Going home after a spinal cord injury (SCI) requires careful assessment of the home environment to ensure it is safe and easy to get around. Doorways may need to be widened, ramps built, and accessible appliances installed.
A home assessment from an occupational therapist should be completed before discharge, but there are some things that can be taken care of in advance that will contribute to spinal cord injury rehabilitation and safety at home.
Wheelchair Mobility and Safety
Furniture should be moved so that anywhere the wheelchair will need to be turned around has a 5 foot by 5 foot radius of open space. A power chair will need more room, about 6 feet by 6 feet. Couches and tables need to be rearranged or moved so the entire home has easy access and exit in case of an emergency.
Doorways will need to be 32″ to 36″ wide, depending on if a turn is required after passing through the doorway. Power doors can be installed, especially if there is a ramp on one side of the door which would make managing opening the door and safely maneuvering through, difficult.
Since wheelchairs have metal parts, care should be taken that they will not be parked too close to fireplaces or heating vents that could conduct heat and cause tissue damage since after spinal cord trauma, the injury victim may not realize they are being burned.
The Bathroom
An accessible bathroom is very important. Special sinks that enable a wheelchair to be pulled up to and under can be installed. There needs to be adequate room around the toilet, with grab bars, to enable transfer. A special lift may be needed for the shower or tub. Other options include a roll-in shower for use with a shower chair. Since bathing will take longer, adequate heating is also needed.
Floors
Wheelchairs move more easily on hard floors or low pile carpeting. Shag carpeting should be removed and replaced. Throw rugs and mats are difficult to maneuver over in a wheel chair. If there is a threshold at a doorway, it should be one inch or lower so the wheelchair can easily pass over.
General Safety
Have a conversation with the local fire and police departments and let them know there is a mobility impaired individual who will need additional assistance in case there is an emergency. Stickers or signs can also be placed at entryways so emergency personnel are aware.
Fire and carbon monoxide detectors should be installed throughout the house. Also place signs if oxygen is in use in the home, since this adds to the fire hazard.
If life-support, such as a ventilator is in use, back-up power will need to be installed.
Advocacy
Dr. Greg Vigna is both a rehabilitation physician and an attorney. He knows what is needed in the home for adequate spinal cord injury care, and will advocate for your life-long needs.
