Open house

Linda Crabtree grips the handlebar of her scooter and leans forward, her dark eyes intense. “I met a lady the other day who had to move out of [one of those] beautiful retirement developments. She has a bad hip and needed a walker but couldn’t get the walker through the door and up the steps,” she says indignantly.

The situation is ludicrous, but it’s not a surprise to Crabtree, 64, of St. Catharines, Ont., who has been contending with access issues most of her life. She has Charcot-Marie-Tooth disease (CMT), an inherited progressive disease of the nervous system that causes muscles in her legs and arms to weaken and waste away. (“The disease affects you mostly from the elbows down and the knees down,” she says.) CMT steals her energy but hasn’t stopped her from pushing for changes to Ontario’s building code. Her goal is to make accessibility the norm in new houses – just as it is in the home she shares with husband, Ron Book, a bungalow she designed 17 years ago.

She knew little of universal design when she planned the house. The concept is based on making products or environments usable by everyone as much as possle without specialized design and usually at little or no extra cost. “As soon as people hear barrier free or universal design, they start thinking white tile, chrome – institutional. Everything’s going to echo and look horrible. Not so!” she says.

Crabtree’s vivid watercolours of autumn leaves line the walls in her living room. With a sweeping gesture, she demands, “Does this look like a room that a person with a disability designed because she’s disabled?” The modern white leather sofa and matching square ottoman turn out to be imperceptibly higher making it easier for her to transition from her wheelchair, but she’s right – the room is just what we all want, an attractive, comfortable refuge.

The home also has “visitability” – friends with disabilities can drop in because there are no steps to overcome and doors and hallways are wide enough for mobility devices. The roomy bathroom has two big doors, one from the master bedroom and one to the hall. “It’s a drive-through bathroom,” says Crabtree. But its accessibility makes this house an exception. “As a person who can no longer walk and climb stairs, I have only been able to visit one home in the last four or five years.”

Demand for accessible housing
According to a Statistics Canada survey in 2001, 12.4 per cent of our population (slightly more than 3.6 million Canadians) had at least one disability (80 per cent of those over 15 with disabilities had more than one). But among people 65 and older, the rate of disability rose to 40.5 per cent. This year, the leading edge of the baby boomers turns 60 and ominously, the Heart and Stroke Foundation’s 2006 Report Card on Health shows 45- to 59-year-old boomers are not as healthy as today’s 65- to 74-year-old seniors. There can be little doubt we are in for a surge of disability – and a new housing trend based on the accessibility needs of those boomers, a generation that has driven housing markets in Canada for more than a quarter of a century. But are we ready for it?

Edmonton-based architect Ron Wickman doesn’t think so. “We tend not to anticipate the future in the housing market,” he says. Builders generally react to buyers’ demands, and that demand isn’t there yet. And most of us are not like Linda Crabtree who confronted the limitations of her disease and successfully planned a home that would accommodate her and her husband for as long as possible.

“It’s a denial thing,” Wickman says. “You don’t want to admit that maybe one day you might not be able to negotiate the stairs and you may be in a wheelchair.”

His lifelong interest in accessible design began with his father. Percy Wickman became a paraplegic during his son’s infancy. As a popular city politician, he had an enormous influence on making Edmonton more accessible for people with disabilities. But his son recalls the many times his father arrived at a supposedly easy-to-enter venue only to be confronted with steps. “You’re constantly reminded that you’re in a wheelchair,” he says.

That personal connection with someone who has a disability makes a big difference in understanding what creates a barrier and how it can be overcome. He worries some architects treat accessibility as merely a technical issue, adapting existing plans rather than designing with insight into a disabled person’s reality. “They simply go into the building code book and make sure they are meeting the code,” he says. He’s campaigning to have architectural students learn to include accessibility at the start of the design process and to make it an invisible part of the design.

Simple designs save money later
Wickman won a Canada Mortgage and Housing Corporation (CMHC) FlexHousing award in 1995 for adaptable and accessible housing design, yet he still has trouble convincing clients to build their homes so they are easily adaptable if one of them becomes disabled. Three key components are on-grade zero-step access; the means to move around and to another floor; and a wheelchair-friendly bathroom. That kind of forward thinking turns out to be good financial planning, too.

“It really makes sense to design your house so that it’s more adaptable,” he says. “If you install three-foot-wide doorways in your home right from the beginning, it will cost maybe five or 10 dollars more per door. If you have to make doors in your existing house wider, it’s anywhere from $800 to $1,200 a door.” Often, he suggests building an elevator shaft by stacking closets one above the other, providing an unobtrusive option to a lift mounted in a staircase. Until needed, the space is simply storage.

Despite his efforts, renovations still make up the bulk of his residential design work, and he admits the cost is substantial in comparison.

Victor Helfand, president of Barrier Free Architecturals Inc., in Toronto, a company that specializes in adapting homes and commercial spaces to the needs of elderly and/or people with disabilities, agrees the incremental cost of building an accessible home is not that large, but he finds many builders resistant. “There are a few coming on side,” he concedes.

Helfand is also a member of a Canadian Standards Association (CSA) committee that sets accessibility standards for older people and people with disabilities. He’s noticed an increasing number of phone calls and inquiries through his company’s website (www.barrierfree.org) from 50-plus people who are renovating homes. They want to know how to prepare their houses or condos so they can comfortably stay if they or their spouse were to become disabled. “I always tell them to wrap their bathroom in plywood and try and widen doors and hallways, if possible,” he says. (The plywood provides support for grab bars and shower seating.) “The biggest areas of concern are getting into the home, getting through it and bathing.”

When someone needs to alter a home to stay there safely, Helfand suggests asking for an assessment by an occupational therapist from the local health authority, who can recommend appropriate changes such as the height of grab bars or products to suit their specific needs. Safety and independence are the greatest worry.

Roll-in showers that replace bathtubs are his company’s biggest sellers, says Helfand. Slip-resistant flooring, grab bars and handsome bathtubs with a ledge for seating can also make conditions safer for caregivers, he points out.

Picking up a kitchen faucet, he demonstrates how easy it is for someone with arthritic shoulders or hands to operate with its single lever fully as long as the faucet. Then, he snaps some grey plastic grids together and shows how they can be combined to create a slight ramp that may allow someone to roll a wheelchair over a threshold.

He predicts that as the population ages, there will be more demand for such innovations with more use of technologies such as voice activation. He’s already seen a wheelchair that can go in all directions and one that could climb stairs. In addition to kitchen cupboards that move up and down, he says there are European toilets that can be raised and lowered to suit each person, disabled or not.

There’s no doubt these specialized products cost more, but Helfand says, “Amortized over five or 10 years, how much more expensive is it?” And they may enable someone to stay in their home longer. In fact, he says, “I know of instances where there are seniors living in condominiums or apartments with round-the-clock care. They hire a caregiver, the cost of which may be as much as being in a nursing home, but they are in their own place.

“People want to avoid nursing homes,” Helfand asserts. “Our generation will be one of the richest ever and will spend money for the upgrades, unlike our parents who went through the Depression.”

Financial assistance
Low-income homeowners and renters who are seniors or have disabilities may qualify for financial assistance through CMHC programs. Intended to help older people stay in their homes as long as possible, Home Adaptations for Seniors Independence (HASI) can provide a forgivable loan of up to $3,500 to help pay for such things as handrails, lever-style door handles, bathtubs and showers with grab bars. Renovations to housing intended for low-income people with disabilities (including rental properties) may be supported by a Residential Rehabilitation Assistance Program (RRAP) for Persons with Disabilities. The limit of the forgivable loan depends on factors such as the dwelling’s value and how far north in Canada it’s located.

Linda Crabtree manoeuvres her scooter next to her computer desk, stands up and pushes a lever, raising the computer, keyboard and lamp to a comfortable level. The moving shelf is the invention of the Ontario March of Dimes (South Region) DesignAbility team, and it allows her to relieve neuropathic pain caused by so much enforced sitting. The team also created a simple device to hold her bed sheets slightly off her body since hypersensitive nerves in her skin make even the pressure of silk sheets painful and sleep-destroying.

Words are Crabtree’s tools for change. A former journalist-editor at the St. Catharines Standard, she still contributes “Access Niagara,” a column on disability and accessibility issues. Working with Eileen Zarafonitis, every two years she publishes a free 40-page accessibility guide to Niagara hotels, restaurants and attractions the two women have inspected. An even more detailed version can be found at www.accessibleniagara.com. “It’s great for people who are disabled because they know where to go in Niagara when they come here,” she says. She also serves on advisory committees on accessibility in St. Catharines and the Region of Niagara.

Local and provincial officials who can initiate changes to improve accessibility will be hearing from this determined advocate for universal design and visitability. “We need our building code standards to be made better,” she says firmly. If the government would do that, “Right away builders and developers would have to comply. We’d have our 32-inch doors and zero-step entrance and the things you need for visitability. Aging in place is the way to go, and the government should be pushing for it. We want people to stay where they are, and the only way to do that is to have the homes accommodate them as they age.”

Linda Crabtree and Ron Book’s home uses principles of universal design. It’s comfortable and attractive. Some of its features include:
• Wide doors (preferably 36 inches); wide halls
• Flat entrance at doors, including access from the garage
• Electrical outlets higher on walls, light switches lower
• Pocket doors
• Drawers rather than cupboards with doors
• Lever handles instead of doorknobs
• Lever controls on sinks, shower
• D-shaped handles for drawers
• Shower seat with DesignAbility-designed device for sliding from scooter to seat
• Handheld shower
• Adequate turning space in bathroom (minimum five feet)
• Skylights for natural light
• Accessible backyard with raised garden beds
• Industrial carpeting compatible with mobility device
• Kitchen “slide factor” – an unobstructed surface allowing her to slide food from refrigerator to sink, and then slide to stove
• Stove controls on side of stovetop; pull-down door on wall oven
• Seamless kitchen flooring

CONNECT
Accessibility and visitability resources:
www.lindacrabtree.com; www.concretechange.org; www.accessibleniagara.com
Ron Wickman, Architect:
[email protected]; 780-430-9935
Barrier Free Architecturals Inc.:
www.barrierfree.org; 416-783-5331; 1-877-717-7027
Home Adaptations for Seniors’ Independence (HASI);
Residential Rehabilitation Assistance Program for Persons with Disabilities (RRAP-D):
Contact CMHC at www.cmhc.ca; 1-800-668-2642 or your local CMHC office.