Fall Prevention Home Modification

Frequently Asked Questions

Here is a collection of commonly asked questions received by the National Resource Center for Supportive Housing and Home Modifications. We hope these responses are helpful to you. These questions are divided into topic categories for your convenience. Click on the topic you are interested in to find relevant questions and answers. If you cannot find what you are looking for, please send your question to homemods@usc.edu. We will research your question for you and provide a response within two weeks.


Architects/ Contractors

1. Where can I find architects or design firms that can provide universal house designs?

The Design Linc: Accessibility Design Resources provides an on-line interior design resource and information service that provides accessible house designs for people with disabilities. Visit their web site at http://www.designlinc.com.

The Center for Universal Design has a design department that provides several services that include conducting architectural and product evaluations. For more information, contact the Center via email at cud@ncsu.edu or visit the center's web site at http://www.design.ncsu.edu/cud.

The American Institute of Architects offers services to both professionals and consumers who are looking for architects. To find an architect in your local area, visit their web site at http://www.aiaonline.com and click on Find an Architect.
Access Housing Corporation specializes in universal design and construction that can customize your home according to your needs. For more information, visit their web site at http://www.accesshousing.com or contact them at 215-663-5803 P.O. Box 236 Cheltenham, PA 19012

2. Can you recommend contractors who will give an estimate on home modifications?

There is a National Directory of Home Modifications and Repair Programs in the on-line library at http://www.homemods.org It contains information on qualified contractors/ remodelers

In Florida, there is a company called PRIME, Inc. (Professional Resources In Management Education), an international healthcare educational corporation, which has a Continuing Education Certificate Program in Environmental Access for Contractors. They would have a network of their certified contractors. They may be reached at cmanage@aol.com .

Many local Housing and Community Development Departments and Area Agencies on Aging have lists of certified contractors or have a home modification and repair program

The National Association of Home Builders has a section on their web site that helps consumers find the suitable remodeler. The section includes information on the entire process of remodeling, including important decisions consumers should make before remodeling, how to find a remodeler, how to live with the newly remodeled home, and finally a link to a list of remodelers in your neighborhood. To visit the section, go to www.nahb.org/consumers/remodeling/choose.htm

3. Can you provide information regarding opportunities and profits for builders/ remodelers who perform home modifications for older adults and people with physical impairments?

The National Association of HomeBuilders (NAHB) has Senior Housing Council offices in local areas. To contact your local office, visit NAHB web site at http://www.nahb.com

The local Area Agency on Aging also might have a Housing Division that could offer i-nformation. To find your local area agency on aging, call the Eldercare Hotline at 1-800-510-2020

Most City Housing and Community Development Departments share a division that administers HUD 's programs, including loans for the development of multi-unit housing for low-income persons and loans and grants for housing rehabilitation and repair

Government Grants/ Funding

1. Is there funding in the form of grants available for renovating homes to be wheelchair accessible?

Assistive Technology Funding and Systems Change Project United Cerebral Palsy Associations (UCPA) at Washington D. C. (800) 872-5827- UCPA provides funding information on equipping homes with technical support to promote independent living. For more information, call the UCPA.

Dept. of Veterans Affairs (DVA) (800) 827-1000- Disabled veterans are qualified for certain home modification benefits. Contact a service officer to determine the modifications paid for by the DVA. Call your local VA or the main office for information

Internal Revenue Service (IRS) (800) 829-1040 - The IRS allows people with disabilities to claim as a deduction the cost of some home modifications.
National Council on Independent Living Center (703) 525-3406 (V) (703) 524-3407 (TDD) - Provides information on how to get funding and referral services in your area.

2. Is there funding available for establishing an assisted living or board & care type facility?

Most sources of funding for assisted living vary from state to state. However, at the federal level, there are three types of government-assisted housing. They are as follows:

Public Housing - These are low cost housing in multi-unit complexes that are available to low-income families, including the elderly and disabled. These units allow tenants to pay no more than 30 percent of their income for rent. The public housing is available to applicants who do not exceed published income levels, pending on the size of the household.

Section 8 Rental Certificates - These certificates are available to very low-income families with incomes not exceeding 50 percent of the median income for the area. Families are allowed to choose where they want to live, subject to HUD standards.

Section 202 Housing - This is a senior citizen housing, usually with supportive services such as meals, transportation, and accommodations for the disabled. Private, non-profit organizations and consumer cooperatives are eligible to offer this type of housing to very low-income households that has at least one person 62 years or older, and the disabled. For information on each of these housing, contact your local housing authority, senior center, or HUD office.

Section 232 Program- This recently developed program supports construction and rehabilitation of nursing homes, assisted-living facilities, intermediate-care facilities, and board-and-care homes by providing mortgage insurance. It is eligible to investors, builders, private non-profit corporations or associations. However, for nursing homes only, applicants may be public agencies that are licensed by the state to care for convalescents and people who need nursing care.

In the year 2000, HUD released the Housing Security Plan for Older Americans. This initiative includes a $50 million increase in funds to hire service coordinators, who help senior citizens get services they need to continue living in their HUD-subsidized apartments, which indirectly turns their current residence into assisted housing. In addition, there is a $50 million fund to convert existing HUD senior housing to assisted living facilities for senior citizens who need higher level of care. This legislation also allows seniors already receiving assistance through vouchers to use the vouchers in assisted living facilities for the first time. For information on how to utilize these funds, contact your local HUD office.

3. Are there loans available for room addition to accommodate frail elders / handicapped relatives?

One possible source of help would be the local FannieMae office. For more information, visit their web site at http://www.fanniemae.com. FannieMae also has 3 programs that might be helpful; the HomeChoice program, Home Keeper program, and the Home Equity Conversion Mortgage. More information is on the web site at http://www.efanniemae.com

Bank of America has Home Modification Loans for Homeowners under their Access Loans category. The program includes fixed interest rates and low minimum loan amounts. To apply for an Access Loan call (available only in the states listed):
California, Illinois: 1-800-843-2632, Texas, New Mexico: 1-800-900-9000 TDD 1-800-833-2632.

4. What resources are there for community/ academic research funding in the area of home modification?

There are many sources to obtain funding for research, through both foundation and government grants. Some examples include:

The National Institute on Aging Public Information Office Building 31, Room 5C27 31 Center Dr., MSC 2292 Bethesda, MD 20892 301-496-l 752 Fax: 301-402-0051

The National Institute of Disability and Rehabilitation Research U. S. Department of Education 400 Maryland Ave., SW Washington, DC 20202-0498 1800-USA-LEARN

There is also an Education Grants Guide, which can be obtained from their web site under "Program and Services " at http://www.ed.gov .

Robert Wood Johnson Foundation College Road P.O. Box 2316 Princeton, NJ O8543-2316 609-243-5946 Fax: 609-987-8746

The Retirement Research Foundation 8765 West Higgins Road, Suite 430 Chicago, IL 60631-4170 773- 714-8080 info@rrf.org


Assessment Tools/ Instruments

What are some assessment tools for senior home modifications?

There are several checklists that focus on different aspects of home modifications: "How well does your home meet your needs?" focuses on comfort, safety, and independence titled by AARP. It is available online here.

It is an easy to follow checklist as the question/answer format takes you room-by-room through the entire house.

Others that focus on home safety are:

  • Group Health Cooperative general checklist" provided by Puget Sound
  • Home Safety Checklist for indoors and outdoors" provided by Bella J. May and FA Davis Co.
  • Home Assessment Checklist for Fall Hazards" by Tideiksaar R. Falls
  • Checklist for Stairways" by Jake Pauls, RPE
  • Bathroom Safety" by Lisa Schulman
  • Safety for Older Consumers: Home Safety Checklist" by the U.S. Consumer Product Safety Commission is available online at: http://www.homemods.org/resources/pages/safety.shtml


The National Kitchen and Bath Association provides summaries of universal kitchen and bath planning checklists, which can be used to evaluate the existing modification done on these sections of the home. To view the checklist, visit their web site at http://www.nkba.org.

There is a home safety checklist provided by the U.S. Consumer-Product Safety Commission to evaluate how safe the living environment is. To obtain the checklist, click on safety.


General Modifications

Can you tell me where to find guidelines for home modification for elderly adults with Alzheimer's disease?

A booklet that provides information and serves as a guide for Alzheimer 's caregivers titled:

"The Caring Home Booklet: Environmental Coping Strategies for Alzheimer's Caregivers " by Jon Pynoos Ph.D.; Evelyn Cohen, M.A.; and Claire Lucas, MSG is available an this web site: http://www.homemods.org under the library section.

Or write to:
The National Resource Center on Supportive Housing & Home Modification 3715 McClintock Ave. Los Angeles, CA 90089-0191 Or call (213) 740-1364; or email request to homemods@usc.edu

"Homes That Help: Advice from Caregivers For Creating a Supportive Home" by Richard Olsen Ph.D.; Ezra Ehrenkrantz, F.A.I.A.; Barbara Hutchings, M. Arch. This book gives advice from a consumer's perspective and is written by professionals who have first-hand experience with Alzheimer's patients.

To purchase this book, contact C.A.B.S.R. / New Jersey Institute of Technology at Room 312 Hazell Center 323 M.L. King Blvd. Newark, NJ 07102 (201) 596-3097 The cost, including mailing & handling, is $17. Checks / money orders payable to: NJIT / C.A.B.S.R.

Check out the web site http://www.agelessdesign.com. It offers current news about Alzheimer's disease, recommends home modifications for Alzheimer's patients, and advice to Alzheimer's caregivers


Universal Design

Where can I find accessible and universal design blueprints?

Accessible design is available from several organizations. Examples include:

The Center for Universal Design from North Carolina State University offers an array of information on universal design projects, services, publication lists, and other resources. For more information, visit their web site at http://www.design.ncsu.edu/cud

Another available resource is the Iowa State University web site, under the category Universal Design and Home Accessibility. Their web site offers several links to home modifications and repair, home assessments, and universal design. The web site address is http://www.extension.iastate.edu.


Publication/ Printed Materials

Are there any print publications on resources regarding home modifications or home safety?

There are many print publications pertaining to home modifications that are listed and available online at http://www.homemods.org under the Resources section.




1. Where can I find bath tub/ shower stall that is wheelchair accessible?

There are some bathware companies that could modify the existing tub and shower to be wheelchair accessible, for example:

The Chiaki Enterprises Pte Ltd. specializes in cutting out part of the existing tub to turn it into an opening, so that the user can walk in. For information, visit their web site at http://www.worldwide.com.sg/.

Another company that also modifies tubs is Mirror Bond Co. 1-800-649-2191.

There are also other companies that manufacture prefabricated tub and shower that are wheelchair accessible, examples are:

Lasco Bath Ware manufactures portable showers that have a low threshold for easy wheelchair accessibility. For more information, visit their web site at http://www.lascobathware.com.

Other companies that carry accessible shower stalls are:
Aquarius at 1-800-443-7269
Access at http://www.aquariusproducts.com/

SWAN Corporation at http://www.theswancorp.com
AWUA GLASS at 901-632-0911

Some companies manufacture bath tubs with a cut out section that can be opened like a door for wheelchair access and closed to prevent water leakage:
Kohler at http://www.kohlerco.com
Bath Ease, Inc. at 714-786-2604

2. What shower modifications can you recommend for a wheel chair dependent person in an independent living facility? Especially the specifics on building a roll-in shower that is wheelchair accessible?

The main concern for a person who uses a wheelchair when showering is access. Therefore, in addition to other assistive shower devices, it is helpful to have roll-in showers in an independent living facility to ease the process of showering.

There are different types of roll-in showers, but the one that is most convenient and easiest to modify is the built-in type. The built-in type of shower shares the existing walls of the bathroom and has the same level of floor as the rest of the room for the roll-in purpose. It also has a slight slope toward the drain under the showerhead to prevent water from flooding the bathroom. A curtain instead of a door usually separates the shower from the rest of the bathroom for easier wheelchair access.

In addition, one could install a wall-mounted bath bench that folds out to the middle of the shower with support legs that fall to the floor when the seat is pulled down. A hand held shower could further ease the process of showering. Manufacturers such as Lasco Bathware offer a series of prefabricated barrier-free showers. Also, installing some horizontal grab bars along the 3 sides of the shower walls could serve as support for transferring. If the roll-in shower is prefabricated, other mounting equipment would be necessary to install the grab bars (see the next question).

3. How should grab bars be installed in fiberglass showers?

A common way to install grab bars in fiberglass showers is through a bolt to the other side and adding a plate, but there is a product called the Solid Mount which makes up the difference between the fiberglass wall and the wall/stud an inch or so further. The product is approximately $35 and can be found in the Beyond Barriers catalog. 1-800-561-2223 or 612-462-3444. For more information on the solid mount, visit their web site at http://www.beyondbarriers.com .

There is a fastening system that eases the process of installing grab bars by minimizing the use of tool. WingIt fastening technology requires two holes be drilled on each side of the grab bar, then WingIt is inserted through the holes to the other side of the wall where its extension clamps expand to grab onto the wall surface on the other side. Therefore, no additional plate is needed to fasten brab bars. WingIts are available from Pinnacle Innovations at 732-257-6900 or visit their web site at http://www.wingits.com.

There is also an article on installation of grab bars in fiberglass showers that includes detailed instructions. The article is on the Fine HomeBuilding web page, it can be found at http://www.taunton.com/fh/features/techniques/17shower.htm.


1. Are there products that modify an existing toilet without raising it?

Modifying an existing toilet without raising the entire structure requires less construction work, and often could be done by the users themselves, without professional help. Usually, an additional tool is added on top of the toilet seat to raise the height. It could be either fixed on by tools or simply latched on without tools. Several companies carry a vast variety of toilet raisers, some examples are:

Dolomite Home Care Products, Inc. offers Dolomite 9000 Raised Toilet Seat with lid, which can be attached to the existing toilet without tools. The raiser offers 2" to 4" rise with an optional arm rests that are 8" from the seat. For further information, contact Dolomite Home Care Products Inc. at 1-888-687-2390, 1-888-657-80007 Fax 50 Shields Court Markham, Ontario L3R 9T5, Canada

Home health and durable medical equipment suppliers such as Continental Hospital Supply & Homecare also offers several toilet seat raisers, such as Raised Toilet Seat by Guardian. It raises seat height 5" above the toilet and has a locking system that requires no tools. For more information or other types of toilet seat raisers, contact Continental Hospital Supply & Homecare at (818) 242-4171, (818) 637-6181 Fax
320 West Cerritos Avenue Glendale, CA 91204

2. What are some specifications to raising the height of a toilet from underneath the entire structure? How reliable is it?

Geofferey Fernie in Toronto developed a toilet riser called Toilevator that is a plastic block, which slides under the toilet to raise it. It is molded to fit the base of the toilet to avoid tripping and can raise the height of the toilet by 3 ½". To find out more information about this product, visit their web site at http://www.dynamic-living.com/toilevator.htm.Or contact LCM Distribution Systems at 1-888-726-4646, 1-204-726-5716, 2506 Fax. 2506 Southern Avenue Brandon, MB, Canada R7B 0S4.

MedWay Corporation also manufactures a similar product that raises the height of a toilet from underneath the structure. To view the actual product and find out more information, contact MedWay Corporation at 1-800-817-3118, 103 Graybark Lane Amherst, OH 44001

3. What company carries the combination toilet, bidet, and dryer product?

TOT0 makes Zoe and Drake, which is a 17.5" height toilet. Several other lines of toilet seat bidets can be found on the American Bidet web site at http://www.bidet.com/bidetsto.htm.

Stair Lifts

1. Where can I find a stair lift that could countersink into the floor for easier access?

Concord Elevator Inc. produces several lifts; one of which called the Discovery is a stair lift that turns toward the room at the top of the stairs for safe landing. For more information, contact Concord at 1-800-661-5112 107 Alfred Kuehne Blvd. Brampton, Ontario Canada, L6T 4K3 Or visit their web site at http://www.concordelevator.com.

2. How much room does the stair lift take up on a legal minimum stair width?

Each manufacture produces different size stair glides in order to fit the varying demand of different consumers. Due to the variation in the architecture of stairs, the room a stair lift takes up would vary from stair to stair that is built with legal minimum width. Below are some examples:
Bruno makes a chair lift called Electra Ride II, which takes up 24" of stairway, and 13" when folded up against the wall. To see the product, visit their web site at: http://www.bruno.com/elev_straight.htm or contact them at 1-800-882-8183.

Inclinator has a similar stair lift that when folded up utilizes 12" of the stair width. To visit their web site, go to http://www.inclinator.com or contact Inclinator at 717-234-8065.

3. Where can I find a pull down kitchen shelf?

As part of the Real Life Design collection, GE makes a pull down kitchen shelf, which is incorporated within a wall cabinet. It has an easy to grip handle and a spring-loaded shelf that could be lowered and locked into place. For questions about the product, call GE answer center at 1-800-626-2000 or visit their web site at http://www.geappliances.com.

Bomarc Design & Construction, Inc. manufactures several barrier-free kitchen products, including a remote wall cabinet that could be moved up and down at the touch of one button. For more information, visit their web site at http://www.bomarcdesign.com.

Accessible Designs/ Adjustable Systems, Inc. also offers a similar type of motorized height adjustable wall cabinet. To see the product and for pricing information, visit their web site at http://www.ad-as.com.

4. Where can I find wheelchair accessible stoves?

GE has a model kitchen called the Real Life Design, in which the stove is wheelchair accessible, with an opening underneath the stovetop for convenient wheelchair access. For more information, visit their web site at http://www.geappliances.com or call GE answer center at 1-800-626-2000.

Kraftmaid Cabinetry, Inc. has a Passport Series kitchen that offers stovetops installed at any height, with an opening underneath for wheelchair access. For more information, visit their web site at http://www.kraftmaid.com or call 1-800-610-2202 for a free KraftMaid Passport Series brochure and video.

AD AS manufactures a motorized height-adjustable cooktop with ample room underneath the stove for wheelchair access. For further information and pricing, visit their web site at http://www.ad-as.com, or contact the customer service at 1-800-208-2020, 208-362-8001, 208-362-8009 fax, or email customerservice@ad-as.com.


1. Where can I find lifts with ceiling tracks for transferring from bed to wheelchair and other parts of the house?

There are several manufacturers that make ceiling track lifts. Examples include:
Guldmann manufactures tracks/ lift 1-800-664-8834.

Barrier Free Lift Systems in Mesquite, Texas also has similar products. For information, contact them at 1-888-485-3626.

Columbus McKinnon in Amherst in New York http://www.cmworks.com or contact the company at 716-689-5400, 716-689-5598 Fax 140 John James Audubon Parkway Amherst, NY 14228

Barrier Free Lifts. 1-800-582-8732

Sure Hands. 1-800-724-5305

2. What lift device would you recommend for small spaces?

Wall or floor mounted lift devices would be suitable for small spaces. Hoyer offers a floor mount lift that when mounted near a bathtub, will allow the consumer to be lifted into and out of a bathtub.

Handi-Move/ SureHands makes a lift called Track- to- Track 100, which can be easily moved from one location to another. For more information, visit their web site at http://www.surehands.com or call SureHands at 1-800-724-5305.


1. Who can I contact for plans on portable ramps?

There are varieties of portable ramps, for accessing different venues. For example, there is side door van ramp, rear door van ramp, threshold ramp, and larger modular ramp for home access and commercial use.

There are several companies that offer home modification consultation and construction of wheelchair ramps: Easter Seals: web site is http://www.easterseals.com. Facility Management Resources sells ramp kits: 4418 University Ave., Des Moines, IA 50311 For more information, contact Kelly Dinges at 1-800-477-6904.

2. Are there guides available on building ramps and information on their requirements?

There is a manual titled "How to build RAMPS for home accessibility" from the Metropolitan Center For Independent Living. It is available for download from http://www.wheelchairramp.org.

The web site also includes information on The Minnesota Ramp Projects, which offers guides on how to build modular wheelchair ramps, low-riser steps, and long tread for home accessibility.

One could also order by mail, fax, or call MCIL at 612-646-8342 TDD 612-603-2001 Fax 612-603-2006 1600 University Avenue, St. Paul, MN 55104-3825.



What type of slip-resistant, reasonably priced flooring would you recommend for the bathroom?

The Australian Safety Flooring Ltd. manufactures vinyl flooring products from slip resistant materials. To find out more about the product, visit their web site at http://www.safetyfloor.com.au

Another Australian company called The Stepless Shower Base manufactures stepless shower base flooring that continues across the bathroom, which is an effective way to prevent falls. To view the model bathroom floor, visit their web site at http://www.steplessshowerbase.com.au or contact the manufacturer I.J. & W. Howden at 61-3-9786-5087, 61-3-9786-0290 Fax 40 Molesworth Street, Seaford Victoria 3198 . You can also email them at sales@steplessshowerbase.com.au for further inquiry.

To prevent leakage between the floor and wheelchair accessible bathtubs, one could usea pond liner, which is available at most Home Depot and other hardware stores.


Grab Bars

What is the optimal placement for grab bars?

The optimal placement for grab bars varies depending on the users. It is difficult to set a standard placement because in order to achieve an optimal result, one needs to take into account the height, weight, and the abilities of the user.

However, the general guidelines are as follow:

An ADA regulation for side clearance at a toilet is 18" from the centerline of the toilet. Also a 1" grab bar should have 1 1/2" space between the grab bar and the wall. That leaves 15 1/2" from the centerline of the toilet to the centerline of the grab bar, and 15" from the toilet centerline to the close edge.

How do you install grab bars?

To ensure a proper and safe installation of grab bars, it is recommended to have professionals install them. Professional installers have more experience and the proper equipment to fasten grab bars tightly at the proper areas, as most grab bars need to be mounted on studs with a strong supporting base.

Solid Mount by Back to Basics provides a stable base for mounting grab bars in existing fiberglass/ plastic shower enclosures. For more information on the product, visit their web site at http://www.solidmount.com.

WingIt Grab bar Fastening System allows you to install grab bars into the wall without blocking. To see their product, visit their web site at http://www.wingits.com or call 732-257-6900.

After installing grab bars, the ultimate test is to lean on each grab bar with all your weight to see if it will support your weight without moving, sliding, or bending and to see if the wall stays firm or if it flexes from the weight. In non-wet areas, such as a toilet, one should fix a 30mm (1 1/4") thick board to the wall at the point of supports. Then install a wood plate on both sides and thru bolting. However the actual location of the studs in relation to the ends of the bar/plate should be considered.

In wet areas, one should use 1/4" polyethylene plates instead of wood, and apply some sealant behind and at the edges of the plate.


Hearing Impairment

What are some devices to help people with a hearing impairment realize they have visitors at the door?

The Sonic Alert Doorbell Signaler helps people with hearing impairments realize that they have visitors. The signaler attaches to a lamp, which flashes as the doorbell rings. For more information, call Dynamic Living at 1-800-940-0605 or visit their web site at http://www.dynamic-living.com.

Are there any devices that help people with hearing impairments to use the phone more efficiently?

TTY, a telecommunication device with keyboard and visual display for people who are deaf, hard of hearing and speech disabled allows the user to use the phone more efficiently. In California, the California Relay Service (CRS) enables a person using a TTY to communicate with a person who does not use a TTY. An operator transcribes the conversation into words, which are displayed, on the screen of the TTY to the person with hearing impairment.

For more information, call MCI CRS at 1-800-735-2929 TTY 1-800-735-2922 Voice Sprint CRS at 1-800-877-5378 TTY 1-800-877-5379 Voice.

There is also the Sonic Alert Telephone Signaler, which attaches to a lamp and flashes the light when the phone rings. For more information, call Dynamic Living at 1-800-940-0605 or visit their web site at http://www.dynamic-living.com.


Assistive Technology

What are some assistive technologies that help bedridden patients with the ability to identify people at the door and lock & unlock doors?

There is a remote keyless entry device called AccessOne manufactured by Kwikset corporation. It serves as a remote to lock/unlock the front door as well as the garage door. For more information, contact the customer service: 516 East Santa Ana St., Anaheim, CA 92803-4250 714-535-8111 Domestic Fax 714-533-9547 International Fax 714-999-2214

Another device called Open Sesame is a remote-controlled door system that unlatches opens and closes a door with a remote control. It uses a special transmitter on the remote to release the locked door through the use of an electric strike plate. For more information, contact Open Sesame at 1933 Davis St. Suite 279 San Leandro, CA 94577 1-800-OPEN-911


A project of the National Resource Center on Supportive Housing and Home Modification,
in affiliation with the Fall Prevention Center of Excellence, funded by the Archstone Foundation.
Located at the University of Southern California Andrus Gerontology Center, Los Angeles, California 90089-0191 (213) 740-1364.