David Reich is a retired architect living in Montreal. He now contends with post-polio syndrome which, over the past few years, has gradually reduced his ability to walk. He has – with his professional knowledge – been able to re-design his home, and along the way, made discoveries that are helpful to others facing similar problems.
“Some people in my position would prefer to move to a one-floor home – a condo or an apartment, so as not to have to contend with stairs. However, I had redesigned my home when our family moved in, and wanted to stay here, so I gradually made more changes as my condition dictated.”
Mobility issues of any kind require a lot of planning to make a home liveable. In case of an emergency, a phone must always be available beside a bed and in reach, preferably with contact numbers in the memory. There are alarms that can be worn around the neck or on a belt , that are automatically triggered if someone falls.
Reich stresses the need for exercise, whatever one’s level of disability: walking, with a walker or between parallel bars helps build leg muscles. In his case, care is required because the problem is in the nerves; however, strengthening the upper body is a must. If someone can use a treadmill, good; if not, there are devices which exercise both legs and arms that can be used by someone sitting in a chair. Even while in his wheelchair, Reich tries to keep legs moving to avoid deep vein thrombosis, for example. This is the problem air travellers are warned about on long flights. Sitting in one place all day can also result in bed sores, which can become infected. And infections take longer to heal when mobility is compromised.
In his own home, after extensive research, Reich installed a stair lift that also can go around corners. He developed light-weight and easy-to-install railings which also can go around corners. What’s more, they are easily gripped and are made so that hands slide along the top of the bar without catching on wall attachments. Railings, he advises, should be on both sides of a stairway for those who can still climb stairs, as well as on both walls of a hallway. Carpets can be a hazard for wheelchairs; wood and other smooth surfaces are ideal.
Among the biggest problems he has encountered are doorways: many are not wide enough for a wheel chair to get through without hitting one’s hands on door frames. Often there are sills. The front wheels of a manual wheelchair are three to five inches in diameter, meaning that a half-inch door sill can be a major barrier, even in a so-called walk-in shower or at the door to your front porch. Reich was able to install ramps of various sizes to counteract the problem.
People who can stand, and walk take it for granted that they will be able to grasp whatever they need. But, if you have both hands on a walker, or are sitting in any kind of wheelchair, light switches have to be close enough and low enough to reach. Another frustration is with items placed too far away on a table or a desk, or that have fallen on the floor. Contents of drawers, should be at the front. It is impossible, sitting in a wheelchair, to reach items at the back of a drawer.
One of the biggest fears is the ever present possibility of falling. When moving from chair to walker or wheelchair, if there is a helper at hand, that person has to be in the right place to give support; and must have the patience to wait until you have settled your centre of gravity and are steady, before you attempt to move. People with vertigo or low blood pressure can also find themselves in this situation, and it is all too easy for even the able-bodied to miss a step and take a serious tumble. The leading cause of emergency room visits are falls. (Note: According to Statistics Canada, in 2008–2009, approximately 20% of Canadians aged 65 and older (862,000 seniors) reported a fall in the previous year. Falls increase with age. About 17% of seniors between the ages of 65 and 69 reported falling in the past year, compared with 27% of seniors aged 85 and older.)
Getting out of a low chair can be difficult. Transferring from one chair to another means getting upright. There are, for examples, extendable poles which can be gripped and can be adjusted to fit the space from floor to ceiling. Hospital beds can be installed at home, and they, too, are adjustable. Also, they usually come with an overhead support that can help someone lift themselves to a sitting a position, or to change positions in bed.
What about going out – for business, for pleasure, to explore the neighbourhood? Instead of round door-handles, levers help make access easier for everyone, including those who are mobile but might have arthritic hands. As for the front door, the lock must be low enough so one can reach it and turn the key.
En route to his destination, the person in the wheelchair will have to get on and off sidewalks. Too often the cross-slope is too steep, and therefore dangerous. In Canadian winters, this is aggravated by snowbanks and ice which create additional hazards. Spring and summer bring cracks in the concrete. While all new buildings in Canada are now required to be accessible, retrofitting old buildings too often meets structural problems. Over all, progress has been much too slow.
Assuming our ‘man in motion’ makes it to his destination, he is confronted by another door. Many buildings now have large round or square shaped handicap buttons which automatically open doors when pressed. The trick here is to be able to push the button and get through the door before it closes, possibly having to make a sharp turn once inside. Doors in all public buildings open out; inside they may open either way. Revolving doors should be avoided.
Going out to a restaurant can also be a challenge, including many which claim to be accessible. Are tables far enough apart so a wheelchair can navigate between them? Can your knees fit under the table? If you want to transfer to a chair, does it have arms? There is no way someone who has difficulty walking should sit on a bench; they are awkward to get into and it is far too easy to tip over sideways. As for the bathroom, it should be large enough to enable a motorized wheelchair to turn – a diameter of roughly five feet.
Many theatres do have spaces for wheelchairs, but the best advice is to get there early. Usually such spaces are limited. Wherever travelling with a wheelchair or a walker, ramps must be wide enough, and the slopes gradual so that whatever your disability, you can maintain control at all times. An article in the June, 2015 issue of Canadian Architect, by Loraine Fowler, Associate Professor of Architecture at the University of Calgary cites two examples in Calgary: one is a new low-rise office complex in that city, which is fully accessible inside, but the pavement leading to the building is curved and divided into strips of concrete with brick pavers in between, making navigation almost impossible for someone in a wheelchair. However, the Taylor Family Digital Library at the University of Calgary provides seamless integration at the entrance, and gentle slopes which provide links between buildings.
Cars can be purchased which allow a driver to use hand-controls; if someone else is driving, there are cars with ramps – smaller versions of those used by most city-run services such as Montreal’s Paratransit or Toronto’s Wheel Trans. Used wheelchairs, motorised scooters, and specially designed cars can be found, but conditions should be checked out by specialists. March of Dimes has useful information about these and other services. Just typing Mobility Devices into your browser will also reveal a wide assortment of sources for helpful appliances and equipment. Because these are medical devises, often there are government subsidies or tax credits available. You might want to check them out at http://www.cra-arc.gc.ca/ndvdls-fmls/menu-eng.html and follow the links.
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