Accessible home design and construction have finally come out of the shadows. In part because it is acceptable to have a disability. In part because contractors can capitalize on a very real need in the community. Our senior citizens, trying to remain safely in their homes, are a huge part of the population seeking accessible design and  equipment.

The hazard in the road is that a ramp, grab bars, and door levers seem to be the focus; 'Universal Design'. Certainly, these are frequently necessary, but are not the whole story. Universal design must be used in conjunction with a clear understanding of a person's current physical limitations and probable future limitations. Design and location of stuff like:

are all influenced by your current and possible future challenges.

The key to success is truly understanding a person's limitations. Sometimes, that means that you have to look reality in the eye. This is frequently difficult. Honest answers to questions like what can I do? / What can't I do? / What is realistic for me to do? / are challenging. Add to that the unpredictability factor of our changing abilities and you realize that easy home modifications are not so easy.

Speak with Occupational and Physical Therapists, nurses, and especially people with similar challenges. The seemingly small details will make a huge difference. Making your home truly accessible is possible with a good, honest assessment of a person's needs. Money will help, too!

      No matter which task I perform, I am relatively safe until I try to move from my wheelchair to another seat [toilet / bed] or back to the wheelchair. Each move of the hands, feet, arms, wheelchair, etc is carefully planned and must be executed exactly to the plan. It is a finely orchestrated dance of the mind and very uncooperative body fighting my arch rival, gravity.
      Yep, gravity. Always there, never faltering, constantly pulling on me and sometimes, bringing me down. That is a physical and emotional state. When I do hit the floor, I am unable to get myself back up. Yes, too many people laugh at the commercial of the old woman crying, "Help, I've fallen and can't get up!" I understand her plight. There is NOTHING entertaining about it.
      So, as I perform a transfer from wheelchair to toilet last week, my attention waivers for a moment and somehow, the wheelchair slides to the right as I move left. That creates just enough space for gravity to reach up and pull my butt into that space. The panic rushes up through my body and my brain races for a solution. I gather my thoughts and strength, take a deep breath and once more, heave toward the toilet. The wheelchair moves more right and gravity gives my butt another pull. Greater panic rushes through me and I am now at the awful, terrible, frightening, OHHHH NOOOOO moment. Still suspended but past the point of recovery with the knowledge of what will happen next. I make one last feeble, futile attempt to find ANY seating. The gap opens, my arms tremble and gravity pulls me down.
      The move is slow and I plop on the floor. The second wave of panic hits harder than the first. Someone left his phone on the desk in another room; 20 million light years away as gravity holds my butt in it's relentless grasp. This means that I will laying on a cold and very hard ceramic tile floor until my wife gets home. The math was easy. It's 12:30 now and my wife MIGHT be home by 6:00.
     She did arrive at 5:30. I'll take ANY blessing at that point. No, I won't be forgetting my phone again and I will try to be more careful. Sir Isaac Newton, you can warm up my cold butt!