Disability accommodation Guide
The current state of disability accommodation in America is often light years ahead of the perception of Americans living with disability.
Too often and for too many, the word disability conjures up images of frail, handicapped people who are unable to live normal lives.
This is an outmoded and offensive stereotype. Over 61 million people have a disability in the United States, just over 25% of the adult population.
It’s highly likely that someone you know is living with a disability.
Disabilities range from minor impairments where an individual is still able to live a nearly fully independent life to severe impairments where constant care and support is required.
In this article, we take a snapshot of accessible accommodation in the USA. We consider:
- disability in today’s America
- what is an accessible home?
- how to choose the ideal home whilst considering any disability requirements
- understanding your access requirements
- specific adaptations you may need to make before moving in
- adaptations you may wish to consider for a later date
- how to cost up adaptations and stick to your budget
- how to find accessible accommodation
- getting help with care in your accommodation
- what to do if you don’t feel safe where you are living
- accessible accommodation and student living
Disability in today’s America
Disabilities come in many forms and modern society is now generally much more equipped to enable individuals with disabilities to have the same aspirations as Americans with no disabilities.
Typical aspirations including living in independent housing to training for and working in a career which reflects their interests and passions.
What are the figures? In the USA alone:
- 13.7% of people with a disability have serious difficulty in climbing stairs,
- 10.8% of individuals who are disabled have a cognition impairment which affects their concentration and decision making abilities,
- 6.8% of people have difficulty performing daily errands alone,
- 5.9% are deaf or have hearing impairments,
- 4.6% are blind or have serious difficulty in seeing, and
- 3.6% of disabled individuals are unable to care for themselves and they require help when bathing and dressing.
When we think about disability-friendly accommodation, we are commonly talking about a home which can be easily used by those with restricted physical movement.
Over 2 million American citizens use wheelchairs to get around and over 6.5 million are dependent on walking aids such as frames or sticks.
We then also must consider impairments such as blindness or deafness, or mental disorders.
Whether you are moving to a new house, you have recently become disabled yourself, or you are caring for someone that is, choosing the most suitable accommodation is an essential step in progressing to a stress-free life for you or the one you love.
What is an accessible home?
Our home is our sanctuary.
It’s important that where we call home is uplifting, secure, and that it is able to provide us with warmth and shelter.
On top of that, having a few key features that we love makes a house a home – features like a beautiful fireplace, a captivating view from a window, or a stylish kitchen can add greatly to our sense of positive wellbeing.
Having a well-designed home fitted to our physical, mental, and emotional needs and our day-to-day existence is important for all of us.
For those of us living with a disability, there are other components that must be considered.
When we start to consider disability-friendly accommodation, many will assume that we are usually talking about a home that can be easily used by those with restricted physical movement.
For a home to be accessible, there are some key criteria that it needs to include.
It should be in a suitable location, within budget, have enough bedrooms and bathrooms for the inhabitants.
It must include other specific individual requirements like ramps, stairlifts, wide doorways, grab rails, and height amended surfaces.
Accessible homes for disabled people may be purpose built or modified to cater for the needs of the individual so that they can live as independently as possible.
The architectural design of a building contributes to the accessibility of a building as does integrating modified furniture and fittings or electronic devices throughout the home.
In the United States, there are seven construction requirements for all multi-family buildings.
These requirements were introduced in the 1988 Amendments to the Fair Housing Act to protect people with disabilities.
For any building of more than four units that was first occupied after March 13, 1991, the following must apply:
- an accessible building entrance on an accessible route to the home
- accessible common and public use areas
- an accessible route through the building
- doors that can be used by wheelchair users
- reinforced walls in bathrooms so grab bars may be installed if needed
- usable kitchens and bathrooms which take wheelchair users into consideration
- accessible light switches, thermostats, and electrical outlets that can be easily accessed by a disabled individual.
Access is usually defined as the limits of what a wheelchair user would be able to reach and control just using their arms.
For example, a light switch needs to be placed at a height on the wall where it could easily be switched on by someone sitting in a wheelchair.
Similarly, sinks and kitchen surfaces need to be designed without cupboards underneath them so they can be reached without any constrictions.
Counter heights may be lower or designed to be height adjustable to accommodate a wheelchair user and a non-disabled person.
Although these stipulations were introduced by law in 1988, millions of households in the United States are not covered by the Americans with Disabilities Act, the Fair Housing Act, or other accessibility concerned laws because they are single-family homes.
Therefore, a huge number of new and existing homes are not truly accessible and they contain many barriers to wheelchair users or disabled individuals.
So, if you have recently become disabled or you have a longstanding disability and you need to move to a new house, read on for detailed information about disability accommodation in the USA today.
Choosing the ideal home
Where you live should bring you happiness and joy.
Just because your home may need certain modifications, fixtures, and fittings to make it habitable for you doesn’t mean it can’t be beautiful, stylish, and inviting.
Choosing your ideal accessible home doesn’t just mean making it wheelchair accessible either.
Americans with sight or hearing disabilities, mental disabilities, or recovering from a life-changing accident or illness have different and individual considerations to take into account.
Whether you are moving to a new property, building your own accessible home, or modifying your existing accommodation, there are some key factors you need to think about to make sure your home supports your day-to-day living and independence.
The key element here is to:
- see the potential in a property,
- know your modification budget, and
- discuss your needs with professionals such as architects and interior designers who can help you achieve your dream home.
Room to move
If you have a mobility disability (for example, you use a wheelchair or a walking aid or you have problems with your balance), you may find regular homes complying with standard building regulations too cramped and tricky to move around in.
Wheelchair users obviously need more space to move around in and the amount of space you need will also depend on the type of wheelchair you use.
If you have support from a carer, you will need to consider there will need to be enough room for you and your carers.
If you have impaired senses or reduced cognitive ability, you also may require a more spacious layout.
An open plan layout is generally best so that there is ample room for you and your carers to move comfortably around all of your furniture and fittings.
This will help you navigate around the space easier as well as reducing the chance of bumps and trips.
Doorways and hallways
Widened doorways is a necessity for many accessible homes.
Doorways should be at least 27 inches wide, preferably more if possible.
You should avoid mouldings as they can catch on wheelchairs but that doesn’t mean you can’t have a stylish finish to your interior design.
Consider pocket doors which slide back into the wall as they tend to be easier to open than traditional side-hung doors.
Alternatively, you might think about having shutter style doors with bifolds which allow for wider apertures between rooms as well as providing privacy when needed.
In some properties, self-closing doors are a fire safety requirement.
If this is the case in a property you are considering, make sure you can open them easily without straining or pulling and that they have a safe back-check facility so the door can be held open if needed.
Corridors and hallways need to be wide enough for a wheelchair to turn around in and, if possible, the doors off the hallway should be opposite one another to offer a straightforward passing between the two rooms without the wheelchair user having to manoeuvre around.
For the main doors to the property as well as the doors inside, lever handles are more suitable than doorknobs because they don’t have to be gripped or twisted.
If possible, entrance cards or key fobs are even better as they offer both security and ease-of-use.
Security peepholes or vision panels will need to be placed on the entrance in a height-appropriate position so that a wheelchair user can check who’s at the door before opening it.
Of course, it’s also possible to have an additional peephole at a higher level for friends, family members, and carers without a disability.
An inviting and accessible entrance
You need a clear path from the driveway to the entrance of the property.
Ideally, this should be a flat surface or incorporate a ramp if there is a gradient.
If there is a ramp, there needs to be handrails at each side.
An inviting addition to the front of your house is a porch area where visitors can wait before entering.
It’s a nice idea to have some seating, floral arrangements, or outdoor ornaments to make this area special and personal to you.
Of course, all of these touches can be added once you find the right home for you so don’t worry too much if you don’t see these elements whilst looking at potential accommodation.
It’s more important to see the potential of what could happen once you have free reign to put your personal stamp on the property.
Windows should be lower to allow wheelchair users an unobstructed view of the outside.
If at all possible, avoid installing horizontal window bars or high window sills which may block lines of vision.
It can be useful to remember that, often, the very best views and light in a property is on the higher floors.
If you choose a higher floor, always make sure these are accessible by stairlift.
Inside the property
Depending on the budget you have for modifications, you can let your imagination run wild in terms of kitting out your property.
We talk about specific modifications for bedrooms, bathrooms, kitchens, and living areas later on in this piece but, when choosing your ideal home, it’s best to:
- see the potential a property has,
- realistically price up the required modifications and
- put together mood boards for your interior design scheme.
- ensure the property has a reliable or a new boiler installed for warmth and comfort
If you are modifying a home for someone with a cognitive disability such as dementia or autism, your interior design needs to be calming and to avoid any strong patterns or colours so as to not overload their senses.
However, this will vary case by case as, sometimes, contrasting colours can help people understand which room they are in.
Consider painting the ceiling a contrasting colour or change textures in the flooring to help a resident identify that particular room.
Checking the level of insulation in a property is important for those who have impaired hearing as poor insulation can affect reverberation between rooms and units.
If someone is hard of hearing and they have their TV on too loud so that it disrupts their neighbors’ quality of life, this may become a major issue.
Soft furnishings like carpets help with improving the quality of sound throughout the property.
Understanding your access requirements
Depending on the nature of your disability or the disability of the person you are caring for, different elements will need to be considered.
This is to make sure every day life is smooth and straightforward with minimal help required from other people.
Access to the property
Getting into and out of your home is the first major point to consider.
Accessibility modifications may be one of the biggest investments required especially if there are considerable changes in terrain and ground levels before you enter the building.
Disabled people who use wheelchairs, walking aids, or sticks, or who have visual impairments need secure access through ramps.
Ramps vary in price and the more complicated the installation, the higher the overall price.
Always make sure that your installer is ADA-compliant.
It’s best to obtain a handful of quotes so you know you’re getting a fair deal.
You can choose between a temporary, removable ramp or a permanent ramp.
Likewise, you could opt to install a platform lift however this is significantly more expensive – budget for a total cost upwards from $5,000.
They can be useful if your property has a steep incline and where using a ramp could be dangerous.
A folding ramp may be suitable depending on the size of your property and how permanent the mobility issue is.
In contrast, a fully installed, permanent ramp will provide secure, easy access for years to come at a fairly average price point.
Property entry points
Getting into the property may be an issue if the door frames are too narrow or the doors too heavy to operate for a wheelchair or disabled user.
A standard doorway that can welcome a wheelchair user is a minimum of 32 inches wide and the door itself no heavier than 5lbs.
This is because a wheelchair user needs to be able to push the door using upper body strength.
Older properties which require their doorways to be widened may cost around $800 per doorway.
An accessible property in the USA should have at least 60% of entrances at the above standard, preferably with at least one private access point for disabled inhabitants.
If the property has peep holes for security reasons, there should be a second peep hole positioned lower on the door for a wheelchair user to make use of, at approximately 43 inches above the ground level.
Consider using windchimes at the entrance of the property to help with location identification for those with impaired sight or cognitive ability.
Touches like this are inexpensive ways to improve accessibility in an inviting and positive way.
Communal stairwell accessibility
Stairs can obviously be an issue for individuals with different disabilities and mobility issues.
The first option to solving this problem is to install a stair lift which, on average, costs around $5,000.
As you can see, this is a considerable investment.
You must also consider the costs of servicing and maintenance in subsequent years as well as potential eventual replacement.
It may be a cheaper and more feasible option to remodel the home to be entirely on the ground floor level to eliminate the stairs completely.
If possible, changing the layout of the accommodation so that the living quarters, bedroom, and bathroom for the disabled person are accessible without changing floors means you may save considerable costs.
Bathing in peace and comfort can be difficult for anyone with a mobility issue.
Bathrooms can also be dangerous places as the combination of water and slippery surfaces means it’s much easier to have an accidental trip or fall.
This is even more common with those who are not as steady on their feet.
An accessible bathroom takes many factors into consideration.
Not only does one need to have the functionality to allow someone who is not able to stand to clean themselves but it needs to be able to allow safe movement around it.
Generally, there needs to be around 60 inches of floor space for a wheelchair user to safely manoeuvre around the room.
The flooring you choose in your bathroom needs to be non-slip in areas which are prone to getting wet.
Bathroom suite options for disabled people may include a shower seat, a toilet frame, or even a walk-in bath or wet room.
The latter are more expensive options and remodelling a bathroom from top to bottom to be disability-friendly can cost upwards of $4,000.
However, to simply use a shower seat or toilet frame can cost a hundred dollars or less depending on your supplier.
Whatever option you choose, it’s recommended that you leave space at the side of the toilet for easy moving between wheelchair and toilet seat, if applicable.
You may opt for the installation of a hoist in the bathroom to enable the disabled individual to be safely transported from the wheelchair into the bath and bath.
These are useful to avoid repetitive strain injury for a carer who otherwise may have to lift the person they’re helping backwards and forward.
Hoists can be expensive and they do require a moderate amount of building work as they need to be securely fastened to the ceiling and wall.
One non-negotiable addition to an accessible bathroom is the addition of grab rails to the walls.
These low-cost solutions can be added anywhere in a property but they are essential in a bathroom to aid movement from toilet, to sink, to shower or bath.
They provide help and extra peace of mind for any disabled bathroom user and they are invaluable especially whilst climbing in and out of your bathing facility.
A final measure in the bathroom of an accessible property is the installation of an emergency cord for extra peace of mind.
Should something go wrong in the bathroom, there is an additional safety measure there that could potentially save someone’s life.
An accessible kitchen
The kitchen is the heart of the home however this is the room most likely to present a range of potential problems to a disabled user.
Kitchens are challenging rooms to make accessible and, much like bathrooms, they can be dangerous if not kitted out correctly and to a safe standard.
Most kitchens in the United States are built around a traditional western system of cupboards and appliances which are elevated.
Cupboards and appliances are often installed too high to be accessible to someone who is using a wheelchair.
To make a kitchen disability friendly, there are a number of adjustments that will need to be undertaken – some of which are easily done but some which may require substantial changes.
The surfaces and countertops in a kitchen are the first port of call to be addressed.
If you are sharing an accessible home with individuals who don’t use wheelchairs, it’s necessary to have adjustable surfaces and countertops which can be raised or lowered as needed.
As with most kitchen refits, these need to be installed by a professional and they are usually designed to be bespoke to the measurements of the room.
A complete kitchen refit including this style of countertop may cost between $2,000 and $3,500 depending on the level of finish you choose.
It almost goes without saying but wall hung cupboard units that are elevated should not be installed unless they are required by users who don’t use wheelchairs.
It’s best to have storage cupboards placed at around 31 inches above the ground. The kitchen sink should be positioned at approximately 27 inches above the ground whereas cookers and ovens should be placed at around 31 inches.
Smaller, less expensive additions for an accessible kitchen include the use of U-shaped handles on drawers and cupboards and pull out trays which help in avoiding unnecessary pulling, leaning, and stretching by a wheelchair user.
Use of grab bars
Grab bars are invaluable pieces of kit for an accessible home and are useful in almost every room – including outside near entrances and exits.
They are available in a variety of finishes to suit your interior and sizes to fit your personal requirements and they usually cost between $10 and $50 each.
They should be placed strategically around your property, if possible, under the supervision of the disabled individual.
This is because they are the person who understands their daily journey around the home the best so they will be able to advise on which are the most suitable locations.
Grab bars make a home accessible because they ensure safer movement throughout the home as well as providing an increased level of peace of mind for any individual who has mobility difficulties or sight impairments.
Having an intelligently placed grab bar installed on a reinforced wall means someone who struggles with their balance or movement can easily regain stability or pull themselves towards their chosen destination.
Accessibly in the bedroom
Depending on the level of disability of the individual, there may need to be minor or major changes implemented in the bedroom.
A major investment, if required, would be the installation of a hoist so that the individual can be lifted from the wheelchair into the bed.
The bed itself is also of great importance.
It needs to be easy to get in and out of for the individual as well as being comfortable, correctly designed for use, and secure.
The mattress on the bed needs to be the same height as the user’s wheelchair cushion for the easiest transfer between destinations unless you are using a hoist in which case this is negotiable.
To prevent the user from falling out of the bed during the night, many professionals recommend the installation of bed rails.
Similarly, floor to ceiling poles or grab bars at the head or foot of the bed might be required so the user feels safe and secure whilst in bed, or if they have to get up during the night.
The position of the bed needs to be considered so that there is maximum floor space for manoeuvring around the bedroom in a wheelchair, if that is required.
You may wish to experiment with different layouts of the bedroom to get the most out of the space – for example, pushing the bed up to the wall in order to gain valuable access route options.
There should be as much space as possible between the door, any drawers or cupboards, the bed, and any other furniture like wardrobes or a desk.
You may choose to install an emergency pull cord that is accessible at the head of the bed if you feel that you need extra protection in place.
This can also give carers and family members an added level of peace of mind as they are usually connected to a central switchboard system.
This system will quickly alert a nominated carer or individual to check on the disabled person if the switch has been activated.
Accessibility in the living quarters
Much like your kitchen, a living room needs to be functional but also homely.
The living room is where you go to relax and wind down, either by watching TV or catching up with hobbies, friend over the telephone or a new book.
None of these elements can be lost by installing accessibility options, they will simply add to the security of this room.
In an accessible home, the living room should be a door-less space with no raised threshold and be a generally clear space to move around in as will be needed.
Much like any room in an accessible property, there should be a uniform level of height throughout the floor area and no steps or potential trip hazards.
If you have a TV or sound system installed, the wires should be kept pinned back away from the floor.
All technology or appliances should be easily turned on and used by the disabled person, so the buttons should be at a suitable height much like light switches.
Be sure of the specific adaptations you might need to make before moving in
Once you’ve chosen your ideal home, it is best to make a list of the specific adaptations you may need to make before you move in.
Your main priorities are likely to be the access points to the home, specifically the main entrance, any back doors, any specific lifts or ramps required, ensuring that doorways are sufficiently wide, and safety measures such as alarm systems.
You also need to make sure both the kitchen and bathroom areas are safe, fit for use by you, and that you can use them straight away.
Your property needs to be secured and alarmed if necessary.
Once these basic elements have been covered, you can start to consider decorating your home in your preferred style to make it inviting and comfortable.
Before moving into your property, other essential modifications professionals recommend that you make include:
- entrance ramps for outside and inside if needed
- floor levelling or use of ramps inside
- doorways widened to at least 27 inches
- doors unable to be opened by a wheelchair user removed or replaced with automatic doors
- lift in full working order if applicable
- stairlift in a 2- or 3-story home if required
- accessible sinks and countertops in the kitchen
- accessible bathing facilities, such as a shower or bath
- accessible sink and toilet facilities in the bathroom
- single lever faucet taps on all sinks
- hardwood or laminate floors that have no trip hazards
- accessible kitchen appliances such as cooker or hob with large font if necessary
- rocker light switches installed between 15 to 48 inches above floor level
- front-loading washer dryer machines for laundry
- grab bars in the bathroom, near doorways or anywhere else the disabled person would find them useful
- handicap parking space established
- door handles instead of doorknobs which are harder to grip
- personal alarm systems
- visual and/or audio smoke and gas alarm systems
Later adaptations you might consider
Depending on your budget at the time, it’s best to undertake the key mobility and accessibility solutions first as mentioned.
Later down the line, you can think about the solutions which are appropriate for helping you as you get older.
This is called ‘aging in place’ and it involves looking at how your property might need to change as your health changes.
Some adaptations that you may wish to think about to help you as you get older include:
- hiring extra help for things around the home like cleaning and laundry
- a stairlift if you haven’t already installed one
- extra grab bars around your property
- changing your bathroom to a walk-in wet room
- re-organising the layout of your property so your living quarters are downstairs
- hiring help to organise your finances or asking a trusted family member to assist you
- purchasing a scooter for trips to local shops and amenities
- a ramp to access your property
For more information on aging in place solutions, there are a number of non-profit organisations who are happy to help:
- National Resource Center on Supportive Housing and Home Modifications
- Eldercare Locator
- Low Income Home Energy Assistance Program
National Energy Assistance Referral Hotline (NEAR)
- National Association of Area Agencies on Aging
- Centers for Medicare & Medicaid Services
- Department of Housing and Urban Development
Costing up adjustments within a budget
The Americans with Disability Act website gives a wealth of information to those with questions surrounding financial aid.
Estimates for making your home accessible can range from $100 to $50,000 or more.
On average for example, it can cost approximately $9,000 to remodel the bathroom which is usually the room requiring the most work.
If you’ve recently become disabled or you are moving into a property that requires significant adjustments to make life easier for you, there are usually a large number of costs you’ll have to consider.
The final cost greatly depends on not only the needs you need to modify the property for but also the current structure and state of the property.
For example, a ground floor apartment will not need modifications such as a stairlift or ramp for a wheelchair user whereas a two-story home will most likely require something to assist you get upstairs.
Similarly, someone with a hearing disability will require modifications for the doorbell and smoke alarm but they are unlikely to need height adjustable surfaces if they are able to walk unaided.
There are different types of remodelling available and various rooms around the home will naturally require different modifications.
It’s also important to take into account the living needs of other inhabitants of the house if they use the same facilities.
Typical renovations and costings to make a home accessible include:
- purchasing a portable ramp for the outdoor entrance of your home – between $100 – $400
- installing a permanent ramp for the outdoor of the house – between $400 – $4,000
- installing a chairlift from the ground floor to the first floor, or first floor to second floor – between $3,000 – $4,000
- widening doorways to make them more accessible to wheelchair users – around $700 per doorway
- levelling the yard outside the property – between $500 – $1,000
- installing handrails either outside the property on pathways or inside if required – $100 per linear foot of railing on average
- remodelling the kitchen – this could be installing height adjustable surfaces at a cost of around $500 – $1,00 or lowering the entire kitchen cabinet arrangement which could cost around $15,000
- installing a walk-in shower in the bathroom – between $5,000 – $6,000
- installing grab bars near the toilet, sink, bath, or shower – around $140 for three bars
- modifying the sink so that it is wall-hung to enable wheelchair users extra space underneath it for accessibility – between $1,000 – $1,500
- laying anti-slip, ADA approved flooring in bathrooms or wet rooms to prevent slips and falls – around $1,300
- modifying faucets to lever handles and showerheads to hand showers – approximately $400.
How to find accessible accommodation
Finding a suitable place to live can be tricky for anyone but especially so if you have specific criteria that you require for your property.
If you have a physical disability and you need somewhere which is accessible but also fits the bill for your wants and needs, there are specialist websites that allow you to search apartments that have the features you require.
Searching online for accessible accommodation is a lot easier now with many websites allowing you the option to disallow non-suitable properties when browsing.
Often, there are tick boxes to narrow down your search options in order for you to just view properties that might be right for you.
What are accessible features in a property?
As mentioned previously in this article, there are many modifications required and available that allow for easier mobility for disabled individuals or those who use wheelchairs or walking aids.
If you are looking for an accessible property through a real estate agent and you go into their office in person, they will help you find a property through their computer system and most likely be able to take you on a tour.
They will ensure they only show you properties with the correct modifications for your requirements so you can find a suitable home as soon as possible.
If you are searching for an accessible property online, most property search engines have an option for ‘disability access’ which is classed as a special feature.
This may be a tick box on the advanced search option so remember to click through to that page on your chosen website.
Here is a selection of apartment search engine sites that offer an advanced search option for accessible properties and where to click for an advanced search:
- www.rentals.com – after searching for your preferred location, click ‘handicapped accessible’ under ‘property features’ or ‘handicap access’ under ‘community feature’.
- www.forrent.com – under ‘community amenities, select ‘disability access’.
- www.apartments.com – after you have searched for your location, open the menu under ‘amenities’, then ‘community amenities’ before clicking ‘disability access’.
- www.apartmentguide.com – click ‘disability access’ under the ‘special features’ option.
Another option is to use a search engine such as Google to search for ‘accessible apartment’ plus the words of the location you are looking in, for example the name of your town, city or state.
If you were looking for an accessible apartment in Manhattan, you would search ‘accessible apartment in Manhattan’.
www.socialserve.com is a not for profit organisation based in North Carolina which hosts individual search engine sites for over 30 American states looking to find accessible apartments at an affordable price.
www.apartmentlist.com offers a personalised apartment search for the United States and you can click to select the accessibility features that you need for your home during your search.
Organising moving to an accessible property
Moving to a new house can be a stressful experience so it’s best to stay as organised as possible.
Here are our top tips to keep your search and move easy, calm and straightforward.
- Research the area you want to move to. Look at the local transportation if this is something you will need as well as local amenities such as shops and medical centres.
- Get your paperwork in check. Make sure you have your personal documentation ready so you can apply for an apartment as soon as you see one that takes your fancy.
For example, during an apartment tour you may wish to bring a list of modification requirements that are required so they can be approved as quickly as possible.
- Have proof of income handy. This is necessary for renting an apartment in America and is critical in getting your application approved.
If you receive benefits as opposed to a working income, make sure you have the relevant documents available.
- Narrow down your hunt to a few favourite places. Search online for apartments in the area you want to live and create a favourites list that you can refer back to in order to compare and contrast your options.
- Get in touch with Non-profit and Federal Programs that might be able to financially assist you. The U.S. Department of Housing and Urban Development (HUD) has housing vouchers available for those living with disabilities.
The Department of Labour Grants is a partner of the HUD and can also provide vouchers to disabled individuals for rental purposes. Accessible Space is a charity that helps disabled people find suitable housing for their needs.
Volunteers of America is a not for profit organisation that develops affordable housing, some of which can be used by disabled people. Habitat for Humanity is a Christian charity which provides housing for people with disabilities.
Mercy Housing also provides affordable housing for those with special needs in The United States.
- Book a tour of the properties you’re interested in. This is vital so you can see how you would live day-to-day in the apartment or house and if the features and modifications will be right for you and your disability.
- Keep asking questions. This is an essential part of the tour and, if you don’t feel comfortable doing this, consider writing questions down for the realtor or have a family member or carer ask them for you.
Don’t be afraid to ask a long list of queries – where you live is one of the most important things in your life so it needs to be right for you.
Some potential questions you will need to ask include:
– whether the estate agent or landlord is happy to make any required adjustments and the legalities surrounding this
– if there are any plans for building work in the future that may make the property more or less accessible than it is now
– if there is a handicap parking space if required
– if there are temporary ramps and if so, where they are stored
– how you can communicate with the landlord if there is a problem once you’ve moved in
– if an additional down payment is required if you need accessibility modifications completed.
- Complete your application and arrange your moving date. If you’ve found the perfect place for you, make sure to get your application in quickly and fingers crossed it will be approved.
Once the paperwork is complete, you can arrange for a removal van to transport your belongings and begin getting set up in your new accessible home.
Getting help at home from carers
Social care and support is available to you if you are living with a disability.
This could range from carers who come into your home daily to people who live with you in your property 24/7 or you could live in sheltered accommodation where there are staff to help with daily living and chores.
Carers can be employed to give your family or partner help in achieving as much independence as possible.
This can help lighten the load of responsibility and also allow your primary carer respite or the opportunity to work in paid employment.
Usually, carers help disabled individuals with a range of day-to-day tasks although the help given actually depends on the nature of your disability.
For example, you may only need help with tasks such as cooking and cleaning but be able to wash yourself.
However, if you have more severe disabilities meaning that you may require daily bathing, you may also need help in getting in and out of bed and in generally moving around your home.
In the United States, most health care providers are private.
This means that, if you do require a carer to help a disabled individual at home, you either have to pay for the service yourself through finance or insurance or by receiving funding or grants to help cover the cost.
Social care in America is means tested so you may be eligible for financial help if you are on a low income, 21% of adults are uninsured for medical help.
However, Medicare is a government funded programme that helps older or disabled people with their health and wellbeing requirements.
The Medicaid programme helps households on low incomes with social care.
This programme doesn’t consider the family home in the assessment of assets but the thresholds are low on non-housing assets.
Medicare covers a limited amount of days in a rehabilitation centre with on-site nurses for individuals who have recently become disabled, for example post hospital discharge.
However, once someone has stayed longer than the allowed days, they will have to pay for the remainder of their stay themselves.
If you do not need rehabilitation but you are unable to live at home, there are residential assisted living centres although not all are covered by Medicare or private health insurance.
However, in 40 states, there are waivers available for low income individuals to be covered by Medicaid in order to stay at the centres.
Residential care home places are costly, usually averaging $45,800 per year for one person.
Living in your own private property and receiving help from a carer can be a cheaper option.
Every state has a different average cost of at-home care and it varies considerably depending on the level of care you require and how many hours per day.
Carers can help disabled adults at home with the following tasks:
- bathing and getting dressed
- transferring and mobility assistance
- assistance with physical activities and exercise
- cooking and cleaning
- administering medication
- grocery shopping
- incontinence care
- transportation to medical appointments, education, or day centres
If you require a live-in carer, you may need to make adjustments to your home.
This could range from renovating a room in the house to be the designated bedroom for the carer or team of workers to making sure they have access to clean and comfortable bathroom and kitchen areas.
Live-in carers will naturally be spending a long amount of time in your property so making the environment as comfortable and welcoming as possible is important for their wellbeing.
The first thing you need to consider is how long you perceive you will need a live-in carer for.
If you are only temporarily disabled, for example after recovering from an operation or medical procedure, you will most likely only require a live-in carer for a short amount of time.
If you are permanently disabled, you may need to consider that you’ll have a live-in carer for the rest of your life.
If this is the case, more permanent modifications are likely to be required to be made to your property.
In either case, a live-in carer will require the following:
- Their own private and secure bedroom. This needs to be well ventilated, safe, and comfortable with a bed, storage space, a mirror, electrical sockets and suitable lighting.
They should have access to clean bed linen and be able to connect to internet WIFI if possible. This could be your spare bedroom, or a study or lounge room could be converted for this purpose.
- Access to a clean, functional bathroom. You need to have hygienic bathing facilities, preferably an en-suite but a sharing bathroom is also fine.
The bathroom needs to have a working lock and storage space for toiletries.
- The freedom to prepare their own food in a clean and functional kitchen as they require. Part of your care plan is likely to include food preparation, but carers are not usually expected to eat every meal with you even if they have prepared it.
If you have a partner or family, it’s important that they also prepare to be sharing their accommodation with a new person.
You could try having some trial sessions so they can build rapport with one another and sit down to discuss your daily routine and the logistics of using the bathroom and kitchen facilities.
All expensive items and assets should always be locked away when you have a live-in carer.
All carers will have undertaken criminal record checks but, as standard practise, it’s best not to leave cash or valuables lying around.
The costs of a live-in carer
The financial implications of having live-in care vary depending on the level of care you require and receive.
However, on average you can expect to pay between $4,290 and $4,385 per month for a live-in carer.
If you require a skilled nurse to come into your home to care for you, it can cost $87.50 per visit.
There are other expenses to think about, too.
Food, fuel, household items, outings and petty cash purchases all have to be accounted for and recorded.
The easiest way to do this is to have a container with the petty cash in, to save all of your receipts, and to make sure a daily tally and record is completed by each member of the caring staff at the end of their shift.
It’s essential you speak with your home insurer about housing a live-in carer as this could affect your policy.
If your carer will be using your car, this also needs to be stated to your car insurance company and they need to be added to your existing policy and named as a driver.
The cost of changing your insurance policies can vary greatly depending on your provider and it’s always recommended to obtain a few quotes before starting a new plan if possible.
Living options if you don’t feel safe where you are anymore
Disabled people are at higher risk of being abused, injured, or threatened in their homes.
Abuse can range from emotional abuse to violence or threats as well as financial abuse.
It is important that disabled individuals have a support network around them that keeps them safe from harm and which can inform them how to raise the alarm and get help if they feel unsafe.
Do you feel unsafe where you are right now?
Do you have a disabled friend or relative you’re concerned about?
In this section, we consider what you should do in these circumstances.
Anyone can be the victim of domestic abuse but disabled individuals may find it much harder to protect themselves, remove themselves from the dangerous situation, or report the crime.
It may also be the case that their carer is also their abuser which can make it even harder for the disabled person.
As with non-disabled people, domestic abuse refers to physical, psychological, financial, or sexual abuse but additional variations of abuse can arise such as:
- an abuser may intentionally withhold care from the individual or neglect them
- an abuser might remove mobility or sensory aids the disabled person needs for their independence
- financial benefits may be withheld from the disabled person meaning they can be controlled and spent by the abuser
- the disabled person may be taunted or degraded in a specific way regarding their disability.
Additional difficulties with abuse and disabilities
Americans who are disabled face increased difficulties with abuse for a variety of reasons.
They may initially be socially isolated due to their condition and see less people day to day which means they have less contact with their friends or family.
A disabled abuse victim may struggle to report any abuse because they have no access to other people without their abuser being present.
They may not be aware of different helplines, charities, or healthcare professionals that can work to resolve the problem.
Disabled people may be reluctant to report abuse because they may fear they will lose their care package, their place in sheltered accommodation, or their living space.
They may fear that, if they report the abuse, they will have to move which may significantly and negatively impact their life.
It is also possible that the victim of the abuse could be reluctant to disclose any issues with their carer or partner because they believe living with their abuser is the only option for staying out of institutional care.
Signs of emotional or violent abuse against an individual with a disability may include:
- unexplained injuries such as bruises, cuts and burns
- not wanting to be touched
- being withdrawn and changes in personality
- being overly keen to do tasks or activities
- compulsive behaviour
- not wanting to do things they previously liked to do
- not being able to concentrate or focus
Sexual abuse against individuals with disabilities
Sadly, individuals who have an intellectual disability are seven times more likely to be sexually assaulted or abused than non-disabled people.
There are complex challenges in this area because sometimes disabled people may not have previous sexual experience so they are unsure of personal boundaries and what constitutes abuse.
They may not be aware of what is classed as sexual violence or have the right communicative tools in order to describe it.
Health-care providers are on the front line of educating intellectually disabled individuals about sexual wellness.
These professionals should provide their service users with the tools needed to have simple and direct conversations with individuals in order to address problems of sexual abuse and violence.
Signs there could be sexual abuse against a disabled individual include:
- contracting an STI or pain in that area
- using expletive or foul language out of character
- not wanting to be touched
- changes in appearance
- behaving in a sexually inappropriate way
Financial abuse against disabled individuals
As with sexual abuse, intellectually disabled adults are much more likely to be victims of financial abuse too.
Financial abuse can refer to mismanagement or appropriation of an individual’s money, property or goods.
This could include exploitation, embezzlement, withholding benefits or pension and exerting pressure to change wills or inheritance documents.
Signs that may point to financial abuse include:
- the caregiver or abuser suddenly acquires costly items
- the disabled individual is increasingly isolated
- valuables, cash, or financial statements are missing
- transfer of assets, unexplained gifts, and lavish spending
- finances are suddenly handled by others without an explanation
- bills are unpaid and utilities are terminated
What to do if you think a disabled person is being abused
If you are seriously concerned about your own or someone else’s immediate wellbeing and safety, you should always call 911 and speak to the emergency services.
If you suspect an adult with a disability is suffering from abuse but you are not absolutely sure, the National Domestic Abuse Hotline is an excellent resource that you can access online or over the phone.
It covers information regarding the Americans With Disabilities Act (ADA) which is legally binding legislation written to provide protection from discrimination for people who are disabled.
Under the Act, social services such as domestic violence shelters and safe houses must be accessible for people with disabilities.
It covers public accommodations and buildings and services which are open to the public, for example doctors’ offices, translation service offices and counselling or legal services.
The ADA was introduced in 1990 and its passing means that people with disabilities have access to safe houses and shelters as well as equal rights to access and benefit from programs that they run.
Shelters from domestic violence may be used by anyone, regardless of their disability, as the services do not have the right to turn anyone away because of health problems or disabilities.
It also means that reasonable accommodation must be provided or changes to the environment must be made to allow disabled individuals to use the shelter.
For example, if the shelter has a ‘no pets’ policy, they will still have to admit an individual who has a service dog.
Changes must be made unless they would be excessively expensive or difficult to do.
Much like how the ADA states that public buildings need to be accessible for disabled people, shelters need to eliminate any structural barriers which would prevent people using wheelchairs or walking aids to enter.
For example, there should be a ramp up to the entrance and doorways which are wide enough for wheelchair access, as well as grab rails in bathrooms and toilet areas.
If you are a disabled adult and you feel unsafe where you are living, you should be aware that there are services and charities that can help you.
If you are in immediate danger, you should call 911.
You can Google local resources in your state for individuals who have disabilities.
The National Domestic Abuse Hotline is available all hours of the day or night, any day of the year.
It is a confidential service for people seeking advice about domestic violence or requiring someone to talk to about an unhealthy relationship.
You can speak to a highly trained advocate and gain information and resources about what to do next.
Accessible accommodation and students
Going to university is an exciting new chapter in anyone’s life.
Choosing your subjects and figuring out where you want to study appeals to you are all big decisions you should take seriously and with careful consideration for your future.
It’s always best to take your time and discuss your options with your trusted support network.
Being disabled and having the chance to study at university is a relatively new concept in America.
It wasn’t until the 1960s that the first university programs were opened up to disabled students and these were established at the University of Illinois Champaign-Urbana, the University of California, Berkeley, and a small number of other campuses.
In 1968, the Architectural Barriers Act was introduced to promote accessibility within university institutions.
However, it wasn’t strictly and absolutely enforced until 2008 where Congress passed the Americans with Disabilities Act.
The aim behind the newer Act is, of course, the full participation in society for people with disabilities.
Today, there are three main laws which protect people with disabilities and promote their learning at a university or college.
These are that a learning institution cannot:
- discriminate anyone because of their disability
- require that a student discloses their disability
A university or college must:
- provide physical access to all facilities, including classrooms, cafeterias, libraries, student unions, hallways, toilets, and other necessary rooms
- provide meaningful and inclusive access to the educational experience
- have a uniform system to address student needs and undertakes it in a consistent and inclusive manner.
Unless you plan on staying at home whilst you attend university, you will need to sign up for university accommodation at least for your first year of studying.
Depending on if you choose a campus or city university, there may be different housing options available to you.
Most American universities have an online registration form that you will need to complete if you wish to live in their accommodation.
If you have a disability, you will be required to register with the academic support services prior to this in order to talk through your accommodation options.
You will be allocated a disability advisor who can help provide further information for you and can answer any specific questions you may have.
All American universities are required to be accessible for anyone, whether you are disabled or able-bodied.
This means by law all buildings need to be accessible and they need to provide accessible accommodation options for disabled students.
Many universities stipulate that, if you have a major disability which affects one or more major life activities, you may be eligible for disability-related accommodation.
Usually, this requires paperwork from a licensed health care professional specifically documenting the impact of your disability on everyday life and what kind of accommodation you will require.
What does accessible university accommodation look like?
Naturally, this will vary from university to university.
Different housing options may include:
- a standard flat with shared bathroom facilities
- an en suite room that has its own bathroom
- a shared bedroom with an en suite room or shared bathroom facilities
- a wheelchair accessible bedroom which could be en suite or have shared bathroom facilities
- a studio flat that is self-contained and has its own en suite bathroom and kitchenette
If you require special equipment such as hoists or other aids, you will need to speak to the student services department of the university you are applying to.
Some universities may be able to customise their rooms to fit your specific needs but this will vary on a case by case basis.
In any accommodation that is classed as accessible, you can expect that:
- access to the accommodation is either by permanent or temporary ramp or with a lift
- doors can be opened easily by wheelchair users, for example they are automatic or have a push button
- the building itself is accessible to different floors using a lift if required
- kitchen and bathroom facilities have been altered to be accessible, using grab rails, lowered or adjustable surfaces and storage areas which can be reached by wheelchair users
- there is plenty of space for a wheelchair to move around the communal areas, bedroom, and bathroom
- there is an option for a carers room close to yours if required
- there are emergency cords in bathrooms and bedrooms if required and fire alarms are flashing lights as well as audio alarms
- any additional required adaptations are explored and installed if feasible.
Going to lectures and seminars can be difficult for the average student living independently for the first time so adding a disability into the mix can make this a challenging time.
Universities have a responsibility to make sure their educational facilities are accessible as well as their accommodation.
You should expect the following to be in place:
- entrances to educational buildings, lecture halls and libraries are accessible for those in wheelchairs or with mobility or sight disabilities by using ramps or lifts
- any doors are automatic or have push buttons to open so that wheelchair users can get inside using their upper body but without leaning or straining themselves
- there are lifts to all required floors of the building
- there are disabled access toilets at convenient locations throughout the facility
- any lecture halls or seminar rooms have wheelchair access and lifts if required
- IT resources are accessible for disabled individuals in different formats if required
Universities and colleges should be continuously striving to be more inclusive for disabled students.
There are a number of ways that they can do this and the student services committee should be in regular contact with you and their other disabled students to make sure individual needs are being met.
Find, modify, and live in your ideal accessible accommodation
Whether you have a longstanding disability, you have recently become disabled or you are temporarily living with mobility issues, your home should be a place of comfort, relaxation, and ease of living.
It should give you back control and it should provide a stable foundation on which you can carry on living your life in the way that’s best for you.
Having an accessible home is your right as an American and as a human being.
As individuals, we all live different lives with different hopes and dreams.
Being as independent as possible is important for anyone and there’s no reason that should change if you have a disability.
There are many steps you can take to make sure your home aids as independent life as possible and adds to your wellbeing and happiness.
In today’s America, there are a wealth of domestic modifications available to suit any need and any budget when creating the ideal living environment for you.
You have the opportunity to build the ideal space for you whether that be through extensive modification and rebuilding or temporary measures before you make the changes permanent once you have the funds available.
From expensive modifications like stairlifts or complete room re-fits to small touches like the use of windchimes near your front door or simply painting a feature wall to help with location identification, home modification for accessibility can dramatically improve a disabled person’s life.