Life on Wheels (91 page)

Outdoor lighting is important so that you can see the path and avoid any surprise obstructions. Motion detectors can turn a light on when it picks up the arrival of your vehicle or your approach from the sidewalk. Motion detectors then can turn the light off after a set period of time, which presumably leaves you enough time to get inside the house. Timers can be installed and programmed to turn the exterior lights on at a given time each day.

It is critical that you have enough electrical power. If you are charging a power wheelchair, have a bed with motorized adjustments, use a ventilator or oxygen, have a remotecontrol system for lights and so on, these will place considerable demands on your power supply. The last thing you want to risk is overloading a circuit and shutting off a ventilator. Using plug taps, power strips, and extension cords so that you can plug more items into existing outlets than would otherwise be possible can quickly overload a circuit and present a real fire hazard. The issue is whether you have enough “amperage” in a given circuit for the amount of power you ask of it.

It might be necessary to add more power to your home or reroute existing power to where it is needed. Some outlets—such as in the basement or garage—might be underused and more valuable when routed to the bedroom, for instance. Running new wires through walls—if necessary—can be very costly and disruptive but is the first choice for aesthetics. An easier and less expensive approach is to use cable raceways that are surface mounted. They can be placed unobtrusively or covered by moldings.

In the bathroom, incorporate ground-fault circuit interrupters into outlets in the wall. These are widely available and found at any hardware store. An interrupter is not a major piece of equipment but will shut off power at the plug rather than at the main circuit if water gets in.

If you need it and can afford it, a battery backup system can be installed that will provide you with a number of hours of emergency power if the system goes out. A generator that runs on a small gasoline engine is another backup option. Call your local authority—city, township, and so on—and let the authority know if someone in your home is at risk if power is lost. In the event of a blackout, the local emergency plan should put a priority on protecting people whose lives might be threatened without electricity, though don’t be surprised if the plan has not yet addressed disability emergency preparation. You might find yourself a local advocate on this issue.

Some local utility companies offer special rates for people with disabilities or have programs that allow you to spread out payments during winter months when the bill might be substantially higher. You should also ask if the companies have a registry or special number to call in the case of an emergency, in the event you need a high priority for having your power restored.

After you’ve checked that you have enough power and can protect yourself in the event of outages, you’ll also want to look at other matters of safety and convenience.

Power receptacles low on the wall are often obscured behind furniture and can be difficult to reach. You can effectively raise power outlets with a power strip—several receptacles on a strip at the end of a two-foot cord. It gives you flexibility for where to position the power and often includes electrical protection from power spikes, which can injure sensitive electronic equipment, and usually includes a master switch that allows you to turn off several items with one push of a button.

Temperature control is very important for people with certain disabilities. With multiple sclerosis, excessive heat can encourage exacerbations. People with arthritis are sensitive to temperature variations, as are older persons, who generally need more heat. Some people with spinal cord injuries are unable to sweat, so they need to keep cool. People on fixed incomes have difficulty spending more money on heating, ventilation, and air conditioning, so they are faced with the tug between saving money and ensuring their safety. Some people address the need for more heat with space heaters, which are often inefficient, are expensive to run, and can be more likely to cause a home fire.

The placement of thermostats is important. Put the thermostat within reach for everyone and make sure it is not in direct sunlight. Zoned heating and air conditioning can be a valued feature. You might want to set a cooler temperature for a bedroom where a temperature-sensitive person sleeps or spends more time during the day. Some thermostat designs are more difficult to use; avoid designs that require pinch and hand strength or on which the numbers are too small to be easily seen. Programmable thermostats allow you to set temperature changes for different times of the day.

Think through emergency procedures for utilities and make sure that shutoff valves are accessible to every family member. For example, you can install a gas shutoff valve that can be turned easily by a long lever-type of handle, without great strength or tools. Also ensure that the path to shutoff valves remains accessible.

Before spending money on expensive heating and cooling equipment, take measures to control air movement and sunlight with passive energy methods:

Be sure windows and doors are well insulated.

Weather-strip around door and window frames.

Make sure that doors to the outside have a good seal at the threshold.

Spray an insulating foam into walls.

Manage the sunlight: when you need heat, open shades and let the sun shine in; close shades when you’re warm enough.

Awnings or eaves of the correct depth will block the sun in summer and let it in during winter.

Fireplaces can remove heat. The heat of the fire travels up the chimney flue and creates a vacuum effect that actually draws warm air out of the house and out the top. Be sure not to leave the flue vent open when you need to keep heat in the house.

The ability to communicate over distances is key for people with limited mobility. The phone can be the link to your social world, maintaining relationships through calls with friends and family. It can allow you to conduct business from home or function as an advocate—for yourself or others. A phone line for an Internet connection can be a link to a wider community, as in the case of this man with Friedrich’s ataxia:

Telephone jacks are best placed near electrical outlets, since computers, fax, and answering machines also need power. General advice is to have at least one phone jack in each room where you are likely to spend more than a few minutes at a time.

A telephone line is also a lifeline. A speaker phone with a speed-dial button might only require pressing one or two buttons, without having to pick up the handset, to make an emergency call. There are services that allow you to carry an alarm button that will make an automatic phone call to a healthcare facility or security agency. Some medical equipment can have similar features, in which a phone call is made if the machine experiences a shutdown that could be life threatening. Dedicated phone lines might be needed in these cases.

Many telephone companies have disability programs to provide special equipment. For example, AT&T gives people speakerphone headsets, or telephones are available with large, lighted buttons that are easy to press. They are free of charge once you and your physician fill out the application.

People with little arm movement can freely access the telephone via puff-and-sip control systems that allow them to choose from a preprogrammed list of numbers or dial a new one. Hands-free telephone access is possible.