerator/freezer with side-by-side doors.
If possible, install a wall-mounted oven; other oven modifications include side-hinged doors and stove dials that face front.
Remove cabinets under the sink and under a portion of countertop to create a food-prep space where you can be seated (again, be sure to insulate any pipes). Use slide-out shelves, lazy Susans, and drawers for easy access to food and dishes.
Use electric jar and can openers and a food processor. "You're given a certain budget of energy every day," says Wechlser. "Why expend that energy on kitchen grunt work when you could use it to go out and see a movie instead?"
In the Home Office
- Computer screens should be at least 17 inches wide if eyesight is compromised. Some computer programs allow you to alter the amount of force needed to tap the keys.
Desks can be raised using blocks or leg extensions (found in adaptive-device catalogues).
In the Living Room
- Use remote-control blinds.
Carry a cell phone or cordless phone; hands-free headsets are also very convenient.
Avoid chairs and sofas that allow you to sink into them or that have slanted backs; the ideal height for seating surfaces is between 19-20 inches.
In the Bedroom
- Install bedside rails to make getting in and out easier, or purchase a hospital bed for maximum maneuverability.
Lower closet rails if you need to reach clothes from a scooter or wheelchair.
Letts recommends touch-sensitive bedside lamps if manipulating switches is hard.