Designing Homes to Accommodate the Chronically Ill

Entering a doorway. Climbing a set of stairs. Navigating a room without taking a tumble.

These seemingly simple acts can represent major challenges to those with such chronic ailments as rheumatoid arthritis, Parkinson’s disease or multiple sclerosis.

If you have such a long-term illness, should you relinquish your aspirations for a beautiful home?

Definitely not, said Dr. Edward M. Phillips, a specialist in physical medicine and rehabilitation at a hospital affiliated with Harvard Medical School.

Those with chronic illnesses who seek to build or renovate a home should dare their architects to design a house where they can live with maximum comfort, safety and aesthetic pleasure.

“Architects love to come up with new approaches,” Phillips said.

Still, Janet Taylor Reilly, the president of a Coldwell Banker corporate relocation division, cautioned that many home builders are unaware of the needs of the medically disabled in the construction of home.

“A lot of builders tend to use the same plan over and over again because it’s popular,” she said.

Dr. Melanie Harrison, a rheumatologist at the Hospital for Special Surgery in New York, recommends a healthy dose of realism for home buyers who have long-term illnesses.

“You have to know yourself, what your limitations have been in the past and the potential for your disease in the future,” she said.

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Harrison was diagnosed with juvenile rheumatoid arthritis at the age of 2. Now 33, she has been generally undaunted by the challenges of her long-term illness, though her vision is limited and she’s never known a day without pain.

A couple of years ago, Harrison went to great lengths to select and renovate an apartment for herself in a Manhattan high-rise. “I bought a real fixer-upper, knowing I wanted it redone to my taste,” she said.

Recognizing she had far more mobility during some periods than others, Harrison purchased a home that would serve her needs on her most difficult days, when movement is arduous and she may have to count on a cane.

Consequently, a first-floor apartment was her best choice, she decided. That way she wouldn’t have to depend on the services of an elevator, which can be unreliable.

The art of creating places and products that serve virtually the entire population--including the disabled and elderly--is known as “universal design.”

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A recent exhibition at a Smithsonian Institution museum in New York, called “Unlimited by Design,” featured 150 examples of what can be done to make homes and work spaces movement-friendly yet attractive.

“There is no reason we can’t make the world easier for a whole lot more people,” said Dianne H. Pilgrim, who has multiple sclerosis and is the director of Cooper-Hewitt National Design Museum.

Cooper-Hewitt’s exhibition demonstrated how even small, inexpensive modifications to conventional housing plans can make a huge difference to many who face physical challenges.

For instance, in the large “dream kitchen” that is part of the exhibition, the counter tops featured a slightly raised edge on the front. This small, inexpensive and barely noticeable adaptation ensures that a Coke spilled on such a counter top won’t run onto the floor.

Why is the raised edge important? Because it means that those using such a kitchen will need to bend over less often to clean spills, a blessing for people who find such a motion painful or impossible, Pilgrim said.

Many buyers--not only the disabled--could benefit from innovations developed for the exhibition.

Its large kitchen, for instance, features shelving and counter tops that can be raised or lowered to meet the needs of a home’s occupants.

This could be a major plus to a petite woman married to a man who is more than 6 feet tall. The model kitchen also includes a center island with a long, flat dishwasher that doesn’t require a user to stoop in order to load it.

As the mature American population ages and long-term illnesses such as arthritis become increasingly prevalent, the concept of universal design will spread. “We’re just starting. The baby boomers are going to bring enormous change,” Pilgrim said.

But home buyers who face movement problems now must deal with the present level of awareness of design issues within the real estate establishment.

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Here are three strategies for meeting your special housing needs:

No. 1: Gather information from experts on design choices.

The term “universal design” was advanced by the late Ronald L. Mace, an architect formerly affiliated with North Carolina State University. You can reach the university’s Center for Universal Design at (800) 647-6777 or on the Web at https://www.design.ncsu.edu/cud.

Printed material on low-cost design adaptations for those with motor disabilities is also available through several nonprofit organizations.

For instance, you can call the National Multiple Sclerosis Society in Atlanta at (800) 344-4867. Another helpful group is the Adaptive Environments Center in Boston at (617) 695-1225.

No. 2: Find an empathetic realty agent who understands your needs.

Whether you’re purchasing a home or planning to have one built for yourself, you need the counsel of a seasoned real estate professional who can screen out existing homes or new-home floor plans that won’t work for you.

“If you’re working with an agent who doesn’t listen, the whole housing thing will be an exercise in frustration,” said Reilly, the Coldwell Banker executive, who also suggests you develop an A, B and C list of priorities before you shop for a home.

No. 3: Insist on designs that are both visually appealing and functional.

These days, there is no reason to surround yourself with unattractive home features simply to have your special needs met.

Those who need help navigating a room, for instance, can now obtain decorative handrails for the interior walls, said Phillips, who teaches at Harvard and also directs outpatient medical services at the Spaulding Rehabilitation Hospital in Boston.

While a pleasing home environment is a quality-of-life benefit, the ultimate goal of housing for those with motor disabilities should be to maximize their freedom of movement.

“Even when no treatment is available, changing your home environment may help maintain independence,” Phillips said.

Distributed by Universal Press Syndicate.