A zero step entry is a doorway to get in and out of your house with ZERO steps.
You know what’s a shame though? Less than 3.5% of homes in the U.S. have one zero step entry according to Joint Center for Housing Studies (2011).
Now, of course, I hope that figure has gone up since 2011. But I highly doubt it!
When I drive around and see new construction for houses and apartments, you better believe I’m rubbernecking to see if they’re putting in one entryway with zero steps!
But here’s the unfortunate truth: I see steps to go inside the front door, back door, and garage door.
Why do builders do this?
Because they do what they know. Builders don’t obsess about accessibility the way occupational therapists like me do!
I understand people think that a couple, two, three stairs won’t hurt anybody from going in and out of their house. But it actually does in the long run.
Let’s try an experiment:
I want you to carry something that requires two hands, like a laundry basket, across level flooring for ten feet.
I’ll wait here. . .
Okay! You’re finished! Great! How much effort did you put into that? How hard are you breathing? Can you still hold a conversation? Are your muscles tired?
Now, I want you to carry that same object up and down at least two stairs. If you have more stairs, try carrying your object up and down all of your stairs.
After all of your stair climbing, how much effort did your body put in to carrying an object up and down the stairs compared to no stairs at all?
As we age, this “simple” task of carrying objects up and down stairs becomes more difficult. Even though I’m in my 30’s, I notice I exert more energy to carry things up and down stairs compared to carrying things across the floor.
I hate to burst your bubble, but there will be a day when it’s harder for you to carry things up and down the stairs. It may be due to a back injury, arthritis, heart condition, etc., etc. You just never know!
So if you DON’T have a zero step entry, what can you do NOW to make sure you’re set for the future?
Start planning your zero step entry for your home!
It can be any entry you desire! The front door, the side door, the back door, the garage door, etc. You pick what works best for you and your house.
You can convert an existing window into a zero step entry door! If you’re creating a door out of a non-existing door, make sure to have the doorway width measure 36 inches for plenty of room to maneuver in and out of the house.
An issue that may come up is the fact that the main level of your house is not the same as the ground outside.
I have that EXACT same issue! So let’s dive into the problem solving process for my humble abode.
The problem for my house is the front and back entryway both have stairs to go inside. I would choose to make my back door zero entry because it’s closest to our driveway. There are several options I can think of off the top of my dome:
1) Install a ramp at the back door and create a minimum 6’x6’ landing for space to open the door and walk inside and outside. The ramp incline would need to gradually rise one foot per inch from the ground level to the height of the door threshold.
In my case, I would need 14 feet of ramp to accommodate the 14 inches from the ground to the top of my threshold. I would also make the ramp width at least 60 inches to allow plenty of room for a wheelchair user.
2) Install a rampscape at the back door. Rampscapes are ramps made by grading dirt to make that gradual incline to the door threshold. They look very pretty when landscaped with whatever materials you choose. I would lay a 6’x6’ concrete patio by the door, a 60 inch wide concrete sidewalk on the rampscape, and add lots of plants around it!
3) Install a vertical lift. A vertical lift is a platform that takes you from ground level and elevates you to the main threshold, like an outdoor elevator! I would still create a 6’x6’ landing to allow enough room to open and close the back door. This option would definitely require an overhead above the vertical lift to protect it from rain and snow.
All of the options above would cost thousands of dollars. The most inexpensive option would be installing a ramp. Personally, I would install an overhang or portico to cover the landing above the back doorway to avoid all forms of precipitation, especially after witnessing Missouri imitating Siberia this year!
Although I don’t have the funds at the moment, I can discuss this with my family, look for ways to fund a zero step entry, and ask for bids to help me select the best option and plan. Creating a zero step entry is a three year goal for me.
If you’re looking into building a new home, then you will spend the least amount of money to create a zero step entry!
Let’s say you wanted your zero step entry to be your garage door. Tell your builder! They can grade the site to ensure you drive into your garage and effortlessly step in and out of your home.
Sometimes, people are concerned that the only style of house they can build to include a zero step entry is a patio home.
If your builder is not willing to make at least one zero step entry and keep whatever style of house you choose, then they do not have the creativity or desire to move outside of their comfort zone.
You can build ANY style of house and have at least one zero step entry.
Whichever doorway you choose, remember: it’s best to have the doorway covered above and to make sure water will drain away from the door. Water is bad inside of the house.
Contact me to help you create a zero step entry! You better do it before you need it!
Do you have a zero step entry? Show us pics. If not, what are your plans? Share in the comments below!
Breaking a bone in your body is one of the worst experiences you can have in your lifetime. Trust me. I know this experience firsthand!
When I was eight-years-old, I climbed the wobbly, rickety chain link fence in the backyard at home and toppled over to fall to the ground breaking my left elbow. I remember passing out from the pain after seeing my mother’s scared facial expression.
At the hospital, I was given pain medication that completely knocked me out. The radiology tech had to keep prodding me to stay awake while taking x-rays of my arm. Eventually, I had surgery to realign my bones with two pins.
I remember the whole experience vividly! I was small and nimble enough to not need any home modifications. BUT I needed help with getting dressed, going to the bathroom, taking a shower, and brushing my hair. The pain from my arm would wake me up sometimes at night. I had to sleep lying on my back with my arm propped up on pillows.
I HATE sleeping on my back!
Luckily, I am right handed and had all the benefits of youth while waiting for my arm to heal! I was able to easily manipulate brushing my teeth, drawing, feeding, playing card games, and anything else you can think of with my right hand. Recovery took no time at all for me as a child. As soon as I was able to use my left arm, I quickly returned to dance lessons and playing piano.
I could never forget how my injury impacted my life in such a profound way. My mother was wary and extra protective while my arm healed. She made sure my sisters and cousins were careful when they played around me. Mom did not want me to be hurt again!
Looking back, I not only see the physical impacts a broken arm had on my life. I also see how I changed the way I took care of myself and how my family members and friends treated me.
As an eight-year-old, I was very independent in taking care of myself prior to the injury, especially as the oldest of four children. When I broke my arm, it felt like going in reverse needing even more help from my mother. She even tied my shoes again. I saw myself as an independent person changing into an interdependent person.
That’s hard even for an eight-year-old child.
I can’t tell you how happy and relieved I was to resume my independence again after my arm fully recovered. But not everyone can experience this type of relief.
As an adult, injuries like broken bones can be more damaging and long lasting than what children experience. This is where it gets deep, people!
Adults have decades of being independent in taking care of themselves and others. A broken bone drastically changes how they view themselves. Accepting help can sometimes be seen in the same vein as becoming older or aging.
Of course, as occupational therapists, it’s easy for us to reassure adults with injuries that they are not old people (there’s nothing wrong with that anyway!). We educate them on all of the ways they can still do what they need and want to do. However, we do need to remind ourselves that when people break a bone, they are grieving the loss (temporary or permanent) of their independence and the way they used to do daily activities. Even little eight-year-old me grieved over not being able to play tag and ride my bike for a couple of months.
Whoa. Grief? Yes. Here’s an example!
Dave broke his tibia stepping off a sidewalk into the street while heading to a coffee shop. He had surgery and needed to use a walker to help balance while hopping on one leg to get around. He quickly realized he needed a lot of help with getting in and out of his house, bed, shower, and going up and down the stairs. Dave was frustrated he could not move easily around his house anymore.
He thought, “Dang, I never thought I would need to do a pistola squat to get on and off the toilet! I don’t want my wife to help me with this every day!”
Dave even needed help picking up his dog’s bowls to put water and food in them! He felt like he had to rely on his wife to do everything. Dave started to feel depressed while his leg was healing because he wanted to do more by himself. Dave loved his wife, but he didn’t want to be soooo intimate with her while toileting and bathing.
He missed his ability to move around and take care of himself on his own time. Dave wondered if he will be able to continue living in his current house as it was. “What if I could never walk again? What will I do?”
In this situation, it’s easy to see why Dave would grieve the loss of his privacy, caring for himself, and moving around. He feels frustrated on how much effort he has to put in to simply move around the house. These emotions are very normal for any person. Have you every had this type of experience? Can you relate to Dave?
There are some things we cannot control whatsoever, like accidents. But we certainly can control our environment! Since we know breaking bones is such a challenging physical and emotional time, I am happy to say there are ways we can prevent lessen some of the pain and maintain our dignity by making changes in the home.
Yes, as a kid, I easily navigated my environment with a broken arm. However, poor adult Dave struggled to move around in and outside of his house with a broken leg. Let me tell you three things he could do to his house to make recovery better:
1) Create one entrance at home with ZERO steps. This will make it easier to use a walker to hop on one leg in and out of the house. Dave will be able to escape the home in case of emergency, see the doctor, go to outpatient therapy, spend time with friends at the ball game, etc. Dave can just enjoy not struggling to get in and out of his own house! He will not feel like a trapped prisoner!
2) Build a bathroom on the main floor of the house. Preferably this will be a full bathroom, but a half bathroom will certainly suffice! Put blocking in the walls in order to install grab bars later if needed. The blocking will allow you to install grab bars at any height! How neat! Grab bars could help Dave get on and off the toilet by himself, but there are a lot more options I can talk about with Dave and his wife.
3) Install a barrier free shower. Dave can easily use this shower with or without a broken leg! A barrier free shower lets you walk in and out without stepping over anything! This type of shower is perfect for all ages and abilities from wheelchair users to people who walk on two legs. Learn more by clicking here or here!
If you can relate to Dave, you may want to consider planning on making changes to your current home. Life is unpredictable, but if you do it before you need it then you are setting yourself up to maintain your independence and dignity in your own home. Please comment below if you or someone you know has had Dave’s experience of grieving the loss of taking care of yourself.
Last week we discussed three ways to pay for home projects that help us and our families live at home safely and independently. Apparently, that article left you hungry for more information! So this week, I wanted to follow up with EVEN MORE financial resources for your consideration!
Let's do a quick recap on the who, what, and why it's important to invest in home projects, such as home modification or remodeling. We all want to live in our homes as long as we possibly can. (I have never EVER met anyone who said they wanted to live in a nursing home!) Despite us wanting to live in our homes forever, over 90% of housing in the U.S. is NOT set up for us to safely age in in place! That means every person in the U.S. needs to start investing in home modifications that will allow us to remain independent caring for ourselves, OR we will ALL end up spending more money on things we hate, like medical bills and rehab.
So you may ask, "Maria, how can I afford to pay for home modifications?" Great question! Here are six solutions for you:
1) If you are a home owner, renter, or landlord with a low to moderate income, listen up! You can request home repairs or simple modifications through your area agency on aging, which is financed by the Housing and Urban Development HOME Program and Community Development Block Grants. In Kansas City, MO, you can click here to request help to fix repairs and install accessible features, like grab bars in the bathroom.
2) Don't worry Missouri farmers and ranchers! I'm thinking about you too! The United States Department of Agriculture and Rural Development offer loan programs for low to moderate income home owners and landlords to buy, build, rehab, or improve a house! It is worthwhile to consider these low interest loans for home improvements that allow you to age in place. Before your family talks you into moving to the city for retirement, look into this type of loan for home modifications to stay safe and independent on your land!
3) Go to your local bank or credit union and ask about the loans they provide that are insured by the Federal Housing Administration (FHA). Let's say you take out a loan that is FHA insured and something terrible happens where you are unable to repay the loan. Not to worry! FHA will reimburse your bank the amount of the loan balance. Since the bank is guaranteed a loan payoff, they are often willing to lower loan requirements for the income and credit score. These types of fixed or variable rate loans are great for low to moderate income homeowners and landlords to make homes accessible for people to live for a lifetime!
4) Do you care for children 18 years and younger with developmental disabilities? Do they feel heavier and heavier every time you pick them up to feed/dress/bathe/toilet them? It's time for some home modifications to protect your back and the health of your child! Check out the Missouri Medicaid waiver that pays for home environmental modifications to make it safer and easier for you to help your kiddo! This waiver is available to both homeowners or renters across the state!
5) If you have trouble getting in and out of your home, take a look at the Missouri Residential Dwelling Accessibility Tax Credit. This tax credit is for people with disabilities who have an income of $30,000 or less a year. You can be credited up to $2,500 for modifying your entryway (i.e. garage, front door, back door, side door) to make it easier to enter and exit your home. Personally, I love being reimbursed by the government for doing something good for my home and my physical health! No more worrying about accidental injuries when getting in and out of the house!
6) Veterans! You have sacrificed your time and lives for our country's independence! Now, it's time for you homeowners or renters to maintain your independence in the community! Go to this link to apply for housing grants to adapt your home! You deserve to live in a home that is set up for you to complete your daily activities. Also, click here to learn more about the Home Improvement and Structural Alterations Grant for veterans that focuses on home modifications specifically for bathrooms, entryways, and kitchens. In my humble opinion, those are the top three places in your home that you should address first!
The time for home modifications is now! I don't care how old you are! I'm looking at you all in your twenties, thirties, forties, fifties, or above! I don't care if you can still walk or drive at night! I don't even care if you think you can rely on your kids in your golden years! People of all ages need to make changes in the home now to live at home for a lifetime. All it takes is one project at a time, folks.
After you find out which financial resources above will work for you, call an occupational therapist, like me, to guide you in creating home modifications custom made for you. Occupational therapists understand that people have different wants and needs in their home. We love working with people to tailor their home environment just for them! In fact, check out the research showing that occupational therapists are the most effective at home modification recommendations!
Lastly, I know that you know people who could benefit from this information. Share this article with every veteran, grandparent, parent, farmer, neighbor you know! Click on the links above and learn more about these grants, waivers, and loans for Missouri residents! Consider this: if you clicked on one link a day, you would be finished in one week. Take notes on which financial resources will and won't work for you to stay organized. If anything, celebrate this Independence Day with looking at ways to pay for your independence in the future!
In college, I took a class called, "Biology of Aging" with great curiosity. The class revealed detailed facts on the decline of every body system throughout the aging process. The recently deceased Philip Roth gave a quote to adequately sum up my overall feelings of the course, "Old age isn't a battle; old age is a massacre." Although it gave me a somber perspective, the class allowed me to be more empathetic and understanding of an older adult's experience while working as an occupational therapist in skilled nursing facilities.
The aging process can be a barrier to a person's ability to be as independent as they used to be. Here are a few examples of barriers to every day living:
As we age, our sensations (i.e. eyesight, touch, smell, taste, hearing, balance) diminish making it more difficult to be aware of potential harm in our homes and community.
There is an increased risk of falling with potential to damage paper-thin skin or break bones plagued with osteoporosis.
The medications prescribed for heart problems, diabetes, sleep problems, or allergies can make older adults feel dizzy when standing up and moving around the home.
Seniors feel insecure about urinary incontinence while going out into the community with the fear of having an accident in public.