A new philosophy known as Universal Design aims to increase independence for everyone in the home, while keeping the home attractive. When efforts began to remove architectural obstacles, terms like barrier-free or handicapped-accessible design were widely used. These are terms that tend to stigmatize a building, implying it has been somehow compromised or institutionalized. Increasingly architects and product suppliers are developing alternatives that fit seamlessly into the overall design, with respect for aesthetics.

The late Ron Mace was an architect with a private practice and director of the Center for Universal Design at North Carolina State University. He had polio as a child. Mace saw that making the world accessible benefits everyone. He saw that the existing terms did not promote integration and in fact generated resentment.

Universal Design says, why not change our thinking and design for everyone all of the time? Let's not call it "design for people with disabilities." Let's call it "good design."

Most people eventually experience a disability of some sort, even if only for a matter of weeks using a wheelchair or crutches. A broken leg or temporary disease could mean being physically limited for months or years. An entrance without steps and an accessible bathroom are suddenly useful at such times. The demographics of the United States are shifting dramatically toward an older population. As you age, you will value features of Universal Design in a home. You might be able to stay in your home longer, despite an illness that might otherwise mean moving to a residential care setting.

More and more, people with disabilities are out in the world, making friends, raising families. These people will be buying homes and deserve a selection in the marketplace. It makes good business sense for builders to incorporate Universal Design principles.

Here I have a big down payment and a pre-approved mortgage, but because I use a wheelchair I have much, much less to choose from than anybody else. It is extremely frustrating, because the place where I will live is the key to the quality of life I want to make for myself. This severely restricted market for accessible homes is keeping me from my dreams, and I don't appreciate the idea that I should have to compromise. You'd think that they would want my money.

Money is a very real issue when you are faced with modifying your home. You might not be able to afford all of the work it would take to achieve full access. Tenenbaum notes that you often have to make tough choices:

I worked with a woman recently where we decided that her best solution was to build an additional room on the first floor, but [the design also] meant she wouldn't be able to go upstairs to yell at her kids about throwing their clothes on the floor. It's very hard, because we're being controlled by budget. Universal access is a goal, but we often have to compromise our goals because of other constraints.

With adaptable design, they don't have to put the grab bars in. You can just put them in where someone needs them. Or in the kitchen, the builder puts the base cabinet under the sink, but makes it removable. He just doesn't bolt it down. You take a couple of screws out and put it in storage.

Private homes and accessibility codes

Current building methods do not lend themselves to easy accessibility. For example, the typical style of home-building puts the main floor up at least several inches to prevent water from flowing in from the ground level, in theory at least. Homes are also raised to allow a "crawl space" for air to circulate under the home, again to remove moisture, or to make room for windows to allow light into a basement space.

When you consider accessibility codes in terms of how legislation would apply to private homes, the issue gets trickier. On one hand, some people hesitate to force accessibility on private homes:

People should be allowed to build the home they want. Maybe I, in my wheelchair, can't deal with a sunken living room, but that should not prevent someone from having one, if that is what they want. We have no business telling people how to build their homes.

This is coming from a wheelchair user who hates visiting people in homes that are uncomfortable or difficult for me. But I would never tell someone that they must build their house to suit me.

But why not require that all new private homes be required to meet minimum standards of accessibility, rather than just public or apartment buildings? We don't accept that someone can just decide, "Oh, I don't feel like having my new house meet all of those expensive fire-safety and structural integrity requirements." The public interest is said to be best served by ensuring a minimum standard of safety for both the first residents and any future residents. Is it unreasonable to expect this of basic accessibility?

When I visit a home where I need a lift up the steps or have to control my liquid intake for lack of a bathroom I can use, my hosts are very apologetic. Consistently, people wish that they could provide a setting that works for me. Some will go out of their way, as a dear cousin of mine recently did by building a portable ramp for the garage entry.

Visitability is always important. When I go to visit my great-aunt and uncle in Illinois they always put up a ramp at one door and hook up the hand-held shower.

You will decide how much you hope or expect others to accommodate you. Friends and relatives also struggle with money issues, and if they live in multi-story homes there will be only so much they can do. They will need your help to understand your needs. Perhaps you can even offer some guidance on specific measures they can take, do a little research into products, and share a creative process with them to optimize your access as much as possible.

Will it look like a hospital?

It is a fallacy that an accessible home must become unattractive to potential buyers. Remember, when you think in terms of Universal Design you are making your home safe, comfortable, and convenient for everyone. Because the design quality of products--from grab bars to kitchen and storage systems--has improved, your home can remain attractive and not look like a hospital. Building contractor Louis Tenenbaum puts it simply:

Beauty really is in the eye of the beholder. One person's institutional is another person's attractive. Personally, I think what's ugly is breaking a hip because the environment was unsafe.

Adapting what's there

The degree of adaptation you can make depends on:

• What you can afford
• What control you have over your home--owned or rented
• The existing design features of your home and/or property

I was fairly lucky that when I was disabled both my parents' houses needed only minor modifications to be made accessible ( bars, hand-held shower, wider bathroom door). Both houses were one story with no more than one step to get in.

Next, there are measures which don't cost much money. Wooden ramps can be built easily; portable, folding metal ramps are available at reasonable cost. Doorknobs can be converted with inexpensive lever handles, and door hinges can be changed to a hinge type that pivots the door aside so the door's thickness no longer blocks your way. Grippers, reachers, and various other tools help to extend your reach and use what strength you have. Remote control systems allow you to turn almost anything on or off in the home, as well as open doors or answer the telephone.

More expensive is the construction cost associated with major work such as widening doors, pouring a concrete ramp and grading the land outside, replacing a bathtub with a roll-in shower, or adding a new room to the house. You might also consider taking down a wall that is not load-bearing--perhaps between the dining room and den--to open up space for ease of movement. Depending on your income and where you live, tax credits might be available for some of these expenses. Some banks extend long-term loans with minimal down payments for disability-related construction.

Take care not to use up all your resources on one adaptation. If you use all your money to build an accessible addition, you won't have funds left for changes in other parts of the house. The result could be that you are isolated in your shiny new wing of the home, unable to freely interact with the rest of the household.