Making the Right Accessibility Plan:

Our family business began after (as a family of many physical and occupational therapists) we saw our patient’s frustration after handymen and contractors provided home modifications, without having any idea of the unique needs and future needs for individuals.  We wanted to offer something different than the ugly medical looking options, and sometimes unnecessarily complicated and expensive options that other providers offered.   So, what is the best approach to planning effective, safe, and aesthetic home accessibility solutions?

A product versus individual focused approach

Over the past decade there has been a remarkable increase in accessibility products, which is not surprising with our aging population.  This trend is expected to continue.  There is a tendency for individuals to associate solutions with products, as they are marketed to address their mobility and self-care challenges.  An example of this would be the walk-in-tub commercials that we are often inundated with, and which advertise this product that lowers the threshold you have to manage to step in and out of the tub, and provides a relaxing whirlpool massage.  The traditional walk-in-tub however, can be quite expensive, more difficult to manage than other options, and can pose problems with temperature regulation as the individual sits wet and naked while the water drains.  This is not to say that the walk in tub can’t be a good option, however it is important that the end user not view that product as the only, or always best solution.  To find the best solutions we should look at the individual person’s abilities, and limitations, and use an analysis of this to find the best solutions for their independence.  As Occupational and Physical therapists, we specialize in working on safety and independence in function, and we work with individuals to maximize function and safety.  These are the foundations that are essential for finding good sound accessibility solutions, and I encourage you to discuss some of these solutions, and feel free to point them to to learn about some of the accessibility solutions that are available.

ADA vs Individualized design

The ADA commercial code, provides building standards for public buildings.  If we are applying ADA codes to our home project, rather than individualized design that meets the needs of the wheelchair user, caregiver, and/or person with limited mobility, then we may be providing an environment that limits the resources, safety and independence of those individuals.  We should be tailoring designs to individuals in the home, that meet their unique dimensions and needs.  What may be appropriate for someone who is 4’5” versus 6’5” will be very different.  Also, what may be appropriate for one person with paraplegia versus another individual may be very different as well depending on their level of function, health, and abilities.  Attention to detail is critical with accessibility work as it can make the difference between independence and dependence.

Accessible modifications CAN look good and improve resale

There are a lot of medical looking safety adaptations, and those sometimes are less expensive, though not always.  Accessible home modifications can look good and be an enhancement to the home.  Many individuals worry also about resale value when doing accessible remodeling.  With an aging population, and growing demographic of individuals with mobility impairments, creating accessible home modifications makes your home more marketable, and more importantly makes your home more beautiful and enjoyable to live in.


If you are looking for accessibility solutions, consider how you move, and manage things currently, and how they may change as you age.  Think about your caregiver, or the loved one you care for, and what their needs will be.  Consider the advice of physical and occupational therapists who work every day with addressing function and mobility to help their patients to become more independent.  And consider the aesthetic options, which can be easier to achieve when you look at a “function first” approach rather than a product based method.

This article was written by Rob Horkheimer, MPT, CEAC, CAPS, ECHM, CLIPP – Owner of BILD

BILD is a Milwaukee based home modification company that provides small to large accessible home modifications, remodeling, lifts, and equipment in Wisconsin and Illinois.  We combine the expertise of interior design, background of physical therapy, and provide education nationally on Accessible Home Modifications to other professionals.

Our website is a great resource for accessibility solutions –